Gum Flap Surgery: Treatment Steps, Aftercare & Risks

What Is Gum Flap Surgery?

Periodontitis (periodontal disease) is the advanced form of gum disease caused by the long-term buildup of plaque and tartar below the gums. The disease permanently destroys your gums, ligaments, and surrounding bone tissue. If periodontitis is left untreated, tooth loss can occur.

If your dentist or periodontist catches periodontitis early, they can control the disease with non-surgical treatments. This includes scaling and root planing (deep cleaning), which is a non-invasive procedure that removes tartar below your gum line.

In addition to root planing treatment, gum flap surgery may also be necessary, depending on the severity of gum disease.

Gum flap surgery, also called periodontal flap surgery, is a popular procedure that treats and repairs periodontal pockets. Periodontal pockets are deep spaces below your gum line that form when gum tissue detaches from your teeth. These pockets cannot be cleaned at home with a normal toothbrush, which creates a perfect environment for harmful bacteria to grow quickly.

Treatment Options: Gum Flap Surgery Steps

Periodontal disease commonly forms if bacteria and tartar collect below your gum line. To counteract the damaging effects of PD, periodontists typically perform scaling and root planing first.

If root planing is not completely effective, your dentist may recommend a gum flap to control the disease. Gum flap surgery is not a cure for severe gum disease. However, it does help reduce the harmful effects of periodontitis by improving your oral health.

Gum flap surgery is typically separated into four steps:

Step 1: Local Anesthesia Administration

A local anesthetic is typically administered before gum flap surgery. The drug is injected into your mouth, numbs the treated area, and causes a loss of nociception (pain receptor).

You remain awake during the entire procedure, but will not feel anything. Local anesthesia also eliminates pain for up to four hours post-op. Depending on needs, anti-anxiety medications or sedatives may also be used.

Step 2: Gum Tissue Incision

After the local anesthetic is in full effect, your periodontist will make a small incision into your gums. This separates your gum tissue from your teeth.

Then, they will gently fold back the gum tissue, which allows for easy access to the tooth roots, ligaments, and surrounding bone tissue.

Step 3: Gum Tissue Removal

After the periodontist accesses the roots, ligaments, and bone tissue, they will carefully remove the inflamed gum tissue. Then, they will clean the roots and remove any remaining debris.

If there is significant bone loss, your periodontist may recommend bone grafts to regenerate new, healthy bone tissue.

Step 4: Stitches

After the periodontist removes the infected gum tissue and cleans your tooth roots, they will close the incision with stitches. They may also recommend follow-up appointments to ensure your mouth is healing properly.

Aftercare Tips for Periodontal Surgery

After the procedure is complete, you may be prescribed mild pain medications and antibiotics to help reduce any discomfort. Gum flap surgery is relatively quick and you should only experience minor discomfort for a few days post-op.

Gum surgery aftercare tips include:

  • Refrain from brushing or flossing the surgical site until it heals
  • After the surgery, a periodontal dressing is placed on the surgical site to protect the healing tissues from heavy forces, such as chewing or brushing. You can gently remove the plaque from the healing tooth or teeth with a toothbrush.
  • Practice good oral hygiene by continuing to brush your untreated teeth as normal
  • Rinse your mouth with warm salt water a few times each day
  • Use ice packs to reduce swelling and inflammation
  • Take over-the-counter pain relievers, such as ibuprofen
  • Rinse your mouth with an antimicrobial mouthwash that contains chlorhexidine to kill bacteria and encourage healing
  • Normally, your periodontist schedules a follow-up appointment about a week after the procedure to ensure everything is healing properly
  • Swelling and minor bleeding are normal. However, if the swelling lasts longer than a few days, you can use an ice pack to control the pain

Possible Complications of Flap Surgery

If you experience bleeding for more than two days, you can develop an infection. Call your periodontist right away if this occurs.

Other possible complications of gum flap surgery include:

receding gums

Gum Recession

Gum recession is when your gums begin to pull away from your teeth. As a result, the roots of your teeth become exposed, which typically causes sensitivity to hot and cold substances.

Root surfaces do not have hard enamel covering them like the crowns of teeth do, which makes them more prone to sensitivity and decay. Receding gums also make your teeth appear longer than they are.

root decay

Root Decay

If you have gum recession, you also have a higher risk of developing root decay. When your gums recede far enough, the root surfaces of your teeth become visible. This allows bacteria to spread below the gum line, which ultimately leads to decay and possible bone loss.


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Resources

Hollins, Carole. Basic Guide to Dental Procedures. John Wiley & Sons, Inc., 2015.

“Periodontitis.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Mar. 2018, www.mayoclinic.org/diseases-conditions/periodontitis/symptoms-causes/syc-20354473.

Perry, Dorothy A., et al. Periodontology for the Dental Hygienist - E-Book. Saunders, 2015.

Stefanac, Stephen J., and Samuel P. Nesbit. Diagnosis and Treatment Planning in Dentistry - E-Book. Mosby, 2015.

Updated on: July 15, 2020
Author
Alyssa Hill
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Medically Reviewed: December 11, 2020
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Lara Coseo
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