What Is It?
Gingival flap surgery is a procedure in which the gums are separated from the teeth and folded back temporarily to allow a dentist to reach the root of the tooth and the bone.
What It's Used For
Gingival flap surgery is used to treat gum disease (periodontitis). It may be recommended for people with moderate or advanced periodontitis, especially if the initial, non-surgical treatment (scaling and root planing) has not eliminated the gum infection. It may also be done in conjunction with another procedure known as osseous (bone) surgery.
Your periodontist or your dental hygienist will first remove all plaque and tartar (calculus) from around your teeth and make sure that your oral hygiene is good. Before flap surgery, your periodontist will determine whether your general health or your current medications allow for a surgical procedure to be carried out.
How It's Done
After numbing the area with a local anesthetic, the periodontist will use a scalpel to separate the gums from the teeth and then lift or fold them back in the form of a flap. This gives the periodontist direct access to the roots and bone supporting the teeth. Inflamed tissue is removed from between the teeth and from any holes (defects) in the bone. The periodontist will then do a procedure called scaling and root planing to clean plaque and tartar. If you have bone defects, your periodontist may eliminate them with a procedure called osseous recontouring, which smoothes the edges of the bone using files or rotating burs.
After these procedures are completed, the gums will be placed back against the teeth and anchored in place using stitches. Some periodontists use stitches that dissolve on their own, while others use stitches that have to be removed a week to 10 days after the surgery. Your periodontist may also cover the surgical site with an intraoral bandage known as a periodontal pack or dressing.
You will have mild to moderate discomfort after the procedure, but the periodontist can prescribe pain medication to control it. Many people are comfortable with just an over-the-counter pain reliever.
It is very important for you to keep your mouth as clean as possible while the surgical site is healing. This means you should brush and floss the rest of your mouth normally. If the surgical site is not covered by a periodontal pack, you can use a toothbrush to gently remove plaque from the teeth. Antimicrobial mouth rinses containing chlorhexidine are commonly prescribed following periodontal surgery. Although these rinses do not remove plaque from the teeth, they kill bacteria and help your mouth to heal.
You may have some swelling, and this can be minimized by applying an ice pack to the outside of your face in the treated area. In some situations, antibiotics may be prescribed to prevent an infection, and these should be taken as instructed. Your periodontist will want to reexamine the area in 7 to 10 days.
After the surgery, you may have some bleeding and swelling. There is a risk that you could develop an infection.
Your gums in the area that was treated are more likely to recede over time. The teeth that were treated may become more sensitive to hot and cold. The teeth also are more likely to develop cavities in the roots.
When To Call A Professional
It is normal to feel some discomfort or pain and experience some minor bleeding during the first 48 hours after the procedure. These symptoms usually subside after a couple of days. Call your periodontist if bleeding continues or if the symptoms deteriorate after the first three days. This can be caused by an infection that has to be taken care of promptly.
American Academy of Periodontology (AAP)
737 North Michigan Ave.
Chicago, IL 60611
©2002-2005 Aetna, Inc. All rights reserved.
Reviewed by the faculty of Columbia University College of Dental Medicine