When non-surgical methods are not enough to address the effects of gum disease, gum flap surgery can restore the health of your smile. When left untreated, periodontal disease can cause extensive damage to the supporting structures of your teeth and eventually lead to tooth loss. dentists can perform a flap procedure to stop the progression of gum disease. It involves incising the gums and temporarily pulling the tissue away from the teeth to treat the roots and jawbone directly. dental practice provides multiple forms of anesthesia and sedation to ensure your comfort during the procedure.
What is Periodontal Flap Surgery?
When advanced gum disease (periodontitis) develops, your teeth are in danger: At this stage, the ligaments and bone tissue that surround them are being destroyed, and you could even begin losing teeth! If the disease can’t be controlled by non-surgical treatments like cleaning and scaling, then periodontal flap surgery may be your best treatment option.
Flap surgery is today’s leading method for treating and repairing periodontal pockets. What are these “pockets?” They are areas below the gum line where gum tissue has detached from the teeth, resulting in an uncleansable space where harmful bacteria can proliferate. These bacteria cause inflammation of the tissues, resulting in sensitivity, bleeding, and pain. Left untreated, they can cause a host of problems including gum disease, loss of the tooth-supporting bone structure, and possibly even systemic (whole-body) problems.
When periodontal pockets develop, the first step in treating them is usually via cleaning and scaling (also referred to as root debridement) with a manual or ultrasonic instrument. If this isn’t effective, then periodontal surgery is considered. Flap surgery isn’t a cure for periodontal disease — but it helps create an environment that makes it easier to maintain your periodontal health. And even if you’re prone to gum disease, proper professional treatment and regular care at home can help keep your teeth healthy for as long as possible.
Candidates for Flap Surgery
A flap procedure is typically recommended for patients with moderate to severe gum disease, or periodontitis, that has not responded to non-surgical treatments such as scaling and root planing. Patients with advanced periodontitis can benefit from gum flap surgery. Symptoms include:
- Inflammation and bleeding of the gums
- Tooth sensitivity
- Tooth mobility
- Severe gum recession
- Tooth loss
- Persistent halitosis
During a consultation with dentist, he will check for signs of periodontal disease and measure the pockets around the teeth. If you have mild to moderate periodontal disease, nonsurgical treatments may suffice. However, cases of advanced gum disease will likely require surgery.
This treatment can remove built-up plaque and tartar around the roots and restore the health of gum tissue. In some cases, an additional procedure can be performed at the same time to repair bone tissue affected by gum disease. Your dentist can determine if gum flap surgery is right for you by examining your oral and overall health during an initial consultation.
The Goals of Flap Surgery
One major objective of flap surgery is to eliminate or reduce the pocket itself. To access it, a flap-like incision is made in the gum tissue. This allows diseased tissue to be removed from inside the pocket, and provides access to the teeth’s root surfaces for a thorough cleaning, which helps to eliminate harmful plaque and calculus (tartar). Afterward, the “flap” is closed, sealing the area. This begins the healing process, which takes place rapidly.
Another goal is the regeneration of periodontal ligament and bone tissue which may have been lost to the disease. A variety of techniques may be used to accomplish this, including high-tech methods of bone grafting and chemicals referred to as growth factors. These approaches help restore the gums to their normal form and function, and promote the healthy and secure anchoring of teeth.
Prior to Procedure
- Tell your dentist of any recent changes to your health, medications, allergies, or supplements.
- Take your prescription medications, unless your dentist says otherwise.
- Talk to your dentist or pharmacist if you are taking more than 1 drug. Some drugs can be dangerous when mixed. This includes over-the-counter medications and herb or dietary supplements.
- You may be asked to take an antibiotic before surgery.
- Arrange for a ride if you are having sedation.
Sometimes, sedative medications are used to make you more relaxed during surgery. If you are undergoing conscious sedation, you will be asked to not eat for at least 6 hours before surgery. Otherwise, you can follow a normal diet.
The Flap Surgery Procedure
Flap surgery is typically done under local anesthesia, sometimes accompanied by oral anti-anxiety medications; alternatively, it may be performed under intravenous conscious sedation. After anesthesia has taken effect, a small incision is made to separate the gums from the teeth. The outer gum tissue is gently folded back to give access to the roots and the supporting ligament and bone tissue.
Next, the inflamed gum tissue can be removed, and the tooth roots can be cleaned; if needed, the area may also be treated with antibiotics or other medications. Bone defects can be repaired with grafting material, and proper regeneration of the periodontal ligament can be encouraged by physical (barrier membranes) and chemical (growth factors) methods. Finally, the incision is closed and the procedure is completed. The time it takes to complete the procedure depends on the extend of the damage and how many gum areas are affected. Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Performed by an experienced hand, state-of-the-art flap surgery has an excellent track record and offers well-established benefits. It’s often the treatment of choice for relieving periodontal disease and helping to maintain your oral health — and preserve your teeth.
Combining Treatment with a Bone Graft
If periodontitis has caused bone recession, doctor can perform a bone grafting procedure as part of your treatment.
If significant bone loss has occurred, a bone graft procedure may be performed at the same time. Finally, the gum tissue is repositioned and the incision is closed with sutures. In many cases, periodontal dressing, or an intraoral bandage, is placed to protect the area during the first few days of recovery.
What To Expect After Surgery
Typically it takes only a few days to recover from a flap procedure. Be sure to follow the home care instructions that your dentist or oral surgeon gives you. If you have questions about your instructions, call the dentist or surgeon. The following are general suggestions to help speed recovery:
- Take painkillers as prescribed.
- After 24 hours, you can rinse your mouth gently with warm salt water several times a day to reduce swelling and relieve pain.
- Change gauze pads before they become soaked with blood.
- Relax after surgery. Strenuous physical activity may increase bleeding.
- Eat soft foods such as gelatin, pudding, or light soup. Gradually add solid foods to your diet as the area heals.
- Do not lie flat. This may prolong bleeding. Prop up your head with pillows.
- Continue to carefully brush your teeth and tongue.
- Apply an ice or cold pack to the outside of your mouth to help relieve pain and swelling.
- Do not use sucking motions, such as when using a straw to drink.
- Do not smoke.
A few days after the procedure, your dentist will remove the stitches.
A flap procedure can save teeth affected by gum disease. Once you heal from a gum flap surgery, your gums should be pink and healthy again and you can prevent the recurrence of gum disease by brushing at least twice and flossing at least once per day. Your dentist can monitor the health of your gums at your six-month cleaning and examination. dentist can also provide you with instructions on the most effective methods for protecting your periodontal health at home.
The roots of your teeth may become more sensitive.The contour or shape of your gums may change.
Gum surgery can introduce harmful bacteria into the bloodstream. Gum tissue is also at risk of infection. You may need to take antibiotics before and after surgery if you have a condition that puts you at high risk for a severe infection or if infections are particularly dangerous for you. You may need to take antibiotics if you:
- Have certain heart problems that make it dangerous for you to get a heart infection called endocarditis.
- Have an impaired immune system.
- Had recent major surgeries or have man-made body parts, such as an artificial hip or heart valve.
Call Your Dentist
It is important for you to monitor your recovery. Alert your dentist to any problems right away. If any of the following occur, call your dentist:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excess bleeding, or any unusual discharge
- Pain and swelling that is not controlled with medication or home care
- Dressing or stitches have come loose or are uncomfortable
- Loose tissue
- Continued swelling after 48 hours
- New or unexpected symptoms
If you think you have an emergency, call for emergency medical services right away.