Periodontal Surgery—Open Flap
(Pocket Depth Reduction)
by Deanna M. Neff, MPH
Periodontal disease refers to bacterial plaque and infections around the gum and tooth root. It can happen around one or several teeth. In its more advanced stages, surgery may be needed to fix damaged gums.
During flap surgery, the periodontist makes a small incision in the gum, pulls back the gum flap, cleans out the infected, plaque-filled pocket, and stitches the gums back in place.
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Reasons for Procedure
This surgery is needed when:
This surgery slows the progression of periodontal disease by reducing deep pockets and bacterial growth. Periodontal disease can cause other health problems if not treated.
Possible Complications TOP
If you are planning to have periodontal surgery, your dentist will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
What to Expect TOP
Prior to Procedure
On the day of the surgery:
A local anesthetic will be used near the gum disease.
Your dentist may recommend conscious sedation. You will be awake, but will have no anxiety during the surgery.
Description of Procedure
This surgery is usually done in an outpatient setting. You do not need to stay overnight. If you are undergoing sedation, you will have an IV placed in your arm to deliver medicine. Your heart rate, blood pressure, and breathing will be monitored during and after the surgery.
The periodontist or dentist will numb the affected area using a local anesthetic delivered through a needle. He will make a small cut in the gum line near the tooth root. The gum flap will be pulled back, and he will clean out and scrape the infected area. The gum flap will be repositioned to minimize the deep pocket size that formed. The gum will be stitched back into place. A dressing will be applied.
How Long Will It Take?
The time it takes to complete the procedure depends on how bad the damage is and how many gum areas are affected.
How Much Will It Hurt?
You may feel mild discomfort while the dentist numbs the affected area or places an IV in your arm. You will not feel pain during the surgery. Medicines can help control pain and anxiety before, during, and after the procedure.
When you return home, do the following for 24 hours to help ensure a smooth recovery:
Call Your Dentist TOP
After arriving home, contact your dentist if any of the following occurs:
In case of an emergency, call for medical help right away.
American Academy of Periodontology
American Dental Association
National Institute of Dental and Craniofacial Research (NIH)
Canadian Dental Association
The Canadian Dental Hygienists Association
American Academy of Periodontology website. Available at: http://www.perio.org/ . Accessed April 19, 2010.
Carson De-Witt R. Periodontal disease. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=16&topicID=1034 . Published September 1, 2009. Accessed April 21, 2010.
National Institute of Dental and Craniofacial Research (NIH). Periodontal (gum) disease. National Institute of Dental and Craniofacial Research (NIH) website. Available at: http://www.nidcr.n... . Accessed April 19, 2010.
Pre and postoperative instructions for periodontal surgery. Kathie L. Davis website. Available at: http://www.kldavie... . Accessed April 19, 2010.
University of Maryland Medical Center. Periodontal disease. University of Maryland Medical Center website. Available at: http://www.umm.edu... . Accessed April 19, 2010.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed June 2012 by Laura Morris-Olson, DMD
Last Updated: 06/04/2012