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Gingival Flap Surgery

What Is It?
What It's Used For
Preparation
How It's Done
Follow-Up
Risks
When To Call a Professional
Additional Info

What Is It?
Gingival flap surgery is a type of gum procedure. The gums are separated from the teeth and folded back temporarily. This allows 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. Usually, a treatment that doesn't involve surgery is done first. This is called scaling and root planing. If this treatment does not eliminate the gum infection, gingival flap surgery may be used. It also may be done along with another procedure known as osseous (bone) surgery.

Preparation
Your periodontist or your dental hygienist will first remove all plaque and tartar (calculus) from around your teeth. He or she will make sure that your oral hygiene is good. Your periodontist also will evaluate your health and the medicines you take. This is important to make sure that surgery is safe for you.

How It's Done
First you will get a shot to numb the area. Then the periodontist will use a scalpel to separate the gums from the teeth. They will be lifted or folded back in the form of a flap. This gives the periodontist direct access to the roots and bone supporting the teeth.

Inflamed tissue will be removed from between the teeth and from any holes (defects) in the bone. The periodontist then will do a procedure called scaling and root planing to clean plaque and tartar. If you have bone defects, your periodontist may eliminate them. This procedure is called osseous recontouring. It smoothes the edges of the bone using files or rotating burs.

Finally, the gums will be placed back against the teeth and stitched in place. Some periodontists use stitches that dissolve on their own. Others use stitches that have to be removed a week to 10 days later. Your periodontist also may cover the surgical site with a bandage. This is called a periodontal pack or dressing.

Follow-Up
You will have mild to moderate discomfort after the procedure. Your periodontist can prescribe pain medicine to control it. Many people feel fine 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 often prescribed after gum surgery. These rinses kill bacteria, delay plaque growth and help your mouth to heal.

You may have some swelling. This can be reduced if you apply an ice pack to the outside of your face in the treated area. In some situations, antibiotics may be prescribed to prevent an infection. Be sure to take them as instructed. Your periodontist will want to reexamine the area in 7 to 10 days.

Risks
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 have some discomfort or pain and some minor bleeding during the first 48 hours after the procedure. These symptoms usually go away after a couple of days. Call your periodontist if bleeding continues or if the symptoms get worse after the first three days. This could be caused by an infection. If so, it should be treated promptly.

Additional Info
American Academy of Periodontology (AAP)
737 N. Michigan Ave.
Suite 800
Chicago, IL 60611-6660
Phone: 312-787-5518
Fax: 312-787-3670
www.perio.org

©2002-2013 Aetna, Inc. All rights reserved.

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