The periodontal flap procedure (or simply flap surgery) is an essential treatment for severe gum disease. When there are severe bacterial infections deep in the gums, you’ll need this specialist treatment by your dentist or periodontist to remove the bacteria, repair the bone and save your teeth.

Knowing more about this treatment will help you feel confident throughout the process. This article explains how the periodontist performs this treatment, who will need it and how to recover quickly.

What Is Periodontal Flap Surgery?

A periodontal flap is a small surgery performed by a periodontist to treat deep gum infections. They gently lift the gum away from the teeth.

  • Deep pockets – Severe gum disease causes deep pockets to form between your gums and teeth. Flap surgery allows them to reach the deepest part of the pocket.
  • Removing bacteria – The dental team will remove all the tartar, plaque and diseased tissue from the root using small instruments.
  • Restoring bone – The dentist will smooth any rough and damaged bone to reduce future bacterial build up.
  • Gum placement – The periodontist will carefully place the gum tissue back onto the teeth using very fine stitches.

Why Do You Need a Periodontal Flap Procedure?

Periodontitis is a severe form of gum disease. Bacteria will start to eat away at the deep connective tissues and bone that holds your teeth in place. This can’t be reached by brushing or scaling.

  • Deep pockets – Normal pockets in your gums are quite shallow and usually range from 1mm to 3mm. If they’re over 5mm deep then flap surgery is needed to remove all the bacteria.
  • Save natural teeth – Severe infections will cause your natural teeth to become loose. By cleaning the root area this will stabilize the tooth.
  • Reduce bacterial spread – Removing the bacteria in the deep pockets will reduce the risk of chronic inflammation spreading throughout your mouth and body.
  • Bone restoration – Often a bone graft is performed alongside the flap surgery to help restore any bone loss.

What Happens During a Periodontal Flap Procedure?

Knowing what will happen during your treatment will help reduce your anxiety. The periodontist will follow strict protocols to ensure you’re comfortable.

  • Anesthetic – The periodontist will give you a local anesthetic to completely numb your gums.
  • Flap creation – Small cuts are made along the gum line to gently lift the gum away from the teeth.
  • Cleaning – The specialist will remove all the hard tartar, diseased tissue and bacteria from the roots.
  • Smoothing – Any rough areas on the root will be smoothed to allow the healthy gum to attach to the tooth.
  • Suturing – The doctor will place the gum flap tightly onto the root of the tooth and stitch using very small stitches.

What Are the Benefits of a Periodontal Flap Procedure?

There are many benefits of having a periodontal flap.

  • Prevent gum disease – Removes hidden bacteria that can’t be reached by daily brushing or deep cleaning.
  • Shallow pockets – The gum tissue will be moved closer to the bone. This means you can clean the area properly at home.
  • Reduced inflammation – Removing the chronic infection will mean no bleeding gums, nasty smells, bad breath and swelling.
  • Save natural bone – Often flap surgery will be combined with regenerative treatments to help save any bone loss.
  • Improved overall health – Managing infection in your mouth will reduce the overall inflammation in your body.

How Do You Recover After a Periodontal Flap Procedure?

Following the correct aftercare will speed up your healing, reduce any swelling and prevent infections.

  • Pain relief – Follow the instructions given to you by your dentist/periodontist to take the painkillers or anti inflammatory medication.
  • Ice pack – Apply an ice pack to the outside of your cheek for 15 minutes.
  • Salt water – Gently rinse your mouth with warm salt water or the chlorhexidine mouthwash prescribed to you 24 hours after.
  • Soft food – Eat cold or warm soft foods such as yogurts, smoothies, mashed potatoes and scrambled eggs.
  • Don’t disturb – Don’t brush or floss over the stitches until your periodontist has confirmed it’s healed correctly.

What Are the Risks and Possible Complications of Periodontal Flap Surgery?

Periodontal flap is a common and very safe treatment. However it’s good to know what could happen.

  • Sensitivity – Your root may feel sensitive to hot and cold for a few weeks.
  • Gums receding – As the gums heal they may look slightly shorter as they’re tightening around your teeth. This is due to the swelling reducing.
  • Minimal bleeding – It’s completely normal to see some pink in your saliva for the first 24-48 hours.
  • Infection – Not following the aftercare advice could cause new bacteria to enter the area.

How Can You Maintain Long-Term Results After Periodontal Flap Surgery?

To help keep your results you’ll need to follow a strict daily hygiene regime and attend regular check ups.

  • Brush twice daily – Using a soft bristled toothbrush (manual or electric), brush all your teeth using fluoride toothpaste.
  • Inter dental cleaning – Clean between your teeth daily using inter dental brushes or water flossers.
  • Periodontal maintenance – Visit your periodontist every 3-4 months for specialist deep cleans and measuring pocket depths.
  • Don’t smoke – Avoid smoking or chewing tobacco. Nicotine will reduce blood flow to your gums meaning they won’t heal as quickly and increase bone loss.

What Are the Frequently Asked Questions About Periodontal Flap Surgery?

Is Periodontal Flap Surgery Painful?

No. The periodontist will use a strong local anesthetic to fully numb your gums. You’ll feel slight pressure when the periodontist is working but will not feel any sharp pain.

How Long Will You Be Off Work?

You’ll generally heal for 7-14 days. After this your dentist will remove any non-dissolving stitches. Full healing will take a few months. Most people will return to work within 1-2 days.

Can Periodontal Flap Surgery Help Rebuild Bone?

Often the periodontist will combine flap surgery with bone grafts, growth factors or regenerative membranes. This will encourage your body to naturally regenerate the height and density of your jawbone.

What Happens If You Don’t Have Flap Surgery?

If you don’t have the flap surgery then the severe bacterial infection will continue to eat away at your jawbone. Over time this will cause your teeth to become loose and become out of alignment. Eventually they’ll fall out or need to be extracted.

Overall, periodontal flap is a safe, proven and effective treatment for severe gum disease. The periodontist will lift your gums to fully clean the deep pockets of bacteria. They will then shape the damaged bone and place the tissue tightly back into place. By saving your natural teeth you’re protecting your biting power, maintaining your bone and helping your long term health. Book a full diagnostic appointment with a periodontist today to assess your gums and stop your gum disease progressing.