Gingivitis is the mildest form of periodontal disease. It causes the gums to become red, swollen, and bleed easily. There is usually little or no discomfort at this stage. Gingivitis is often caused by inadequate oral hygiene. Gingivitis is reversible with professional treatment and good oral home care.
Untreated gingivitis can advance to periodontitis. With time, plaque can spread and grow below the gum line. Toxins produced by the bacteria in plaque irritate the gums. The toxins stimulate a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. Gums separate from the teeth, forming pockets (spaces between the teeth and gums) that become infected. As the disease progresses, the pockets deepen and more gum tissue and bone are destroyed. Often, this destructive process has very mild symptoms. Eventually, teeth can become loose and may have to be removed.
Flap Procedure for Gum Disease
You may need surgery for severe gum disease (periodontitis) if it cannot be cured with antibiotics or root planing and scaling. A flap procedure cleans the roots of a tooth and repairs bone damage caused by gum disease. A gum specialist (periodontist) or an oral surgeon often performs the procedure.
Before the procedure, you will be given a local anesthetic to numb the area where the doctor will work on your gums.
The doctor will pull back a section of your gums to clean the roots of your teeth and repair damaged bone, if needed. The gum flap will be sewn back into place and covered with gauze to stop the bleeding.Bone may be:
- Smoothed and reshaped so that plaque has fewer places to grow.
- Repaired (grafted) with bone from another part of the body or with man-made materials. The doctor may place a lining on the bone graft to help the bone grow back. The lining may need to be removed later.
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.
Why It Is Done
The flap procedure is necessary when severe gum disease (periodontitis) has damaged the bones that support your teeth.
How Well It Works
If you maintain good dental care after the surgery, the flap procedure should allow you to clean your teeth and gums better. Your gums should become pink and healthy again.
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.
What To Think About
- A flap procedure is often needed to save teeth that are supported by a bone damaged by gum disease.
- Gum disease usually will come back if you do not brush and floss regularly after surgery.
- To promote healing, stop all use of tobacco. Smoking or using spit tobacco decreases your ability to fight infection of your gums and delays healing. To learn more, see the topic Quitting Smoking.
- You will need to see your dentist regularly so that he or she can follow your progress. If your gum disease spreads, you may lose teeth.