Periodontal (gum) disease can be a very aggressive infection: Left untreated, it can destroy the vital periodontal structures that protect teeth and maintain their attachment to the jaw. The end result—tooth loss—harms both your health and appearance. Controlling gum disease and ultimately restoring health and appearance to damaged gums and tooth-supporting bone requires aggressive treatment—sometimes even surgical measures. Periodontal (gum) surgery treats moderate to advanced disease.
If the infection has caused deep periodontal pockets (5 mm or more) or has settled beyond the reach of manual scalers, then gum surgery may be needed to access, clean and repair the diseased areas.
Flap surgery is one type of procedure used to access the deeper pockets of infection and clean them. The surgeon, usually a periodontist, creates a three-sided flap in the gum tissue, with one side still attached to the blood supply. The resulting opening resembles the flap of an envelope. Opening the flap, the surgeon can then access deep periodontal pockets to perform plaque removal, as well as repair receded gum tissue or lost bone. When finished, the surgeon then sutures the flap closed with self-dissolving stitches.
Regenerative techniques may also be needed to re-grow lost tissue and bone. These involve the use of various grafting procedures to obtain tissue from the roof of the patient’s mouth or another source and attach it where needed. Once in place, the graft acts as a scaffold for new gum tissue to grow upon and develop. These micro-surgical techniques require meticulous skill (and some level of art) not only to place the grafting material so it is most conducive to growth, but also to fashion it cosmetically to achieve the most attractive result.
These and similar procedures are usually performed with local anesthesia, sometimes supplemented with other sedation methods. Special cleaning instructions will be given to protect the site from further infection, and any minor discomfort after the procedure can usually be managed with anti-inflammatory medication (like ibuprofen) for a few days.