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 1 or several teeth. In its more advanced stages, surgery may be needed to fix damaged gums.
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Reasons for Procedure TOP
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
Problems from the procedure are rare, but all procedures have some risk. Your dentist will review potential problems, like:
Before your procedure, talk to your dentist about ways to manage factors that may increase your risk of complications such as:
What to Expect TOP
Prior to Procedure
Sometimes, sedative medications are used to make you more relaxed during surgery. If you are undergoing conscious sedation, you will be asked to not eat for at least 6 hours before surgery. Otherwise, you can follow a normal diet.
A local anesthetic will be used near the gum disease.
Your dentist may recommend conscious sedation. You will be awake, but will not have anxiety during the surgery.
Description of Procedure TOP
This surgery is usually done in an outpatient setting. You do not need to stay overnight. If you are undergoing sedation, you will have it through an IV. 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. They will make a small cut in the gum line near the tooth root. The gum flap will be pulled back, and the infected area will be cleaned and scraped. 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? TOP
The time it takes to complete the procedure depends on the extend of the damage and how many gum areas are affected.
How Much Will It Hurt? TOP
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
Post-procedure Care TOP
At the Dentist Office
During your stay, the dental staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
When you return home:
Call Your Dentist TOP
It is important for you to monitor your recovery. Alert your dentist to any problems right away. If any of the following occur, call your dentist:
If you think you have an emergency, call for emergency medical services right away.
American Academy of Periodontology
National Institute of Dental and Craniofacial Research (NIH)
Canadian Dental Association
The Canadian Dental Hygienists Association
Periodontal (gum) disease: Causes, symptoms, and treatments. National Institute of Dental and Craniofacial Research website. Updated August 2012. Accessed August 10, 2015.
Periodontal pocket reduction procedures. American Academy of Periodontology website. Available at:
...(Click grey area to select URL)
Accessed August 10, 2015.
6/6/2011 DynaMed Plus Systematic Literature Surveillance Available at: http://www.dynamed.com: 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 September 2016 by Michael Woods, MD
Last Updated: 8/10/2015
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