Flap Surgery

 

 When advance gum disease (periodontitis) develops, the ligaments and bone tissue that surrounds the teeth are being destroyed, and could even begin losing teeth. If the disease can’t be controlled by non-surgical procedures like scaling, the periodontal flap surgery may be the best treatment option.

Flap surgery is the leading procedure for treating and repairing periodontal pockets. Periodontal pockets are the areas under the gum line, where gum tissue has detached from the teeth, resulting in a un cleansable space where harmful bacteria can proliferate. These bacteria causes inflammation of the tissues resulting in sensitivity, bleeding and pain. If left untreated they can cause a host of problems including gum disease, loss tooth-supporting bone structure and possibly even systemic problems.

The first step in treating the periodontal pockets is scaling with manual or ultrasonic instruments. If it is ineffective, periodontal surgery is considered. Flap surgery isn’t a cure for periodontal disease, but it helps create an environment that makes it easier to maintain periodontal health.

Indications : A flap procedure is typically recommended for patients with moderate to severe gum disease or periodontitis that has not responded to non-surgical treatments. Patients with advanced periodontitis can benefit from flap surgery, and they present with the following symptoms: Inflammation and bleeding gums, Tooth sensitivity, Tooth mobility, Severe gum recession, Tooth loss, Persistent halitosis.

Procedure : One major objective of flap surgery is to eliminate or reduce the pocket itself. Flap surgery is typically done under local anesthesia. A small incision is made to separate gums from the teeth. The outer gum tissue is folded back to allow access to the roots, supporting ligament and bone tissue. The inflamed gum tissue can be removed and the tooth roots can be cleaned, if needed may also be cleaned with antibiotics and medications. Bone defects can be repaired with the grafting material and regeneration of the periodontal ligament can be induced by physical and chemical methods. Finally the incision is closed and sutured. Post surgical pain and discomfort can be managed with medications.

Post surgical care instructions:

-- Take pain relievers as prescribed.

-- After 24 hours rinse the mouth with warm salt water several times a day to reduce swelling and relieve pain.

-- Change gauge pads before they become soaked with blood.

-- Eat soft foods.

-- Do not lie flat. This may prolong bleeding. Prop up your head with pillows.

-- Continue to carefully brush and clean your tongue.

-- Apply an ice or cold pack to the outside of the mouth to help relieve pain an swelling.

-- Do not use sucking motions when using a straw or drink.

-- Do not smoke.

 A few days after the procedure the dentist will remove the sutures.

Risks : The roots of the teeth may become more sensitive. The contour or shape of  gums may change. Gum surgery may introduce harmful bacteria in to the blood stream. Gum tissue is also at risk of infection.

One may need to take the antibiotics before and after the surgery if :

-- Have certain heart problems which may increase the risk to get the heart infection endocarditis.

-- Have an impaired immune system.

-- Had recent major surgeries, having prosthesis ( artificial hip, artificial heart valve)

About the author:

Name: Dr. Abhilash Dandy

Qualification: B.D.S

I graduated as a Dentist from Sibar Institute of Dental Sciences, Guntur. I have done my externship program at Rutgers school of dental medicine, New Jersey, USA. I have clinical experience of 3 years and currently working as Administrative head — Dental wing in MediCub India, Hyderabad.