What is Flap Surgery?
- Aug 21 2017
At what stage of gum disease is flap surgery recommended?
Going for a routine dental exam and getting the “all clear” that everything looks good has to be one of the best feelings there is. No one wants to hear about cavities or loose fillings or other problems. Top of the list of things that we would prefer to never hear from a dentist are the words “gum disease”. Not only does it imply that we have been remiss in our dental hygiene practice, but there can be serious consequences.
Gum or periodontal disease, which is an inflammation of the gum line, can progress to the bone surrounding the teeth. Many people currently have some form of gum disease, which is usually caused by bacteria, mucus and other particles forming a sticky coating on the teeth called plaque. If not removed by daily brushing, plaque can harden and eventually lead to the first stage of gum disease, gingivitis. This early stage of gum disease can usually be treated with professional cleaning and consistent attention to good dental hygiene practices at home.
When the inflammation is not stopped at the first stage, however, it can advance to periodontitis. At this point, the gums begin to pull away from the teeth and pockets are formed. Infection soon sets in, and the immune system steps up. The combination of bacterial toxins and the white blood cells that the body sends to fight the infection end up actually doing damage to the bones and connective tissue that support the teeth. Not only can the end result be tooth and bone loss but there is the risk of developing serious health issues, such as heart disease, stroke and Type 2 diabetes.
At this point, your dentist will try non-surgical procedures, like antibiotics, scaling and root planing. This involves using lasers or ultrasonic devices to remove built up plaque, which has hardened into tartar and smoothing the surfaces of the roots to discourage its return. This is the stage where flap surgery may become necessary if these earlier attempts are unsuccessful.
What to Expect During Flap Surgery
Flap surgery begins with the dentist using a scalpel to lift and fold back the gums, like a flap, separating them from the teeth. Once this has been done, the dentist has better access and will be able to remove inflamed tissue and thoroughly clean areas that were inaccessible before. If there are bone defects, they can also be eliminated. The flap will then be placed back in position and stitched with either dissolving stitches or ones that will need to be removed in one to two weeks. Some dentists, or periodontists, also make use of a dressing called a periodontal pack to cover the area.
The entire procedure is done under local anesthetic, and you can expect mild to moderate post-surgery pain. An ice pack may be recommended to reduce swelling and prescription or over-the-counter medications for any pain. Antibiotics may also be prescribed during this period because it is especially important to keep the mouth as clean as possible to avoid new infection.
While flap surgery can be very effective at getting rid of infection and preventing further damage, the area that was treated will be more susceptible to receding in the future. There may also be increased sensitivity to hot and cold, as well as cavities developing in the roots. Obviously, the best course of action would be to prevent the need for flap surgery or any other similar procedure. Daily, consistent brushing and flossing, combined with regular check-ups and cleanings are a very small price to pay for healthy gums and teeth.
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