Periodontal Flap Surgery

This section is dedicated to the latest information on oral health topics, culled from authoritative sources such as the American Dental Association.

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Heart Disease

Poor dental hygiene can cause a host of problems outside your mouth-including your heart. Medical research has uncovered a definitive link between heart disease and certain kinds of oral infections such as periodontal disease. Some have even suggested that gum disease may be as dangerous as or more dangerous than other factors such as tobacco use. A condition called chronic periodontitis, or persistent gum disease, has been linked to cardiovascular problems by medical researchers.

In short, infections and harmful bacteria in your mouth can spread through the bloodstream to your liver, which produces harmful proteins that can lead to systemic cardiac problems. That's why it is critical to practice good oral hygiene to keep infections at bay-this includes a daily regimen of brushing, flossing and rinsing.


Antibiotic Prophylaxis

In some cases, patients with compromised immune systems or who fear an infection from a dental procedure may take antibiotics before visiting the dentist.

It is possible for bacteria from your mouth to enter your bloodstream during a dental procedure in which tissues are cut or bleeding occurs. A healthy immune system will normally fight such bacteria before they result in an infection. However, certain cardiovascular conditions in patients with weakened hearts could be at risk for an infection or heart muscle inflammation (bacterial endocarditis) resulting from a dental procedure.

Patients with heart conditions (including weakened heart valves) are strongly advised to inform our office before undergoing any dental procedure. The proper antibiotic will prevent any unnecessary complications.


Dentistry Health Care That Works: Tobacco

The American Dental Association has long been a leader in the battle against tobacco-related disease, working to educate the public about the dangers inherent in tobacco use and encouraging dentists to help their patients break the cycle of addiction. The Association has continually strengthened and updated its tobacco policies as new scientific information has become available.

Smoking and Implants

Recent studies have shown that there is a direct link between oral tissue and bones loss and smoking. Tooth loss and edentulism are more common in smokers than in non-smokers. In addition, people who smoke are more likely to develop severe periodontal disease.

The formation of deep mucosal pockets with inflammation of the peri-implant mucosa around dental implants is called peri-implantitis. Smokers treated with dental implants have a greater risk of developing peri-implantitis. This condition can lead to increased resorption of peri-implant bone. If left untreated, peri-implantitis can lead to implant failure. In a recent international study, smokers showed a higher score in bleeding index with greater peri-implant pocket depth and radiographically discernible bone resorption around the implant, particularly in the maxilla.

Many studies have shown that smoking can lead to higher rates of dental implant failure. In general, smoking cessation usually leads to improved periodontal health and a patient’s chance for successful implant acceptance.


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Tooth Wear.When advanced gum disease (periodontitis) develops, your teeth are in danger: At this stage, the ligaments and bone tissue that surround them are being destroyed, and you could even begin losing teeth! If the disease can't be controlled by non-surgical treatments like cleaning and scaling, then periodontal flap surgery may be your best treatment option.

Flap surgery is today's leading method for treating and repairing periodontal pockets. What are these “pockets?” They are areas below the gum line where gum tissue has detached from the teeth, resulting in an uncleansable space where harmful bacteria can proliferate. These bacteria cause inflammation of the tissues, resulting in sensitivity, bleeding, and pain. Left untreated, they can cause a host of problems including gum disease, loss of the tooth-supporting bone structure, and possibly even systemic (whole-body) problems.

When periodontal pockets develop, the first step in treating them is usually via cleaning and scaling (also referred to as root debridement) with a manual or ultrasonic instrument. If this isn't effective, then 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 your periodontal health. And even if you're prone to gum disease, proper professional treatment and regular care at home can help keep your teeth healthy for as long as possible.

The Goals of Flap Surgery

One major objective of flap surgery is to eliminate or reduce the pocket itself. To access it, a flap-like incision is made in the gum tissue. This allows diseased tissue to be removed from inside the pocket, and provides access to the teeth's root surfaces for a thorough cleaning, which helps to eliminate harmful plaque and calculus (tartar). Afterward, the “flap” is closed, sealing the area. This begins the healing process, which takes place rapidly.

Another goal is the regeneration of periodontal ligament and bone tissue which may have been lost to the disease. A variety of techniques may be used to accomplish this, including high-tech methods of bone grafting and chemicals referred to as growth factors. These approaches help restore the gums to their normal form and function, and promote the healthy and secure anchoring of teeth.

The Flap Surgery Procedure

Periodontal flap surgery.

Flap surgery is typically done under local anesthesia, sometimes accompanied by oral anti-anxiety medications; alternatively, it may be performed under intravenous conscious sedation. After anesthesia has taken effect, a small incision is made to separate the gums from the teeth. The outer gum tissue is gently folded back to give access to the roots and the supporting ligament and bone tissue.

Next, the inflamed gum tissue can be removed, and the tooth roots can be cleaned; if needed, the area may also be treated with antibiotics or other medications. Bone defects can be repaired with grafting material, and proper regeneration of the periodontal ligament can be encouraged by physical (barrier membranes) and chemical (growth factors) methods. Finally, the incision is closed and the procedure is completed.

Performed by an experienced hand, state-of-the-art flap surgery has an excellent track record and offers well-established benefits. It's often the treatment of choice for relieving periodontal disease and helping to maintain your oral health — and preserve your teeth.

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Periodontal Flap Surgery - Dear Doctor Magazine

Periodontal Flap Surgery Most surgical patients are surprised by how comfortable the experience of flap surgery is and how painless it is afterward. Today's highly sophisticated and meticulous techniques allow the periodontal surgeon to reconstitute, regenerate, and reconstruct lost and destroyed tissues. Find out how periodontal surgery can prolong the life of your teeth... Read Article

Periodontal (Gum) Disease - Dear Doctor Magazine

Understanding Gum (Periodontal) Disease Have your gums ever bled when you brushed or flossed? This most commonly overlooked simple sign may be the start of a silent progressive disease leading to tooth loss. Learn what you can do to prevent this problem and keep your teeth for life... Read Article