Periodontal Surgery -- Open Flap
(Pocket Depth Reduction)
Reasons for Procedure
- Deep infected pockets have formed and it is too hard to keep them clean
- Gums around the teeth are damaged and cannot be fixed with nonsurgical techniques, like deep cleaning and medications
- Tooth sensitivity
- Changes in gum appearance
- Reaction to the sedation
- Gum swelling
- Nausea and vomiting
What to Expect
Prior to Procedure
- Tell your dentist of any recent changes to your health, medications, allergies, or supplements.
- Take your prescription medications, unless your dentist says otherwise.
- Talk to your dentist about any medications you take, including over-the-counter medications. You may need to avoid certain medications.
- You may be asked to take an antibiotic before surgery.
- Sometimes, sedative medications are used to make you more relaxed during surgery, even though you are awake. If you are undergoing conscious sedation, you will be asked to not eat for at least six hours before surgery. Otherwise, you can follow a normal diet.
- Arrange for a ride if you are having sedation.
- Remove contact lenses.
- Wear comfortable clothing.
- Bring any paperwork as directed.
Description of Procedure
How Long Will It Take?
How Much Will It Hurt?
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- Washing your hands often and reminding your healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incision
- Rest as needed.
- Take medications as directed. Over-the-counter medications for pain, like ibuprofen, may be used.
- Apply ice to the side of your cheek for 20 minutes at a time to reduce pain and swelling. Wrap the ice in a towel. Do not place the ice directly on your skin.
- Drink plenty of fluids.
- Eat small amounts of soft or pureed foods.
- Do not smoke, rinse your mouth, or use a straw.
- Apply dressings or gauze to the area as directed to absorb blood and saliva.
- Do not exercise for a few days as directed.
- Do not drive if you took a sedative or narcotic pain reliever.
- Be sure to follow your dentist’s instructions.
Call Your Dentist
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, a lot of bleeding, or any unusual discharge from the surgical site(s)
- Pain and swelling that is not controlled with medication or home care
- Dressing or stitches have come loose or are uncomfortable
- Loose tissue
- Continued swelling after 48 hours
- Other new symptoms, allergic reactions, or concerns
- Persistent nausea and vomiting
American Academy of Periodontology http://www.perio.org
National Institute of Dental and Craniofacial Research (NIH) http://www.nidcr.nih.gov
Canadian Dental Association http://www.cda-adc.ca
The Canadian Dental Hygienists Association http://www.cdha.ca
American Academy of Periodontology website. Available at: http://www.perio.org/. Accessed April 19, 2010.
Carson De-Witt R. Periodontal disease. EBSCO Patient Education Reference Center website. Available at: http://www.ebscohost.com/thisTopic.php?marketID=16&topicID=1034. Published September 1, 2009. Accessed April 21, 2010.
National Institute of Dental and Craniofacial Research (NIH). Periodontal (gum) disease. National Institute of Dental and Craniofacial Research (NIH) website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm. Accessed April 19, 2010.
Pre and postoperative instructions for periodontal surgery. Kathie L. Davis website. Available at: http://www.kldaviesperiodontist.com/images/WEB%5FPRE%5F%5FAND%5FPOST%5FOP%5FINSTRUCTIONS.pdf. Accessed April 19, 2010.
University of Maryland Medical Center. Periodontal disease. University of Maryland Medical Center website. Available at: http://www.umm.edu/patiented/articles/what%5Fprocedures%5Ftreatment%5Fof%5Fperiodontal%5Fdisease%5F000024%5F8.htm. Accessed April 19, 2010.
6/6/2011 DynaMed's Systematic Literature Surveillance Available at: http://www.ebscohost.com/dynamed: 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.
- Reviewer: Michael Woods, MD
- Review Date: 09/2013 -
- Update Date: 00/12/2014 -