Munson Health
Periodontal Surgery -- Open Flap

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by Neff DM

(Pocket Depth Reduction)


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.
On the day of the surgery:
  • Remove contact lenses.
  • Wear comfortable clothing.
  • Bring any paperwork as directed.


A local anesthetic will be used near the gum disease.
Your dentist may recommend conscious sedation. You will be awake, but will have no anxiety during the surgery.

Description of Procedure

This surgery is usually done in an outpatient setting. You do not need to stay overnight. If you are undergoing sedation, you will have an IV placed in your arm to deliver medication. 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 he will clean out and scrape the infected area. 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?

The time it takes to complete the procedure depends on how bad the damage is and how many gum areas are affected.

How Much Will It Hurt?

You may feel mild discomfort while the dentist numbs the affected area or places an IV in your arm. You will not feel pain during the surgery. Medications can help control pain and anxiety before, during, and after the procedure.

Post-procedure Care

At the Dentist Office
During your stay, the dental staff will take steps to reduce your chance of infection, such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
  • 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
At Home
When you return home, do the following for 24 hours to help ensure a smooth recovery:
  • 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.


American Academy of Periodontology

National Institute of Dental and Craniofacial Research (NIH)



Canadian Dental Association

The Canadian Dental Hygienists Association



American Academy of Periodontology website. Available at: Accessed April 19, 2010.

Carson De-Witt R. Periodontal disease. EBSCO Patient Education Reference Center website. Available at: 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: Accessed April 19, 2010.

Pre and postoperative instructions for periodontal surgery. Kathie L. Davis website. Available at: Accessed April 19, 2010.

University of Maryland Medical Center. Periodontal disease. University of Maryland Medical Center website. Available at: Accessed April 19, 2010.

6/6/2011 DynaMed's Systematic Literature Surveillance Available at: 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.


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