If your periodontal disease is severe, you might be advised to undergo a surgical procedure to thoroughly clean out bacteria that are too deep to be removed through scaling and root planing. You might also require surgery to restore tissue and bone that has been destroyed by periodontal disease.
This procedure involves cutting into the gum and revealing the bone and teeth underneath so the area can be carefully and completely cleaned. The disease-causing bacteria and any pieces of calculus are removed, and then the gum tissue is sewn securely back into place around the teeth.
If you have severe tissue and bone destruction from periodontal disease, you might need another procedure after flap surgery called a graft. During a graft, your dentist or dental specialist may remove a bit of tissue or bone from another area of your body, and attach it to areas in your mouth that need new tissue or bone growth. Alternatively, there are two other sources of graft tissue. One is a material harvested from donors called an allograft, the other is a biosynthetic graft material. In addition to grafting procedures, a tiny bit of mesh material may be placed between your gum and bone. This technique prevents the new gum tissue from growing into the area where bone should be.
Gum disease. American Dental Association Mouth Healthy website. Available at:
Accessed July 27, 2011.
Periodontal (gum) disease: Causes, symptoms, and treatments. National Institute of Dental and Craniofacial Research website. Available at:
http://www.nidcr.nih.gov/OralHealth/Topics/GumDiseases/PeriodontalGumDisease.htm#surgery. Updated March 2011. Accessed July 27, 2011.
Periodontal treatments and procedures. American Academy of Periodontology website. Available at:
https://www.perio.org/consumer/treatments-procedures. Updated May 2011. Accessed July 27, 2011.
Last reviewed September 2015 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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