Gum surgery (also called periodontal surgery) is a procedure to treat advanced gum disease (periodontitis) when non-surgical treatment — such as deep cleaning (root surface debridement) — has not fully resolved the problem.
The most common type is called open flap debridement. The gum is gently lifted away from the tooth root to allow thorough cleaning of the root surfaces and removal of diseased tissue, before the gum is repositioned and sutured back in place.
Why might I need gum surgery?
Gum surgery is considered when:
Deep pockets (spaces between the gum and tooth root) remain after non-surgical treatment and cannot be cleaned effectively at home or by the dental team
Bone loss around the teeth continues despite non-surgical treatment
The shape of the gum or bone makes thorough cleaning difficult without surgery
The BSP (British Society of Periodontology) Step 3 protocol recommends surgical treatment when pocket depths of 6mm or more persist after thorough non-surgical treatment and supportive care.
What are my alternatives?
Continued non-surgical maintenance — more frequent professional cleaning to manage but not resolve the disease. Suitable for some patients who cannot or choose not to have surgery.
Tooth extraction — for individual teeth with very severe bone loss where the prognosis is very poor regardless of surgical treatment.
No further treatment — periodontitis is a progressive disease. Without adequate treatment, bone and tissue loss will continue, and teeth may eventually be lost.
Your dentist or periodontist will discuss the risks of not treating versus treating based on your specific situation.
What does the procedure involve?
Gum surgery is carried out under local anaesthetic, usually in sections of the mouth at a time:
Local anaesthetic — the area is numbed thoroughly. You will feel pressure but not pain during the procedure.
Flap reflection — small incisions are made in the gum and the tissue is gently lifted back to expose the tooth roots and surrounding bone.
Cleaning — root surfaces are thoroughly cleaned and smoothed. Any inflamed tissue is removed.
Bone reshaping or grafting — in some cases, the bone may be reshaped or a bone graft added to encourage regeneration.
Suturing — the gum is sutured back into position. Stitches are usually removed 1–2 weeks later.
Risks and possible complications
Common (affect more than 1 in 10 people):
Swelling, bruising, and soreness for 3–7 days after surgery
Some bleeding from the gum for up to 24 hours
Gum recession and tooth sensitivity — after surgery, gums may sit lower around the teeth, making roots slightly exposed. Teeth can look longer and feel more sensitive. This usually improves over weeks to months but some change may be permanent.
Uncommon (affect about 1 in 10 to 1 in 100 people):
Infection requiring antibiotics
Increased spacing between teeth as swelling reduces
Temporary or rarely permanent numbness of gum tissue
Rare:
Damage to adjacent structures — your surgeon will discuss any specific anatomical risks with you
After your surgery
Recovery guidance varies depending on the extent of surgery. Generally:
Take over-the-counter painkillers (ibuprofen and/or paracetamol) as directed
Apply a cold pack to your cheek for the first few hours to reduce swelling
Eat soft, cool foods for the first few days
Do not disturb the sutures or probe the area with your tongue or fingers
Continue gentle oral hygiene in areas away from the surgical site. An antiseptic mouthwash (chlorhexidine) may be prescribed for the immediate post-operative period.
Avoid smoking — this significantly impairs healing and worsens the long-term outcome
Attend your review and suture removal appointment
Questions to ask your dentist or periodontist
Which areas of my mouth are being treated and how many sessions will I need?
How much gum recession should I expect to see after surgery?
What is the long-term outlook for my teeth after surgery and supportive care?
How often will I need to come for maintenance appointments?
Will my teeth always require intensive maintenance from this point on?
This leaflet is for general information only and does not replace professional dental advice. It is intended to support — not replace — the discussion with your dentist about your individual options, risks, and treatment plan. Treatment outcomes vary between patients depending on individual circumstances. Your dentist will confirm exact fees and what is suitable for your specific circumstances before you agree to any treatment.
When to Seek Urgent Help
If you experience heavy bleeding that does not stop within 30 minutes, severe spreading swelling, or difficulty swallowing after gum surgery, go to A&E immediately or call 999.
References
Aligned with guidance from: BSP (British Society of Periodontology), SDCEP, FGDP(UK), NICE.