Your Guide to Gum Surgery
A clear guide to surgery for gum disease. Find out what it involves, why it may be advised after non-surgical treatment, and what to expect.
Urgent help: who to contact
Call 999 or go to A&E now if, after gum surgery, you have heavy bleeding that does not stop within 30 minutes, severe swelling that is spreading, or difficulty swallowing.
What is gum surgery?
Gum surgery (periodontal surgery) treats advanced gum disease (periodontitis). It is used when treatment without surgery has not fully fixed the problem. That treatment is usually a deep clean of the roots (root surface debridement).
The most common type is called open flap debridement. The gum is gently lifted away from the tooth root. This lets the roots be fully cleaned. Diseased tissue is taken away. Then the gum is put back in place and stitched.
Why might I need gum surgery?
Gum surgery may be offered when:
- Deep pockets (gaps between the gum and the tooth root) are still there after treatment without surgery. They cannot be cleaned well at home or by your dental team.
- Bone loss around the teeth carries on, even after treatment without surgery
- The shape of the gum or bone makes it hard to clean well without surgery
The British Society of Periodontology (BSP) Step 3 plan advises surgery when pockets of 6mm or deeper are still there. This is after full treatment without surgery, and follow-up care (supportive care).
What are my other options?
- Carrying on with care that is not surgery — more frequent cleaning by your dental team. This manages the disease but does not cure it. It suits some people who cannot have surgery, or choose not to.
- Taking the tooth out (extraction) — for single teeth with very severe bone loss. These teeth have a very poor outlook (prognosis), with or without surgery.
- No more treatment — gum disease (periodontitis) gets worse over time. Without proper treatment, bone and gum loss will carry on. In the end, teeth may be lost.
Your dental team or gum specialist (periodontist) will talk through the risks of treating and of not treating. This will be based on your own mouth.
What happens during surgery?
Gum surgery is done with a numbing injection (local anaesthetic). It is usually done on one part of the mouth at a time:
- Numbing — the area is fully numbed. You will feel pressure but not pain during the surgery.
- Lifting the gum (flap reflection) — small cuts are made in the gum. The gum is gently lifted back to show the tooth roots and the bone around them.
- Cleaning — the roots are fully cleaned and smoothed. Any inflamed tissue is removed.
- Bone reshaping or grafting — sometimes the bone is reshaped, or a bone graft is added to help new bone grow.
- Stitches — the gum is stitched back into place. Stitches are usually taken out 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
- Gums shrinking back (gum recession) and sensitive teeth — after surgery, your gums may sit lower around the teeth. This leaves the roots slightly exposed. Teeth can look longer and feel more sensitive. This usually gets better over weeks to months, but some change may be permanent.
Uncommon (affect about 1 in 10 to 1 in 100 people):
- Infection that needs antibiotics
- Bigger gaps between teeth as the swelling goes down
- Numb gums. This may be temporary, or rarely permanent.
Rare:
- Damage to nearby parts of the mouth. Your surgeon will talk to you about any risks that apply to you.
After your surgery
Recovery advice depends on how much surgery you had. In general:
- Take painkillers you can buy without a prescription (ibuprofen and/or paracetamol) as directed
- Adults: follow the dose on the packet. Children: use children's paracetamol or ibuprofen and give the dose on the packet for their age. Check with a pharmacist, dentist or doctor before you take ibuprofen if you have asthma, have had a stomach ulcer, have heart, kidney or liver problems, take blood-thinning medicines, or are pregnant.
- Hold a cold pack against your cheek for the first few hours to reduce swelling
- Eat soft, cool foods for the first few days
- Do not touch the stitches or poke the area with your tongue or fingers
- Keep cleaning your teeth gently away from where you had surgery
- You may be prescribed a chlorhexidine (antiseptic) mouthwash to use straight after surgery
- Do not smoke. Smoking greatly slows healing and makes the long-term result worse.
- Go to your review appointment, where your stitches are taken out
Questions to ask your dental team or gum specialist (periodontist)
- Which areas of my mouth will be treated, and how many visits will I need?
- How much gum shrinkage should I expect 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 visits?
- Will my teeth always need intensive maintenance from now 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 dental team about your individual options, risks, and treatment plan. Treatment outcomes vary between patients depending on individual circumstances. Your dental team will confirm exact fees and what is suitable for your specific circumstances before you agree to any treatment.
Sources
- BSP implementation of European S3-level evidence-based treatment guidelines for stage I–III periodontitis in UK clinical practice (Journal of Dentistry 106:103562). British Society of Periodontology (BSP), 2021.
- Prevention and Treatment of Periodontal Diseases in Primary Care, 2nd edition. Scottish Dental Clinical Effectiveness Programme (SDCEP), 2024.
- Gum disease. NHS website (nhs.uk), reviewed April 2026.
Links checked 18 October 2026.
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