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Periodontal surgery is indicated when non-surgical treatment — scaling and root planing — has not fully resolved gum disease, or when structural problems (recession, bone loss, altered gum architecture) require surgical correction. The right surgery depends on what the problem is, not on a standard protocol applied to all gum disease. At Dazzle Dental Clinic, periodontal surgical decisions are made by specialist periodontists based on your specific diagnosis. Our gum surgery and guided tissue regeneration services cover the full range of periodontal surgical procedures. Ongoing maintenance is supported by our professional teeth cleaning programme.
Access Flap Surgery
Access flap surgery is periodontal surgery in its most fundamental form: the gum is incised and elevated to allow direct visual and instrument access to root surfaces and bone that cannot be adequately reached through non-surgical instrumentation. It is indicated when pocket depths remain above 5–6mm after completing non-surgical treatment, or when residual calculus and biofilm are confirmed radiographically at depths inaccessible to closed debridement.
At Dazzle, access flap surgery uses a papilla-preserving incision design where anatomy permits — this preserves the interdental papillae that are the most aesthetically and functionally important gum tissue. Microsurgical instruments and sutures (5-0 or 6-0 monofilament) are used for precise tissue management and closure.
Osseous Surgery
Osseous surgery — surgical modification of the bone architecture around teeth — is indicated when irregular bone contours around teeth maintain pockets that prevent adequate hygiene. The objective is to produce bone levels that the patient can maintain with home care. It is not reversing bone loss; it is reshaping what remains into a maintainable architecture.
Regenerative Periodontal Surgery
Where bone defects are three-walled or combined (with a substantial three-wall component), guided tissue regeneration (GTR) or enamel matrix derivative (EMD) application can produce new attachment — regeneration of the periodontium rather than mere repair. This is technically demanding and case selection is critical. Published data: 3–5mm clinical attachment gain in appropriately selected three-wall intrabony defects with EMD or GTR. See our GTR membrane guide for technical detail.
Gum Recession Treatment: Soft Tissue Grafting
Root coverage for recession defects uses connective tissue grafting (subepithelial connective tissue graft — CTG) or allograft membrane. The tunnel technique — where the graft is delivered through small incisions rather than a reflected flap — minimises the surgical site and patient discomfort. Predictable root coverage depends on recession class (Miller Class I and II have the best prognosis), graft thickness, and blood supply to the surgical site.
Crown Lengthening
Crown lengthening exposes more tooth structure by removing excess gum and sometimes supporting bone. It is indicated for functional crown lengthening (restorative margin below the gum level, biologic width violation), aesthetic crown lengthening (gummy smile correction), and for fracture lines at or below the gum margin that prevent restorative access. See our detailed periodontal diagnosis guide for how these decisions are made clinically.
FAQs
Q1: How is periodontal surgery different from scaling and root planing?
Scaling and root planing is non-surgical: instruments are inserted under the gum margin to clean root surfaces, but the gum is not elevated. Periodontal surgery involves making incisions to fold the gum back, providing direct visual access to root surfaces and bone. Surgery achieves more complete debridement in deep or complex defects that non-surgical treatment cannot fully reach.
Q2: Does periodontal surgery hurt?
The surgery is performed under local anaesthesia. During the procedure, patients feel pressure and movement but not pain. Post-operatively: mild to moderate discomfort for 2–5 days managed with prescribed analgesics. Minimally invasive surgical techniques at Dazzle reduce post-operative discomfort compared to conventional flap approaches.
Q3: How long is recovery?
Most patients resume normal activities within 2–3 days. Diet is modified (soft foods) for 1–2 weeks at the surgical site. Strenuous exercise is avoided for 48–72 hours. Suture removal is at 7–10 days. The gum healing process continues for 6–8 weeks; final assessment is at 3 months post-surgery.
Q4: Will my gums recede after surgery?
Some gum margin repositioning occurs after access flap surgery as the tissue heals to its new level. This is explained and anticipated before surgery. With appropriate case selection and surgical technique, recession beyond the expected initial remodelling is uncommon. For cases where aesthetic recession is a concern, surgical planning accounts for this before the procedure begins.
