Oral surgery gum-tissue flaps.
With some surgical extractions, it will be necessary for the dentist to create a gum-tissue flap.
The idea of a flap is that when it is reflected (pealed back), it allows the dentist access to both the tooth and bone tissue that surrounds it.
After the tooth has been removed, the flap is then returned to its original position and stitched back into place.
How are the tissue flaps created for oral surgery made?
Here's how a dentist "lays" a flap when performing a surgical tooth extraction.
1) They first use a local anesthetic (give you a "shot") so to numb up your tooth and its surrounding tissues.
2) They'll then use a scalpel to score the outline of the flap, cutting directly through the gum tissue down to the bone.
(Since you're numb, you won't feel any pain. You will, however, feel the pressure of the scalpel.)
3) Once the flap's outline has been scored, the dentist will reflect it back (peal it back from the bone).
One edge of the flap will be where your gums and teeth meet. Somewhere along this edge, the dentist will insert a tissue "elevator" (a hand tool that looks like a small, somewhat pointed, flat-bladed screwdriver).
As the elevator is pushed underneath the outline of the flap, the gum tissue will peal back, thus exposing the underlying bone and tooth.
(Once again, since you're numb, you won't feel any pain. You will, however, feel the pressure of the elevator being worked along your jawbone.)
4) At this point, the flap has been completed. The dentist can now perform whatever procedure is required as a part of the tooth extraction process (such as bone removal, tooth sectioning).
5) Once your surgery has been completed, the dentist will stitch the tissue flap back into place.
Why are tissue flaps made so large?
When compared to the width of the space where your tooth has come out, a tissue flap may look like it involves a comparatively large area. Here's why:
1) Since the whole idea of creating a tissue flap has to do with visibility and access, the flap must be large enough to fulfill these needs.
2) If the flap is too small, the dentist will tend to pull and stretch the tissue. This trauma will complicate the extraction site's healing process.
3) The dentist needs a firm base over which to suture (stitch) the flap back into place. This means that the edges of the flap must extend over and rest upon undisturbed bone.
4) The flap must maintain an adequate blood supply. For this reason, the still-attached base portion of a flap is always broader than its free edge.
