Flap surgery can be described as the loosening of the gum from bone to expose and clean underlying tooth structures. In advanced periodontal disease, when scaling and root planning have been unsuccessful in eliminating the entire pocket of decay, or when there has been bone loss that needs to be surgically corrected, then a dentist may perform periodontal flap surgery. In flap surgery, under local anaesthesia, small incisions are made in the gum, so that it can be lifted back to expose the tooth and bone. The entire area is carefully cleaned and all tarter and infected granulation tissue are removed and the bone is examined. Because periodontal disease causes bone loss, often the bone will need to be re-contoured in order for the gum to heal properly. When the procedure is done, the gums are sutured in to place on top of the bone. The entire flap procedure typically requires from 1 to 3 hours to perform with only two quadrants of the mouth being addressed in a single visit. The sutures will remain in place for approximately one week, and a patient will likely be given a prescription for pain medication and antibiotics.