A gingival flap is created during gingival flap surgery, a procedure where gum tissue is separated from surrounding teeth and deflected back to allow a dental surgeon access to the jawbone and the root of the tooth. A gingival flap is created prior to bone grafting and before a dental implant is placed, but it can also be used before treating periodontitis, or gum disease. During the procedure, the gums are numbed with a local anesthetic and a surgeon uses a small scalpel to make a u-shaped incision and fold the flap of gum tissue back. Then, the surgeon will graft bone or place the implant, replace the flap, and suture it closed. This is usually done with dissolvable sutures for patient comfort. With most dental implant procedures, a gingival flap must be made twice and possibly even three times. First to graft bone, then to place an implant, then to remove the cover screw and place the abutment.