Pocket Reduction
As the bacteria that cause
periodontal disease release toxic substances, they trigger the
breakdown of gum and bone. The gum then separates from the
teeth, forming gaps that are called periodontal pockets.
Bacteria settle in these pockets and because they cannot be
removed by the patient's daily oral hygiene, they continue to
accumulate and reproduce. Without proper treatment, the bacteria
will continue to populate these pockets, creating further gum
and bone destruction.
The first step in the treatment of periodontal disease involves
the removal of the bacteria that inhabit the periodontal pockets
in the form of plaque and tartar. The removal of the pocket
irritants - scaling and root planning - is combined with oral
hygiene instructions that are aimed at improving the patient's
ability to control plaque and avoid bacteria from reinfecting
the periodontal pockets. Several weeks after completion of
scaling and root planing, a periodontal re-evaluation is
completed to assess the healing response. If the periodontal
pockets do not decrease and the gums are still unhealthy,
surgical treatment may be indicated.
Pocket depth reduction is a term used for a series of different
surgical procedures aimed at gaining access to the root surface
to effectively remove calculus and to reduce the size of the
pockets to help prevent bacteria from settling in.
What to Expect
Pocket depth reduction is done in our office
with local anesthesia. After lifting the gum
back, the bacterial plaque and tartar are
removed from the root surfaces. Infected
bone and gum tissue are removed and areas
where bacteria can hide are cleaned and
smoothed out. This allows gums to better
reattach to healthy bone and eliminate gum
pockets. Stitches are placed to aid in
healing. The stitches are usually removed
about ten days after the surgery. Follow-up
appointments are scheduled as necessary to
evaluate healing and plaque control.
Post-surgical discomfort may last a few days
and is usually minimal. It can be easily
managed with commonly available
over-the-counter medications such as
acetaminophen or ibuprofen. Patients can
expect to follow their normal routine the
day after surgery. We will provide special
instructions related to diet, exercise, and
medications.
After pocket depth reduction, patients may
experience heightened tooth sensitivity.
This is temporary and usually resolves
within a few weeks. There are chemical aids
available that help reduce sensitivity.
Some people also may experience looser teeth
after periodontal surgery. This also is a
transient finding that occurs as part of the
normal healing process. With proper plaque
control and bite adjustment, the teeth
usually tighten up in a few weeks.
Another concern after pocket depth reduction
is that the teeth may appear longer and that
there are spaces in between the teeth.
Actually, longer teeth are the result of
periodontal disease, not of periodontal
surgery. As periodontal disease infects and
destroys the bone that encases the roots,
the root surfaces become exposed. They do
not appear exposed because they are covered
by the inflamed, swollen gums that form the
periodontal pocket. Without proper
treatment, the periodontal pockets continue
to deepen, giving way to more infection,
bone loss, and eventually tooth loss and
systemic complications.
Benefits
If periodontal pockets do not resolve after
scaling and root planing, we may recommend
pocket depth reduction. Whether Dr. Gurinsky
performs a gingivectomy, periodontal flap
surgery, or osseous surgery, the patient
will benefit from the reduction in pocket
depth and the reattachment of the gums to
the root surface. Pocket depth reduction,
when followed by supportive periodontal
treatment, is a predictable procedure that
can help keep teeth healthy and reduce the
risk of serious health problems related to
periodontal disease.
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