Pocket Reduction Surgery
Pocket reduction surgery ( gingivectomy, osseous surgery and apically positioned flap surgery) is a collective term for a series of several different surgeries aimed at gaining access to the roots of the teeth in order to remove bacteria and tartar (calculus). This is the most predictable way of halting the progression of periodontal disease.
The human mouth contains dozens of different bacteria at any given time. The bacteria found in plaque (the sticky substance on teeth) produce acids that lead to demineralization of the bone and supporting attachment of teeth, and ultimately contribute to periodontal disease.
Periodontal infections cause a chronic inflammatory response in the body that literally destroys bone and gum tissues once they invade the subgingival area (below the gum line). Gum pockets form and deepen between the gums and teeth as the tissue continues to be destroyed.
Periodontal disease is a progressive condition which, if left untreated, causes massive bacteria colonization in gum pockets can eventually lead to teeth falling out. Pocket reduction surgery is an attempt to alleviate this destructive cycle, and reduce the depth of the bacteria-harboring pockets.
Reasons for the pocket reduction surgery
Pocket reduction surgery is a common periodontal procedure which has been proven the most effective at eliminating bacteria, reducing inflammation and saving teeth. The goals of pocket reduction surgery are:
- Reducing bacterial spread – Oral bacteria has been connected to many other serious conditions such as diabetes, heart disease and stroke. Oral bacteria can travel to various parts of the body from inside the bloodstream and begin to colonize. It is important to decrease bacteria in the mouth in order to reduce the risk of secondary infection.
- Halting bone loss – The chronic inflammatory response induced by oral bacteria leads the body to destroy bone tissue. As the jawbone becomes affected by periodontal disease, the teeth lose their rigid anchor. When the teeth become too loose, they may require extraction.
- Facilitate home care – As the gum pockets become progressively deeper, they become incredibly difficult to clean by the patient. The toothbrush and dental floss cannot reach to the bottom of the pockets, increasing the risk of further periodontal infections.
- Enhancing the smile – An oral cavity that is affected by periodontal disease is not attractive to the eye. In fact, smiles may be marred by brown gums, rotting teeth and ridge indentations. Pocket reduction surgery halts the progression of gum disease and improves the aesthetics of the smile.
What does pocket reduction surgery involve?
Before recommending treatment or performing any procedure, the periodontist will perform thorough visual and x-ray examinations in order to assess the condition of the teeth, gums and underlying bone. Once all non-surgical attempts to stop the progression of periodontal disease is found not responsive, pocket reduction surgery may be performed under local anesthetic with or without oral sedation depending on the preferences of the patient.
The gums will be gently pulled back from the teeth to gain access to the deep root surfaces and bacteria and calculus (tartar) will be eliminated. Scaling and root planing will generally be required to fully remove the ossification (tartar) from the surface of the tooth root. If the root is not completely smooth, a planing procedure will be performed to ensure that when the gums do heal, they will not reattach to rough or uneven surfaces. The bone abnormalities which is a common consequence of periodontal disease is also corrected.
The gum is then sutured with tiny stitches that are left in place for 7-10 days.
Though the gums may be more sensitive immediately following the procedure, which will gradually subside in time. There will be a significant reduction in pocket depth and a vast improvement in the condition of the teeth and gums. A 4-6 week follow-up visit will evaluate the outcome of the surgery.
If you have any questions about pocket reduction surgery or treatment for periodontal disease, please ask Dr. Bashiri and staff.