Pocket reduction surgery (also known as gingivectomy, osseous surgery and 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).
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 tooth surface, 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 effective at
eliminating bacteria, reducing inflammation and saving teeth. The goals of pocket reduction surgery are:
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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 dentist will perform thorough visual
and x-ray examinations in order to assess the condition of the teeth, gums and underlying bone. Pocket reduction
surgery may be performed under local or general anesthetic depending on the preferences of the patient.
The gums will be gently pulled back from the teeth 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 final part of the surgery is usually the administration of an antimicrobial liquid to eliminate
any remaining bacteria and promote healing. The gum is then sutured with tiny stitches that are left in place
for 5-10 days.
Though the gums will be more sensitive immediately following the procedure, there will be a
significant reduction in pocket depth and a vast improvement in the condition of the teeth and gums.
If you have any questions about pocket reduction surgery or treatment for periodontal disease,
please ask your dentist.