Pocket Reduction Surgery

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 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 bacterial 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:

• 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. A reduction in bacteria in the mouth reduces 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.
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• Facilitate home care – As the gum pockets become progressively deeper, they become increasingly more difficult to clean at home. Toothbrushes and dental floss cannot reach to the bottom of the pockets, increasing the risk of further periodontal infections.
  
  
• Enhancing the smile – 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, a periodontist will perform thorough examinations in order to assess the condition of the teeth, gums and underlying bone.

The gums are gently pulled back from the teeth and bacteria and calculus (tartar) is eliminated. Scaling and root planing will generally be required to fully remove the 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, which is left in place for 5-10 days.

Though the gums will be more sensitive 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.