Pocket Reduction
Pocket ReductionAs 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 ExpectPocket 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.
BenefitsIf periodontal
pockets do not resolve after scaling and root planing, we may recommend
pocket depth reduction. Whether Dr. Grimard 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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