Pocket reduction surgery (also known as gingivectomy, osseous surgery, and flap surgery) is actually a collective term for a series of several different types surgeries aimed at gaining access to the roots of the teeth in order to remove bacteria and tartar (calculus).
At any given time the human mouth may contain dozens of different types of bacteria. The bacteria which is found in plaque, a sticky film which forms on the teeth, produce acids which can damage the tooth surface, and ultimately contribute to periodontal disease.
Periodontal infections cause a chronic inflammatory response in the body which 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 large colonies of bacteria to form in these gum pockets, which can eventually lead to tooth loss. Pocket reduction surgery is an attempt to halt 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:
Reducing bacterial spread – Oral bacteria has been connected to many other serious conditions such as diabetes, heart disease and stroke. Once they have entered the bloodstream, oral bacteria can travel to, and colonize, distant parts of the body. 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 caused by oral bacteria leads the body to destroy bone tissue. As the jawbone becomes affected by periodontal disease, the teeth lose their secure anchor. And when the teeth become too loose, they may require extraction.
Facilitate home care – As the gum pockets become progressively deeper, it becomes incredibly difficult for the patient to effectively clean them. The toothbrush and dental floss used during daily brushing and flossing cannot reach to the bottom of the pockets, increasing the risk of further periodontal infections.
Enhancing the smile – A mouth that is affected by periodontal disease is not attractive to the eye. In fact, attractive smiles are negatively affected 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 either local or general anesthesia, depending on the preference of the patient.
The gums will be gently pulled back from the teeth and bacteria and calculus (tartar) will be removed from all tooth surfaces. 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, much like sanding, 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 after the procedure, this will pass, and there will be a significant reduction in pocket depth and a vast improvement in the condition of the teeth and gums.
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