Pocket reduction surgery (also known as osseous surgery) is a term for surgery aimed at gaining access to roots of the teeth in order to remove bacteria and tartar (calculus).
The human mouth contains hundreds of different bacterial species at any given time. Deeper pockets will harbor more aggressive bacterial types which will produce toxins and cause a chronic inflammatory response in the body that literally destroys bone and gum tissues once they invade the sub gingival area (below the gum line). This process is referred to as periodontitis. Deep pockets form and deepen between the gums and teeth as the tissue continues to be destroyed, and this creates a more favorable environment for more aggressive bacteria and the vicious cycle of destruction continues.
Periodontal disease is a progressive condition which, if left untreated, causes massive bacteria colonization in gums pockets that can eventually lead to teeth falling out. Pocket reduction surgery is an attempt to alleviate this destructive cycle, and reduce 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. 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 to 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 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 teeth, gums and underlying bone. Pocket reduction surgery (osseous surgery) is used to repair mild to moderate bone damage caused by periodontitis. The purpose of this surgical procedure is to contour the bony structure around the tooth and place the gums as close to the bone line. During this procedure, our surgeons reshape the bone to get rid of the damaged, uneven areas. This 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 planning from the surface 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 planning procedure will be performed to ensure that when the gums do heal, they will not reattach to rough or uneven surfaces. 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.
The area treated will then heal for four to six months. After this healing period, your periodontist will evaluate your healing and decide an appropriate periodontal maintenance interval with the dental hygienist.