Pocket reduction surgery is a procedure that allows visible access to treat gum disease by removing bacteria trapped in a “pocket” between your teeth and gums. Generally, pocket reduction surgery is performed on patients with advanced or serious gum disease that can’t be effectively treated with other periodontal procedures, like scaling. This type of surgery may also be used in combination with other treatments, such as gum or bone grafting, if there is advanced periodontal breakdown involving significant gum and/or bone involvement. Most if not all patients manage post procedure discomfort with over the counter pain medications.
Pocket reduction surgery is typically a good option for patients who suffer from progressing or advanced gum disease that does not respond to or cannot be treated by other periodontal procedures. Patients that undergo pocket reduction surgery typically have large or deep pockets around one or more affected teeth. These pockets make it easier for plaque and bacteria to pool between the gums and teeth, which may lead to tooth decay, bone damage, and tooth loss.
If you suffer from periodontal disease, your doctor can determine if pocket reduction surgery is right for you or if there are other treatment options available.
Before scheduling a pocket reduction surgery, you’ll meet with your periodontist for an initial consultation. Once you and your periodontist determine the best course of treatment, you’ll schedule the procedure. Generally, this type of surgery can be completed in a single visit, though your doctor will determine the best course of action for your specific condition.
On the day of surgery, you’ll receive local anesthesia to keep you comfortable during the procedure. Once you are prepped for surgery, your periodontist will gently separate the gum tissue from your teeth, pulling it back to reveal the root of your tooth. At that time, they will remove any infected tissue, tartar or plaque buildup present below your natural gum line as well as evaluate the health of the tooth root and surrounding bone. Ultrasonic instrumentation, which utilizes instruments that spray water, vibrate and aid in removal of infected tissues or reshaping of irregular root or bone shapes, is commonly used.
Depending on the severity of your condition, your doctor may also remove any diseased gum tissue or smooth and reshape affected bone. Doing so will aid in the healing process and in combination with good oral hygiene/overall health will work to prevent bacteria and tartar from pooling under the gums in the future. After that’s complete, the doctor may apply an antimicrobial solution to kill any remaining bacteria and will place stitches, often dissolvable, to close the gap between your teeth and gums.
Pocket reduction surgery and scaling and root planing can treat periodontal disease, but the best course of treatment depends on a patient’s unique circumstance, including the rate of progression and any existing or potential damage to the gum, teeth, and jaw bone.
Scaling and root planing is a non-surgical option that can treat early-stage or mild periodontal disease. Much like pocket reduction surgery, the end goal is to prevent the accumulation of bacteria and plaque and reduce or eliminate pockets that form between a patient’s gums and teeth. However, the key difference is that scaling and root planing provides less visibility for identification, removal, and treatment of disease associated issues.
During the procedure, the doctor will use dental tools including ultrasonic instrumentation previously mentioned, to scrape away plaque buildup, a process also known as scaling. Next, they will complete the root planing or reshaping part of the procedure. The periodontist will identify irregular root surfaces and smooth them to make it easier for the gums to re-adhere to the teeth. Scaling and root planing is often completed over multiple visits, each focusing on a specific section of the teeth and gums.
Scaling and root planing is a routine part of surgical pocket reduction procedures – plaque and tarter is scraped away and roots smoothed – but when performed alone, surgical efforts are unable to be used to roll back, remove, or otherwise treat gums and bone.
Scaling and root planing is less invasive and may be a better option for individuals without moderate to severe periodontal disease. However, some early studies indicate that pocket reduction surgery is more effective in reducing pocket depth and prohibiting disease progression.
The use of laser therapy to treat gum disease is an emerging science to date. According to the American Academy of Periodontology consensus statement on the use of laser therapy to treat gum disease (provide link from www.perio.org or cite here), there are no significant advantages to the use of lasers over traditional therapies in the treatment of gum disease in regards to reducing post procedure discomfort or increasing long term treatment success.
An experienced periodontist can help you make the best treatment decisions for your oral health.
The primary goal of pocket reduction surgery is to allow visible access to evaluate and treat gum disease related issues and to help patients who are experiencing moderate to advanced periodontal disease. After the surgery is complete and the gums are healed, the pockets between the teeth are significantly decreased or eliminated. In combination with good oral hygiene and overall health, bacteria and plaque are less likely to pool beneath the gum line and cause pain, swelling, gum or bone destruction, tooth decay or tooth loss.
Your dentist plays an invaluable role in your oral health, but if you’re considering pocket reduction surgery to combat advancing periodontal disease, it’s a good idea to consult an experienced periodontist. Periodontists specialize in gum disease and are more equipped to identify and treat moderate to serious periodontal diseases that can affect your teeth, gums, surrounding soft tissue, and jaw bone. They can also provide the care necessary to treat chronic gum disease, prevent existing issues from progressing, and help maintain your overall oral health for a lifetime.
Dr. Bonacci, D.M.D. is an American Board of Periodontology Certified periodontal and dental implant specialist who can help you obtain the pain-free smile you deserve. His careful and science-based approach to periodontal health ensures patients receive the care they need to treat existing periodontal concerns and maintain their oral health well after. Contact Dr. Bonacci today to set up your initial consultation.