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Andrew Sullivan, DDS & Joel Pascuzzi, DMD, LLC
Specializing in Periodontics
Oral Medicine and Implant Surgery
Call: (201) 437-9098

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) and reduce pocket depths.

The human mouth contains vast amounts of different bacteria at any given time.  The bacteria found in plaque (the sticky substance on teeth) produce endotoxins and other substances that 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 massive bacteria colonization in gum pockets and can eventually cause teeth to fall out because the disease destroys the supporting jawbone.  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

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 the body to destroy supporting bone tissue.  As the jawbone becomes affected by periodontal disease, the teeth lose their rigid anchor and become mobile.  When the teeth become too loose, they may require extraction.

  • Facilitate home care – As the gum pockets become progressively deeper, they become incredibly difficult for the patient to clean.  The toothbrush and dental floss cannot reach 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 inflammed 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 periodontist will perform thorough clinical and X-ray examinations ,in order to assess the condition of the teeth, gums, and underlying bone. Pocket reduction surgery is performed under a local anesthetic.

The gums will be gently reflected back from the teeth and bacteria and calculus (tartar) will be eliminated.  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 will be performed to ensure that when the gums do heal, they will not reattach to rough or uneven surfaces, but to a smooth surface.

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 following the procedure, there will be a significant reduction in pocket depth and a vast improvement in the condition of the teeth and gums, but the teeth will appear longer depending upon the amount of bone destruction from the disease.

If you have any questions about pocket reduction surgery or treatment for periodontal disease, please contact our practice.