Periodontal Pocket Reduction
The supporting tissues (bone and gum) around your teeth should fit snugly around your teeth like a turtleneck around your neck. When you have periodontal disease, these supporting tissues around your teeth are destroyed, forming “pockets” around the teeth. The gum collar becomes loose and starts to separate from the teeth making the pocket spaces longer where bacteria can be trapped. The pockets start out in the gum tissue and the bacteria can burrow deeper and destroy the bone underneath. This allows the gum to further separate from the teeth and the pockets become deeper still. If enough bone around the teeth is destroyed the teeth will become loose and eventually will be lost or need to be extracted.
A periodontal pocket reduction procedure may be recommended if deep cleanings do not resolve the pocket depths around the teeth. The goal of the this procedure is to make the “turtle neck” or pocket around the teeth smaller so that every time you clean your teeth, you do a better job (remove more bacteria) and every time you get your teeth cleaned at the dental office, they can do a better job as well (remove more bacteria). Typically, when you brush and floss your teeth, you can only reach 3 to 4 mm under the gum edge and your hygienist can only reach 4 to 5 mm with available cleaning instruments. Any pocket of 6 mm or more will have residual bacteria residing within it and can cause more breakdown of the gum and bone tissue around your teeth.
During a pocket reduction procedure, the periodontist folds back the gum tissues and removes the disease-causing bacteria and any dead or diseased tissue and then secures the remaining healthy tissues into place at a healthier level around the teeth. The periodontist can reach areas that are not accessible to you at home or the dental hygienist. In some cases, irregular and diseased surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone. This procedure is completed using local anesthetic (regular freezing) and is done every day at a periodontal office. You can drive afterward and most people go back to work the following day.