Periodontal Disease Surgical Treatment
What to do when you’ve got bacteria in your pockets? Read more about our periodontal surgery services.
Wait, did we just switch from dentistry to laundry advice? No, we didn’t. But expect some common ideas as we discuss treating gum disease.
Periodontal disease or gum disease is a bacterial infection under the gums. If you were to peak behind the gums, you’d see the top of the tooth roots, the spaces between the teeth and the jaw bone. Once bacteria take root under the gums, they hollow out little houses or pockets under the gums in the spaces between the teeth and in the bone. In these pockets, the bacteria collect food debris and live happy little bacteria lives destroying the gum tissue and the bone that hold teeth in place.
So when we talk about bacteria in your pockets, we mean that literally… you probably just thought we meant different pockets.
So what do we do about those pesky, gum disease causing bacteria in our pockets?
The same thing we’d do if we have bacteria in our jeans’ pockets – clean them out! Scrape out the gunk. Pressure-wash if necessary. Disinfect. Lather on antibacterial anything. Isn’t that what we’d do if we have disgusting bacteria hoarding food in the pocket of our favorite jeans?
That’s what we do in the mouth too. We clean out the pockets using tinier cleaning tools, more precision and no laundry detergent. This first cleaning process is called root planing and scaling. Our hygienist uses her instruments to plane and scale the roots of teeth, ie clean the bacteria out from under the gums. This allows the body’s own healing processes to do their job and restore a healthy balance.
If Root Planing and Scaling is so effective, why do you have a page about periodontal surgery services?
So glad you asked! Lets stay with the jeans analogy for a minute. Imagine that the bacteria have eaten through the corner of the pocket and are now working their way down the pant leg. Now, of course, when it comes to jeans, we’d clean the pockets and then simply turn the leg inside out and keep cleaning. But, we can’t turn your gums inside out to reach the depths of deep infection pockets. In order to clean pockets extending more than 6mm below the gums, periodontal surgery services are necessary. Surgery is the only way to successfully remove bacteria from deep pockets.
Pocket Reduction Surgery: Evicting Bacteria Infection One Pocket at a Time
After root planing and scaling, patients frequently see their pocket depths return to a healthy normal range. This means 2-3 mm readings with some 4 mm’s. However, even on a strict maintenance cleaning schedule, it is still possible for the bacteria to deepen pockets occasionally. When this happens, the teeth nearest the pocket are at high risk for being lost. To save the teeth, it’s necessary to get that pocket back to normal. Since we can’t turn the gums inside out, we have to open them surgically to clean and repair the area and the pocket.
Osseous Surgery: Evicting Bacteria One Neighborhood at a Time
Sometimes, when people have been neglecting their teeth and haven’t kept up the three to four month maintenance schedule, we’ll see pockets pop up throughout the mouth and when we look a CT Scan of the mouth, we see highly uneven bone levels. In these cases, pockets are developing deep and fast because the bone loss creates space for extra bacteria. Removing the bacteria requires leveling the bone so that the gums attach evenly to the teeth. This surgery is similar to pocket reduction, but on a larger scale. The gums have to be opened, everything has to be cleaned and then the bone is recontoured, sometimes with the help of grafting.
Gum Grafting: Replacing Lost Gums
If you read our missing teeth pages or watched our video implant seminar, then you may have already heard us say that Gums follow bone. For patients with gum disease (periodontal disease), this means that as their disease dissolves bone, the gums dissolve away as well. This eventually leaves tooth roots exposed.
Exposed tooth roots are a problem. First of all, they get infected and get cavities more easily. Exposed tooth roots are also painfully temperature sensitive and unattractive. Whether you’re hoping to replace your lost gums because you think it looks bad or because you can’t stand the zinging shock every time you drink a cold coke or a cup of coffee, a gum graft is going to be your go-to solution.
Like other periodontal surgery services, (perio surgeries) it’s always necessary to remove and treat infection first and to build up bone as necessary. After laying a firm foundation, a gum graft is completed, typically using a small amount of tissue from the roof of your mouth.