Periodontal Disease Surgery Services
What to do when you’ve got bacteria in your pockets? (Hint: think periodontal surgery services)
Wait. What pockets? Are we talking about dentistry or laundry advice? Dentistry, of course! Still, you can expect some common ideas as we discuss treating gum disease.
Periodontal disease or gum disease is a bacterial infection under the gums. In periodontal disease, bacteria hollow out little houses or pockets under the gums in the spaces between the teeth and in the bone. After that, the bacteria collect food debris and live happy little bacteria lives destroying the gum tissue and the bone that hold your teeth in place.
So when we talk about bacteria in your pockets, we mean that literally…
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. Isn’t that what we’d do if we had disgusting bacteria hoarding food in the pockets 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 in your jean’s pocket have eaten through a corner and are now working their way down the pant leg. Yuck! If this had really happened to your jeans, you’d probably turn the leg inside out to clean it up.
Fortunately, we don’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, we use periodontal surgery services. 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 agressive bacteria to deepen pockets occasionally. When this happens, the teeth nearest the pocket have a higher risk of loss.
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 pocket.
Osseous Surgery: Evicting Bacteria One Neighborhood at a Time
Sometimes, when people with periodontal disease don’t keep on a regular 3-4 month maintenance cleaning schedule, we see pockets appear throughout the mouth. When we look a CT Scan of a mouth like this, 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’ve heard us say that Gums follow Bone. For periodontal patients, that means that their gums dissolve away as the bacteria dissolve their bone. This leaves tooth roots uncovered.
Why are exposed tooth roots a problem?
- First of all, they get cavities more easily.
- Secondly, exposed tooth roots are also painfully temperature sensitive and unattractive.
Whether you want to replace lost gums because they looks bad or because you dread the zinging pain every time you drink a cold coke or a cup of coffee, a gum graft is going to be your best 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.