Pocket reduction surgery (also known as 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).

The human mouth contains hundreds of different types of bacteria at any given time. Certain bacteria cause a chronic inflammatory response in the body that literally destroys bone and gum tissues. As periodontal disease progresses, deeper pockets form and between the gums and teeth as the tissue continues to be destroyed.

Periodontal disease is a progressive condition which, if left untreated, causes loss of soft tissue, bone, and the attachment between the teeth and jawbone, and can eventually lead to tooth loss. Pocket reduction surgery alleviates the destructive cycle by completely debriding (cleaning) the root surfaces under the gum line and reducing the depth of the bacteria-harboring pockets.


Reasons for 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:

  • Decreasing pocket depths – Periodontal disease results in deeper pocketing in between the gingiva and teeth and defects in the supporting jawbone. Traditional surgery techniques aim to correct defects in the bone and reduce pocketing to produce more stable, healthy tissue, which is easier for the patient to clean at home and easier to clean during dental appointments.
  • Reducing inflammation – Swelling, redness, and bleeding are signs of gingival inflammation. Removing irritants causing this inflammation is an important component of periodontal surgery.
  • Facilitating attachment between soft tissue and teeth – Healing following periodontal surgery will allow for the soft tissue to reattach to teeth, further reducing pocketing and improving periodontal health and hygiene efforts.
  • Facilitating home care – As the gum pockets become progressively deeper, they become incredibly difficult to clean by the patient. The toothbrush and dental floss cannot reach to the bottom of the pockets, increasing the risk of further periodontal infections. By correcting the anatomic deficiencies in soft tissue and bone resulting from periodontal disease, your ability to clean your teeth is improved, minimizing the potential for disease to progress.


What does pocket reduction surgery involve?

The gingival tissue will be gently separated from the teeth by an incision made between the tooth and gum tissue. Plaque and calculus (tartar) will be eliminated with scaling and root planning, and re-contouring of the gum tissue and bone is done with many of the same instruments commonly used for dental fillings and crowns, as well as a variety of specially designed surgical instruments. Finally, the gingival tissue is sutured (stitched) back in place. Following surgery, some discomfort may be expected, although the majority of surgery patients report minimal need for strong pain medications following surgery. You may experience temporary increased sensitivity to hot and cold liquids following periodontal surgery, which should return to normal a few weeks after surgery. Additionally, teeth may feel more “loose” or mobile after surgery, but stability can be expected to return to pre-treatment levels as the soft tissue heals. Pain and discomfort generally subside within a few days to about one week. Many patients in our practice report minimal discomfort after surgery, and for the first week, minimal impact on the ability to go to work or school, or participate in normal activities as soon as one day after treatment. Every patient is unique, and their experience may vary. Be sure that Dr. Knochel is aware of your normal activities, such as distance running, cycling, weight training, scuba diving, parachuting, or other activity that our treatments may impact over the immediate post-operative period.

You can contact our team today to learn more about pocket reduction surgery in Tucson, Arizona, and to make an appointment with Dr. Knochel.