INFORMATION for Patients about POCKET REDUCTION SURGERY

Your Periodontist has carefully measured the pockets of your teeth with a periodontal probe. The probe is used to measure the distance between the top of gum and the level at which the gum attaches into the roots of your teeth. "Normal", healthy probing depths range from 2-4 mm; abnormal probing depths are 5 mm or deeper. Five (5) mm are used as a "cut-off" mark for several reasons. One reason is that it is not possible for you to clean pockets that are 5mm or deeper. If you are not able to clean these deep pockets, then bacteria (plaque) are able to collect. In fact, the environments in these deep pockets favor the type of bacteria that can cause or favor the progression of bone and tissue loss.

Abnormally deep pockets must be professionally cleaned by our Hygienist; these deep pockets can be difficult to clean and they also require more time for cleaning. If the depths of the pockets can be reduced or even eliminated, then you, your Periodontist and hygienist will have improved and increased access for cleaning. Thereby, the build-up of bacteria and the progression of gum (periodontal) disease can be more readily controlled.

Pocket Reduction Surgery will decrease or reduce the depths of the pockets around your teeth.

After Pocket Reduction Surgery you may notice the following:

- Your teeth may feel and look longer. More tooth and root structure will be visible above the gum line. This is known as recession. If your teeth have crowns (caps), the edges of the crowns, where the crown meets the tooth, may now be visible and sometimes these crown edges have a dark color.

- There may be more space between your teeth, which could make it easier for food to be caught between your teeth, but it will now be easier for you to clean between your teeth.

- Your teeth may be sensitive after the surgery. Sensitivity may be present to hot, cold, sweet and sour. This sensitivity usually fades over time. Desensitizing treatments may become necessary. Even if your teeth are sensitive, it is important for you to maintain good oral hygiene: inadequate cleaning of your teeth will permit plaque to build up around your teeth and this will worsen and prolong the sensitivity.

- You may notice an increase in the looseness (mobility) of your teeth. This is usually a temporary condition. However, if you are performing jaw habits such as grinding or clenching your teeth, the mobility may worsen and continue and you must inform us of such habits.

After Pocket Reduction Surgery, it is important for you to follow the Post-operative Instructions. Good oral hygiene is required for proper healing to occur and healing is usually complete within 4-6 weeks. Despite corrective periodontal surgery, it is very important for you to adhere to the recommended schedule for your Supportive Periodontal Care.

I understand that this surgery has been recommended to decrease pocket depths around my teeth and to improve the relationship of the soft tissue to the underlying supporting bone. I understand that this surgery allows direct visualization of the bone, the root, and the associated pocket thus facilitating removal of bacterial deposits and toxins from the root surface. I understand that some bone recontouring may be required to promote a proper gum-tooth relationship. Following surgery, sensitivity to temperature as well as some tooth mobility is likely, however these are generally of a temporary nature. I appreciate the fact that following healing, the visible portion of the teeth will be longer and that there will be larger spaces between the teeth. However, more of the tooth will be accessible for cleaning and the number and depth of pockets or hiding places for bacteria will be reduced. I further understand that if I have existing crown or bridge work that the margins of these restorations may be exposed by surgery or there may be larger spaces beneath the bridgework. If surgery is being performed on the upper front teeth, there may be some compromise in esthetics because of increased tooth length. Finally, I understand that the success of periodontal surgery is contingent on performing surgery before bone loss is too advanced, excellent oral hygiene, and regular maintenance cleanings following surgery. I understand that dental insurance may not reimburse me the entire surgical fee.