One of the most common oral health issues among US adults is periodontal (gum) disease. The mild form, gingivitis, and the advanced form, periodontitis, are estimated to affect 70% or more of the population of adults over 30.
Periodontitis is also the leading cause of tooth loss among patients in this demographic. In many cases, patients are able to treat periodontal disease non-surgically in the early stages. However, as the disease advances, it steadily destroys not just the gum tissue but the alveolar bone that provides support to anchor teeth in place.
Gum disease is just one of the oral health concerns that may require periodontal surgery. Oral cancer, traumatic injury, and tooth loss may also make periodontal surgery necessary.
Regardless of the cause, there are a number of treatment options to restore gum health available from San Antonio Oral & Maxillofacial Surgery Associates, but the two most common procedures are regenerative therapy and pocket reduction surgery.
Pocket Depth Reduction Procedures
When gum and bone tissue breaks down due to gum disease and other health concerns, pockets of space form around the natural dental structure. Rather than the alveolar bone and soft tissue fitting snugly against the root of the tooth, there is increasing space between the teeth and gums.
This space makes it possible for plaque and tartar to build up more easily leading to further oral health concerns. Pocket depth reduction involves many of the same steps required for regenerative treatments. We begin by opening the gum tissue to expose underlying areas of concern.
We remove bacteria, plaque, tartar, and infected tissue. Then, the roots are carefully smoothed to limit the chances that bacteria and tartar will be able to build up in the future. Finally, we reattach the gums with sutures. We may also incorporate topical or oral antibiotic therapy to promote oral health during the healing and recovery process.
Contact Dr. Mazock and his San Antonio team to schedule a consultation if you’ve suffered from advanced periodontal disease or other oral health issues that make periodontal surgery necessary. We’re happy to answer questions, make recommendations, and review your treatment options.
The first line of defense against gum disease is a unique type of cleaning called “scaling and root planing.” In this procedure, an ultrasonic cleaning device is used to remove plaque and tartar from your teeth where regular cleaning devices can’t reach: under the gum line, on the tooth, and around the root.
Then the rough surface of the tooth and the root are smoothed out (planed). This provides a healthy, clean surface that makes it easier for the gum tissue to reattach to the tooth.
If you address your gum disease before it becomes severe, scaling and root planing may be the only treatment you need. However, as with any dental procedure, after-care is vital.
In order to keep your teeth in good shape and resist future occurrences of gum disease, you must brush and floss daily, eat a healthy diet, avoid tobacco use, and have regular dental checkups. Even after a successful scaling and root planing, if you don’t attend to your teeth properly, it’s quite likely that you’ll develop gum disease again.
Surgical Treatment Options
If the tissue or bone surrounding your teeth is too damaged to be repaired with non-surgical treatment, several surgical procedures are available to prevent severe damage and to restore a healthy smile. We will recommend the procedure that is best suited to the condition of your teeth and gums.
The following is a list of common types of periodontal surgery:
Pocket Depth Reduction
In a healthy mouth, the teeth are firmly surrounded by gum tissue and securely supported by the bones of the jaw. Periodontal disease damages these tissues and bones, leaving open spaces around the teeth that we call pockets. The larger these pockets are, the easier it is for bacteria to collect inside them, leading to more and more damage over time. Eventually, the supportive structure degrades to the point where the tooth either falls out or needs to be removed.
During pocket reduction procedures (also known as “flap surgery”), we fold back the gum tissue and remove the bacteria hiding underneath, as well as the hardened plaque and tartar that have collected. We may also remove any tissue that is too damaged to survive. We then sew the healthy tissue back into place. Now that the tooth and root are free of bacteria, plaque, and tartar, and the pockets have been reduced, the gums can reattach to the teeth.
When the bone and tissue supporting the teeth have been lost due to severe gum disease, we can restore these areas with a regeneration procedure. During this process, we begin by folding back the gum tissue and removing the bacteria, plaque, and tartar. Depending on your situation, we may then perform a bone graft to stimulate new bone growth, or apply a special kind of protein that stimulates tissue growth to repair the areas that have been destroyed by the disease.
A frequent symptom of gum disease is gum recession (also called gingival recession). As the gums recede, more of the roots are revealed. This can make teeth appear longer and can also create sensitivity to hot or cold liquids or food. It also exposes the tooth to increased damage from gum disease, as bacteria, plaque, and tartar attack the surface of the tooth and the root.
During a soft-tissue graft, tissue from the top of your mouth or another source is sewed to the gum area, to cover the roots and restore the gum line to its original, healthy location. This procedure can also be performed for cosmetic reasons.