Gingivectomy - Pocket Depth Reduction

In a healthy disease free mouth your bone and gum tissue should fit firmly around the teeth. If you have periodontal disease (gum disease), this will result in the inflammation and destruction of supporting gum tissues and bone by bacteria, forming pockets or gaps around the teeth.

Coupled with genetic and environmental risk factors for gum disease and poor home care and if regular dental treatment is not sought, these pockets will become deeper and harbour more bacteria. This accumulation of bacteria will lead to further tissue and bone loss and may require the affected tooth or teeth to be extracted.

The Periodontist will measure the depth of pockets in your mouth. Measurements up to 3mm are within the range of healthy gums. Anything over 4mm can be too deep for you to clean effectively at home so a procedure to reduce the pocket depths may be recommended.

 

The Procedure

This procedure is called a Gingivectomy and is carried out under a local anaesthetic. The infected gum tissue is removed and bacterial deposits are scraped away from the root surface, leaving a smoother cleaner surface. Once healing has taken place the gums will firm up against the tooth resulting in decreased pocket depths. Sutures may be used to hold the gums in place (these need to be removed 7-10 days after surgery), or a dressing is placed over the area. This dressing will often fall off after 3-4 days. If it does not, you can remove it yourself or an appointment can be made for removal.

 

Post operative considerations

After surgery, it is important not to clean the surgical area for about 5 days or until the sutures have been removed. Using a mouth wash containing Chlorhexidene (i.e. Savacol, plaquacide, available from chemists), is all that is needed for keeping the area clean during this period. After this initial period of healing, gentle brushing with a soft toothbrush can be resumed. You will be given instructions on the use of an interproximal brush (a small bottle brush shaped brush to use between the treated teeth

You may experience some post-operative sensitivity to hot or cold drinks or food. This is only transient and can be minimized by the use of desensitizing agents (Sensodyne tooth paste after surgery)

 

Benefits of Treatment

Reducing the pockets depths and removing the bacteria will prevent further damage caused by periodontal disease. A combination of daily home care and professional maintenance (a scale and clean every four to six months) are necessary to improve your chances of maintaining healthy teeth and gums.

 

Figures below show the removal of excess or infected gum and the
periodontal dressing in place at completion of surgery.