Your bone and gum tissue should fit snugly around your teeth like a turtleneck. When you have periodontal disease, this supporting tissue and bone is destroyed, forming “pockets” around the teeth. Over time, these pockets become deeper, providing a larger space for bacteria to thrive and wreak havoc.
As bacteria accumulate (called tartar, or calculus) and advance under the gum tissue in these deep pockets, additional bone and tissue loss follow. Eventually, if too much bone is lost, the teeth become mobile because there is no bone remaining to hold them in place. This is periodontal disease and if it continues, teeth will be lost as well as supporting bone. (See “Why do I care about bone loss?”).
Flap surgery is sometimes performed to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for you, your dentist, and your hygienist to keep the area clean. This common surgery involves reflecting the gum tissue and removing the tartar. The gums are then gently replaced so that the tissue fits snugly around the tooth again.
A pocket reduction procedure is recommended if daily at-home oral hygiene and a professional care routine cannot effectively reach these deep pockets.
In some cases, irregular surfaces of the damaged bone are smoothed to limit areas where disease-causing bacteria can hide. This allows the gum tissue to better reattach to healthy bone. In other cases, additional bone may be placed, or grafted, to prevent further infection by bacteria, and give the teeth back some support.