Wednesday, January 6, 2016

How Healing Periodontal Pocket Involves

By Douglas Hamilton


Complete and sufficient treatment of periodontal pockets and disease requires commitment from the patient. There are two primary goals involved in the treatment process. Reducing and/or removing the formed bacterial colonies underneath gums is the first goal of treatment. The other primary goal is reducing vulnerability of the patient by eradicating risk factors such as smoking. Both primary goals are achieved from home if the pockets are still in their infancy stages. However, professional intervention is needed in healing periodontal pocket if the disease is already advanced.

In early stages of the disease, only the gum is affected, while the bone remains largely unaltered. The depth of pockets is very shallow, only extending to 5 millimeters at most. Scaling and root planing, also referred to as deep cleanings is the most commonly used process in this case. The process aims at removing all formed calculus in the gums.

Sometimes pockets may be noticed to be tender when the surgeon is doing scaling and root planing. In such a case, the gums need to be numbed to avoid pain. After the process, there should be no pain felt. To avoid future reoccurrences, it is upon the patient to do thorough brushing and flossing every day so that plaque does not build up again. The gums usually snug back up on the root as they heal.

Bone tissue is usually lost in moderate and advanced cases of pockets. Moderate pockets are slightly deeper and can reach seven millimeters in depth. The great depth involved makes cleaning the bottom of the pocket difficult because it cannot be accessed using scaling and root planing method. Therefore, flap surgery is the only preferable option. Flap surgery enables sufficient access to calculus which allows thorough cleaning to be done.

In flap surgery, an incision is made between the tooth and gum. The surgeon then peels the gum back from the neck of the tooth involved after making the incision. The peeling gives sufficient access for cleaning deep-seated calculus and debriding the tooth. After finishing the surgery, all altered tissue is returned to initial position. As such, cosmetic change is minimized.

One problem with flap surgery is that the gum never reconnects to the tooth after the incision. That way, pockets continue to persist, even though the infection is removed. To avoid future reoccurrence of this problem, the patient has to continuously go for frequent hygienist cleanings to control the infection. Similarly, the periodontist can reposition gums so as to eliminate pockets during the surgery.

There are also cases where the pockets may be too advanced or too deep or where surgery is simply just not an option. Very deep pockets are usually hard to treat fully and there will always be residual pockets left. In such cases, the only applicable solution is to try and minimize the pockets and chances of reoccurrence.

Periodontal disease and pockets have been considered to be chronic diseases that are incapable of being eliminated completely or cured. Patients continue to be susceptible after treatment while causes of infection and plaque are ever present in the mouth. The best solution is daily vigilance in dental hygiene.




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