Periodontics
Pocket Reduction Surgery in Los Angeles
When the pockets are too deep to clean from above.
Deep cleaning reaches a great deal, and past a certain depth it stops being enough. Flap surgery gives the access. Smile LA Downtown Modern Dentistry uses it where the pockets have gone beyond what scaling can resolve.
The access
What the surgery does
Scaling and root planing reaches a great deal, and past a certain depth it stops being enough — not because the technique fails but because the instrument is working blind through a narrow opening. Lifting the gum tissue solves that. The root surfaces and the structures around them can then be cleaned thoroughly and under direct vision, and the tissue is re-contoured before it is closed so that it heals back against the tooth with a shallower pocket than it had. That last part is what makes the result last. A pocket that has been cleaned but left deep will simply refill; one that has been made shallower is a pocket you and we can actually keep clean afterwards.
- Access The reason for the procedure. A deep pocket cannot be cleaned reliably through its opening.
- Thorough cleaning Of the root surfaces and the structures around them.
- Re-contouring So the tissue heals against the tooth with a shallower pocket than before — which is what makes it maintainable afterwards.
Where it sits
Where it sits in the treatment sequence
Usually after scaling and root planing, when the pockets have not responded enough. Where bone has been lost around the tooth, bone grafting or guided tissue regeneration may be done at the same time — the point of getting access is to do everything the site needs while it is open.
Afterwards, the result is held by periodontal maintenance.
Why it is worth doing
Advanced periodontitis affects the bone supporting your teeth and, if left untreated, results in tooth loss. Our methods aim to preserve affected teeth wherever possible, and this is one of them. See gum disease.
The short answer
Pocket reduction surgery, also called flap surgery, is a periodontal procedure that treats pockets between the gums and teeth that are too deep to clean from above. The gum tissue is lifted so the root surfaces and surrounding structures can be cleaned thoroughly under direct vision, then re-contoured before it is closed. The tissue heals against the tooth with a shallower pocket than before, which makes the area maintainable and helps preserve teeth affected by advanced periodontitis.
Pocket Reduction Surgery FAQ
- What is flap surgery?
- Flap surgery is a procedure that lifts the gum tissue so the structures underneath can be cleaned thoroughly and the gums re-contoured, which reduces pocket depths. Lifting the tissue lets the root surfaces be cleaned under direct vision rather than through a narrow opening. The tissue is re-contoured before it is closed so that it heals against the tooth with a shallower pocket than it had.
- Why can a deep clean not do it?
- Past a certain depth, a pocket cannot be cleaned reliably through its opening, so the surgery is about access. Scaling and root planing reaches a great deal, but in a deep pocket the instrument is working blind through a narrow opening. A pocket that has been cleaned but left deep will simply refill, while one made shallower can actually be kept clean afterward.
- Will I need it if I have gum disease?
- Not necessarily. It is used where pockets are deep, usually after scaling and root planing has not reduced them enough. Whether it is needed depends on how your pockets respond to that first stage of treatment.
- Is anything else done at the same time?
- Often, yes. Where bone has been lost around the tooth, bone grafting or guided tissue regeneration may be carried out while the site is accessible. The point of getting access is to do everything the site needs while it is open. Afterward, the result is held by periodontal maintenance.
