While it may sound unappealing, reduction of pathological pocketing through the procedure known as gingivectomy is an effective means of treating a condition commonly encountered when you are diagnosed with periodontal disease. Often, when you do suffer from periodontal disease, you will exhibit some loss of jawbone around your teeth. This loss of jawbone will leave empty spaces beneath your gums. These spaces below your gums are called pockets. If your pockets become too deep to clean out with a toothbrush and floss, they are referred to as being pathological or indicative of disease.
Pathological pockets, because they can not be efficiently cleansed when you brush and floss, trap food inside them that the bacteria in your mouth which cause periodontal disease feed on. Anyone who has any of their natural teeth has a vast number and variety of bacteria in their mouths. Your body defends itself against these bacteria by means of inflammation. Unfortunately, many patients’ bodies respond with so much inflammation that their own jawbone is destroyed in the process. When you develop this stage of periodontal disease, it is called periodontitis. To treat periodontitis successfully, it is essential to reduce the depth of your pathological pocketing. Otherwise the causative bacteria will continue to have a place to flourish in your mouth and your body’s inflammatory response against them will persist in diminishing the jawbone around your teeth. If this loss of jawbone progresses unchecked, your teeth will eventually loosen and then be lost.
One way of reducing these pocket depths is through deep cleanings (technically known as quadrant scaling and root planing) done with Novocain to remove all build-up under your gums. This phase of treatment, however, has only a limited potential to lessen deep pocketing. Any pockets that remain pathological after quadrant scaling and root planing has been completed for you will need to be further reduced to a level that you can reasonably be expected to keep clean by brushing and flossing. Gingivectomy is a simple way of accomplishing this needed further reduction.
An eye tooth with pathological pocketing at it (arrow) has some gum pared away from it to
reduce the pocket's depth and this "gingivectomy" produces healthier gums.
Gingivectomy is basically the process whereby excess gum tissue over your pathological pockets is trimmed away to decrease the extent of those pockets. Dr. McArdle accomplishes this using a scalpel or electrosurgery unit after first profoundly numbing the gum tissue to be removed. He will measure your pocket depths before and after the procedure with a periodontal probe to confirm that sufficient tissue has been removed to ensure cleansability with a brush and floss. Often times some of your tooth’s root surface will be exposed during this process. Because newly exposed root surface can be quite temperature sensitive and also has an increased risk of tooth decay, a fluoride treatment will be perf ormed for you after the gingivectomy to lower the chances of these complications occurring. Regrettably, some instances of pathological pocketing cannot be remedied using gingivectomy alone when the degree of damage to the underlying bone is too extensive. In these cases, Dr. McArdle will refer you to a periodontist (gum specialist) for more comprehensive surgical care in those circumstances.
IF YOU HAVE ANY QUESTIONS ABOUT
GINIVECTOMY, PLEASE ASK DR. MCARDLE.