Bone pocket of the tooth. Why do gum pockets appear and how is treatment carried out? Treating gum pockets at home

From this article you will learn:

surgical methods for treating periodontitis – reviews from dentists,
flap surgery, curettage of periodontal pockets – price 2020.

The article was written by a dental surgeon with more than 19 years of experience.

Why do you need to do curettage?

To understand why you need to do curettage or flap surgery, you need to delve a little into the details of the development and course of periodontitis. Periodontitis develops against the background of poor oral hygiene, the presence of a large amount of soft microbial plaque and hard dental deposits. The latter trigger an inflammatory process in the gums, which first manifests itself as bleeding when brushing teeth, pain and swelling of the gums, and later these symptoms are also accompanied by tooth mobility, their displacement, suppuration from under the gums, etc.

So, in the gingival sulcus it turns into hard tartar, which is very tightly attached to the surface of the tooth neck (Fig. 1-2). Tartar microorganisms produce toxins that trigger inflammation in the gums.

During inflammation, the following occurs:

Bone atrophy around the tooth –
those. The bone begins to gradually dissolve. Compare the level of bone tissue in relation to the roots of the teeth in a person without concomitant periodontitis (X-ray 3a) and in a person with moderate periodontitis (X-ray 3b). The distance between “a” and “b” is the level of complete destruction of inert tissue, which is evident from the absence of bone beams in this area.
Moreover, it should be noted that bone tissue does not simply disappear without a trace, but is replaced by the so-called granulation tissue, which contains a large number of microbial cells, cells that resorb bone (osteoclasts), etc. The appearance of granulation tissue contributes to even more rapid subsequent bone destruction.

Formation of periodontal pockets –
under the influence of inflammation caused by dental plaque, destruction occurs not only of the bone, but also of the periodontal attachment of the tooth to the bone (Periodontium). Periodontium is the microligaments between the tooth root and the bone, with the help of which the tooth is securely attached to the bone tissue.
In Fig. 4 you can see the differences between diseases such as Gingivitis (in which there is no bone destruction, no periodontal pockets) and Periodontitis (in which there is active bone destruction and the formation of periodontal pockets). In periodontitis, the cumulative destruction of bone tissue and periodontal ligaments leads to the formation of periodontal pockets (Fig. 4).
A periodontal pocket is an area whose width and depth has been destroyed by bone tissue, there is no attachment of the gums to the surface of the tooth root, and the defect itself is filled with granulation tissue, dental deposits, and pus. Patients often call a periodontal pocket a dental pocket, a gingival pocket, a pocket in the gum. Such gum pockets can be identified by probing with special periodontal probes or x-rays.
In Figures 4-6 you can see the clinical situation of one patient regarding a deep periodontal pocket in the interdental space between the canine and premolar:
→ in Fig. 4 you can see that the periodontal probe penetrates under the gum by 5-6 mm, with the norm being 1-2 mm.
→ Fig. 5 shows an x-ray of this tooth. It shows that there is a bone defect. Destruction of bone tissue appears radiographically as darkening (indicated by black arrows).
→ Figure 6 shows the appearance of the bone defect during the process of gingival detachment. The granulation tissue from the periodontal pocket has already been practically removed and hard tartar is clearly visible on the surface of the root, which was the cause of bone destruction and the formation of a periodontal pocket.

Surgical treatment of periodontal diseases, in contrast to therapeutic treatment, allows:

So, when deep periodontal pockets of 3-4 mm were formed, partial replacement of bone tissue with granulation tissue occurred - the process essentially becomes irreversible, despite any local and general anti-inflammatory therapy, treatment with antibiotics, laser, removal of dental plaque, etc. d. Why?

Firstly– it is almost impossible to completely remove dental plaque from deep periodontal pockets. The fact is that the doctor inserts the ultrasonic attachment under the gum “blindly”, i.e. he makes movements without seeing what exactly is happening in the periodontal pockets. Therefore, as a rule, a large amount of subgingival deposits remains, which continue to have a destructive effect.
In addition, removing subgingival dental plaque is an extremely painstaking, lengthy task, and the patient will never know if there is anything left there. Therefore, in the context of a paid commercial procedure, spending precious time looking for small subgingival pebbles is not very profitable.
Secondly– if deep periodontal pockets have formed, then in them, even after removal of dental plaque and anti-inflammatory therapy, conditions are created for the development of infection and further progression of periodontitis.
Therefore, the only method of treating periodontitis that guarantees improvement is the one that will eliminate:
→ periodontal pockets,
→ remove all subgingival dental plaque,
→ remove granulation tissue that has replaced the resorbed bone.
This can only be done using surgical methods for treating periodontitis.

Surgical methods for treating periodontal diseases

There are several methods of surgical intervention for periodontitis:

curettage of periodontal pockets – “open” and “closed”.
patchwork operations.

1. Closed curettage of periodontal pockets –

Purpose of the operation: to remove granulations from periodontal pockets and subgingival dental deposits. Disadvantages of the technique: curettage is carried out blindly, there is no visual overview of the surface of the roots, periodontal pockets, which is why both granulations and dental deposits remain en masse in their places.

Closed curettage can be more or less effective only with shallow periodontal pockets up to 3 mm, i.e. the mildest degree of periodontitis. With moderate and severe periodontitis, closed curettage (due to a temporary reduction in the mass of granulations) can only temporarily improve the condition of the gums, but this phenomenon will only be short-term, and periodontitis will definitely progress further. In Fig. 7 (a, b) you can see the tools with which closed curettage is performed.

This type of curettage is popular in dental clinics that do not have an experienced periodontist surgeon, and therefore the operation is performed by an ordinary general dentist or even a periodontist. These specialists have neither the skills nor experience in performing complex surgical interventions in the oral cavity, which include open curettage and flap operations.

2. Open curettage of periodontal pockets –

Before starting the operation, careful preparation must be carried out -

After removal of granulation tissue, antiseptic treatment of the surface of tooth roots and bone tissue, synthetic bone is “planted” into deep bone pockets (Fig. 10). This is necessary for bone tissue restoration. Naturally, it is impossible to restore it in full, but it is quite possible to reduce the bone pockets.

In Fig. 11 (a, b) you can see x-rays BEFORE and 3 months AFTER the operation. On an x-ray taken several months after surgery (Fig. 11b), the increase in bone mass in the periodontal pocket can be easily seen.

Suturing. Sutures are placed in the area of the interdental papillae (Fig. 12). At the end of the operation, a gum bandage is also applied, which will protect the operation area and promote speedy healing. Sutures are removed 10 days after surgery.

3. Flap surgery for periodontitis –

The purpose of the operation: to remove all subgingival dental plaque, remove inflammatory granulation tissue from under the gums, eliminate periodontal pockets, stimulate the restoration of bone tissue by “replanting” synthetic bone tissue. Those. exactly the same as with Open curettage. The difference is that the incision during flap surgery is made 1-1.5 mm from the edge of the gum. This thin 1.5 mm strip of gum is further removed. This is done because with prolonged inflammation, the marginal gum is modified in such a way that it can no longer fit tightly to the surface of the teeth, and therefore it must be removed.

Since the flaps of the mucous membrane are mobile, at the end of the operation they are pulled towards the necks of the teeth, which in most cases helps prevent the “drooping” of the gums. There are techniques for flap operations not only for generalized periodontitis, but also to, for example, cover gum recession.

Curettage of periodontal pockets: price 2020

How much does curettage of periodontal pockets cost? The price for 2020 in Moscow will depend on the type of technique, as well as the cost of the materials used (primarily bone material).

closed curettage of periodontal pockets - the price for 1 tooth will be from 500 rubles.
open curettage of pockets – the price for 1 tooth will be from 1500 rubles.
patchwork operation - price for 1 tooth from 2,500 rubles, and a segment of 6-8 teeth - from 10,000 rubles.

This cost, as a rule, does not include the price of bone material. Can be used as high-quality expensive bone material Bio-Oss (Switzerland) - 6500 rubles. per pack of 0.5 g, and Russian drugs such as Kolapol and Kollapan, which cost several times less.

Curettage, patchwork surgery: reviews

I will briefly summarize patient reviews after different types of interventions.

Closed curettage –
It should be done only in the initial form of periodontitis, when there are only shallow periodontal pockets up to 2-3 mm. For moderate and severe periodontitis, in the presence of deep periodontal pockets, it is absolutely ineffective. However, the operation takes little time, is easily tolerated, does not require highly qualified doctors (usually dentists who do not have the skills for major operations like to do it), and is relatively inexpensive. This is the only plus.

Open curettage and flap operations –
Pros: These are the only methods that allow you to eliminate periodontal pockets and achieve stabilization of periodontitis, as well as, by replanting bone tissue, reduce the amount of bone tissue atrophy (which can also reduce tooth mobility). Therefore, if you want to chew with your own teeth for as long as possible, then the choice of surgical technique is obvious.

Cons –

Requires a highly qualified doctor and should be performed only by dental surgeons specializing in periodontology.
The operations are expensive: they require not only the payment of a doctor and nurse, but also the purchase of expensive consumables, for example, synthetic bone tissue, expensive suture material (it must be monofilament), etc.
Removal of inflammatory granulation tissue and inflamed gums may be accompanied by “recession” of the gums (i.e., exposure of the roots). The amount of root exposure will directly depend on the initial amount of bone tissue atrophy.
Also, after the operation, the appearance of the gingival papillae temporarily changes; they are flattened and do not occupy the entire space between the teeth. After a few months, the gingival papillae take on their normal shape and the interdental spaces are thus eliminated.
The operation is time-consuming: a segment of 7-8 teeth takes about 2 hours.

Sources:

1. Add. professional,
2. Based on personal experience as a periodontist,
3. National Library of Medicine (USA),
4. American Academy of Periodontology (USA),
5. “Atlas of cosmetic and reconstructive periodontal surgery” (Cohen E.).

A gum pocket is a depression that separates the gum from the tooth. When periodontal tissue becomes diseased, it enlarges, causing food particles to get into the cavity, soft plaque to accumulate, and tartar to be deposited. These unfavorable factors cause inflammation of the gums and, if left untreated, lead to loosening and gradual loss of teeth. You can prevent their loss by seeking medical help in time.

Normally, the pocket in the gum is deepened no more than 3 mm. The small depth of the neck formed from soft tissues does not prevent its self-cleaning. Progressive deepening and inflammation of gum pockets is a characteristic symptom of periodontal disease. The gums between the teeth swell, begin to hurt, and pus may appear from it. The initial stage of the disease is gingivitis. At this stage, it is quite easy to remove inflammatory phenomena - you need to carefully monitor oral hygiene, regularly undergo professional teeth cleaning to remove soft and hard plaque, rinse your mouth with antiseptics and herbal infusions.

Further development of the inflammatory process is accompanied by a significant increase in the number of bacteria. The enzymes they secrete negatively affect periodontal fibers, gradually causing their destruction. At this stage, the gum pockets undergo a number of changes and become periodontal. The activity of the inflammatory process increases, the soft tissues affected by it bleed when touched, and erosions occur on the gums.

The cavity between the tooth and the gum becomes deeper, the connective tissues that ensure the integrity of the dentition are affected by inflammation and weakened.

In the absence of treatment and cleaning of the gum pockets, the process will spread not only to the fibers of the periodontal ligaments, but also to the bone tissue of the jaw.

Reduction of gums leads to gradual exposure of the tooth. Destroyed tissues are not able to secure the root tip in the hole and at some point it falls out.

At the initial stage of the disease, the pockets in the gums are washed with an antibacterial agent once a year. Additionally, daily application of medications to the affected areas and rinsing of the mouth with medicinal compositions are prescribed. For moderate periodontitis, the curettage method is effective; for severe disease, photodynamic, surgical methods and cable splinting are used.

Types of curettage, indications for the procedure

There are open and closed types of curettage. This technique ensures effective removal of tartar, food debris, affected gum tissue and softened tooth cement. To perform closed curettage, a diode laser or ultrasonic scaler is used. This method of treating gum pockets is used in cases where the depth of the cavity surrounding the tooth does not exceed 5 mm. The cavity is cleaned, the tooth root is processed and polished, and the affected tissue is removed. This helps restore the connection between teeth and gums.

Open curettage is a surgical procedure using local anesthesia. During the operation, the tissue in the area of the interdental papillae is dissected, tartar is removed, and the gingival pocket is thoroughly cleaned of deposits. Then a drug is applied that accelerates the growth of the epithelium and suppresses the activity of pathogenic microbes. The tooth root is polished to ensure a tighter fit of the mucous membrane to it and the wound is sutured. The rehabilitation period after the procedure is two weeks, after which patients note positive results - the gums do not bleed, do not hurt, hyperemia and swelling go away, and the depth of the pocket decreases.

Indications for curettage are:

the depth of the pocket of exfoliated gum tissue exceeds 3 mm;
a large amount of solid deposits has accumulated;
the gums are affected by the inflammatory process.

Photodynamic method

Advanced or severe forms of periodontal disease can be treated non-surgically using photodynamic therapy. Before the procedure, the gums are treated with chlorophyll obtained from spirulina algae. In response to its application, epithelial cells begin to produce photosensitizer substances. After 30 minutes, the doctor directs a laser beam to the diseased tissue. Its radiation leads to the breakdown of photosensitizers with the release of active oxygen.

Under the influence of the oxidative process, the microbes that caused inflammation are completely destroyed. The doctor removes damaged areas of tissue and closes the gum pocket. The advantage of this treatment method: gentle, painless effect and high efficiency - a single procedure is enough to eliminate inflammation and bleeding. A film forms on the gums, preventing infection and recurrence of the disease. The use of osteogenic drugs and amino acids helps restore damaged tissues.

When the depth of the periodontal pocket is more than 4–5 mm, the flap method is used. During the operation, the gum is separated from the surface of the tooth, the contents of the pocket are removed, and the cleaned cavity and root are treated with an antiseptic. The soft gum tissue is then secured in the correct position with sutures. In most cases, the method gives positive results. Its disadvantages include the stress experienced by the patient and the long recovery period.

Cable-stayed splinting

This treatment method helps strengthen teeth that have begun to become loose. The splinting technology involves tying the movable units of the dentition with an aramid thread, which is particularly durable. Thin grooves are drilled along the perimeter of adjacent teeth, and after placement, the thread is covered with reflective material. The color of the filling matches the shade of the teeth, so it is almost invisible.

The cable splinting method prevents loosening of the dentition, while simultaneously ensuring natural mobility of the teeth, preventing the jaw bones from atrophying. Fastening with an aramid thread does not interfere with diction and does not cause discomfort in the patient. To restore voids in the dentition in place of lost teeth, it is advisable to use dentures not made of metal-ceramics, but combining ceramics and glass or titanium, so as not to overload the jaw.

At the initial stage of periodontal disease, to improve the condition of the gums, you can use preparations made from plant components according to traditional medicine recipes. They inhibit bacteria and improve wound healing. Additionally, it is useful to massage the gums with a soft-bristled toothbrush, followed by rinsing the mouth with infusions of chamomile, oak bark or sage.

The following remedies provide a good therapeutic effect:

Peels of unripe walnuts, infused with olive oil (1 tbsp per 250 ml). To infuse, the mixture should be placed in the refrigerator. Periodically you need to take out the jar and shake it. After a week, strain and use to lubricate the gums 3-5 times a day.
Plantain infusion or juice. To prepare the infusion, pour 20 g of leaves with a glass of boiling water. Use as a mouth rinse. Juice squeezed from fresh leaves of the plant is applied to the diseased areas of the gums 3 times a day.
Compresses made from grated fresh beets. The mass, without squeezing, is wrapped in gauze and kept on the gum for 15 minutes. Frequency of use - 3 times a day.
Infusion of the herb Knotweed. Pour a glass of boiling water over a spoonful of crushed vegetative parts of the plant. Let it brew for 15 minutes. Use 2 times a day, applying tampons soaked in warm infusion to the gums.
Gruel from crushed sea buckthorn berries. Wrap the fruit mass in a two-layer piece of gauze and apply to the affected areas 2 times a day for 20 minutes.
Tincture of viburnum fruits with honey. You need to mix 500 g of berries with the same amount of buckwheat honey and 500 ml of 70% ethyl (medicinal) alcohol. Place in a dark place for 2 weeks. Directions for use: 1 tbsp. l. 3-4 times a day for 20 minutes. before meals. Taking the product helps strengthen the immune system and cure periodontal disease. Additionally, you can apply cotton swabs moistened with tincture to the gums.

Prevention of periodontal disease development

Regular brushing of teeth, rinsing the mouth after each meal, and using floss (special thread) to clean interdental crevices can prevent inflammation of the gums and deepening of gum pockets. Periodically, but not constantly, pastes containing abrasive substances should be used to remove hard deposits. High-quality removal of tartar will be ensured by professional teeth cleaning using ultrasound.

For timely detection and elimination of pathological processes occurring in the oral cavity, it is recommended to visit the dentist 2 times a year.

Periodontal disease: definition, causes, symptoms

Periodontal (gingival) pockets are pathological formations between the gum and tooth tissues, which appear as a result of disruption of the dental epithelial attachment and are a sign of inflammatory-destructive changes in the tissues around the tooth (periodontal).

The presence of periodontal pockets is one of the main criteria for idiopathic periodontopathy of various origins.

Anatomical certificate

The connection of the tooth to the jaw bone occurs due to a special ligament rich in type 2a collagen fibers - periodontal tissue. This ligament is needed to cushion the tooth, reduce the chewing load and distribute it evenly during the act of chewing.

Normally, the periodontium has a thickness of about 0.2 mm and is hermetically protected from the harmful effects of microorganisms found in the oral cavity by the dental epithelial junction - the lining of the flat non-keratinizing epithelium of the gums, which is attached to the cement of the tooth. The space between the gum and the neck of the tooth is then called the gingival groove.

Under the influence of certain factors, periodontal tissue can become “depressurized,” which leads to its contamination with oral microflora, the formation and, as a result, the triggering of inflammatory changes in it.

Causes of formation of gum pockets

Pathological changes in periodontal tissues are multifactorial in nature. The main reasons that can result in the formation of a periodontal pocket are:

The appearance of pockets in the gums is characteristic of periodontal diseases with an inflammatory component, that is, for idiopathic periodontopathies, where inflammation of the tissues surrounding the teeth is one of the symptoms of a general disease. These are, as a rule, trophic (diabetes mellitus, long-term smoking) metabolic disorders, bone diseases (histiocytosis) or conditions causing severe immunosuppression (leukemia).

Symptoms, development and progression of the disease

After periodontal contamination by microbes from the oral cavity, it becomes involved in the inflammatory process. The bone tissue that surrounds the tooth is in the area of reactive inflammation (i.e., it experiences the action of biologically active substances that trigger this process), and also receives insufficient blood supply due to tissue swelling.

This leads to irreversible bone resorption near the periodontium and deepening of the gum pockets. These changes are always progressive in nature and are accompanied by both loss of bone tissue and its rarefaction (the phenomenon of osteoporosis).

All these changes are accompanied by symptoms that depend on the form of periodontitis and its severity:

according to the extent of the lesion: and;
according to the clinical course: acute, chronic, aggravated;
according to the severity of changes:
- 1st degree (pocket depth does not exceed 3.5 mm),
- 2nd degree (tooth pocket depth from 3.5 to 5 mm),
- 3rd degree (pocket increases to 5-7 mm),
- 4th degree (the depth of the spinal cord is more than 7 mm).

The following is subject to a similar interpretation:

Grade 1 corresponds to bone loss up to 1/3 of the root length;
2 degrees - from 1/3 to 1/2;
3 degrees - from 1/2 to 2/3;
4 degrees - exposure of the roots by more than 2/3 of their length.

With chronic periodontitis of 1-2 severity, patients do not feel much concern. They may only occasionally notice their appearance when chewing solid food. At a later stage, pathological is noted.

Acute forms of periodontitis and exacerbation of the chronic process are accompanied by, periodontal bleeding. In severe cases, there may be an increase in body temperature to 38 0 C, weakness, drooling, severe and painful swelling and hyperemia of the gums with a positive symptom of fluctuation (so-called). Periodontitis of 3-4 degrees of severity is also accompanied by tooth mobility.

Idiopathic periodontopathies have a pronounced inflammatory component during periods of exacerbation. Against the background of a general disease, periodontal abscesses develop, and pathological changes in the periodontium tend to progress rapidly.

Diagnostic criteria

The doctor must find out the location of periodontal pockets, the cause of their formation, the severity and clinical form of the concomitant disease. All this information forms the final diagnosis. For this use:

survey, collection of life history;
inspection; Kulazhenko test to determine the resistance of capillaries to mechanical stress;
assessment of the level of oral hygiene;
detection: Schiller-Pisarev test;
(orthopantomography);
other methods of visualizing bone changes (MRI, CT);
rheography, if there is an obvious pathogenetic component of malnutrition of periodontal tissues.

A doctor can make a final diagnosis only if the following 4 criteria are met:

The photo shows a periodontal probe used to measure gum pockets

Presence of symptomatic gingivitis. On examination, the gums are red or bluish, the Schiller-Pisarev test is positive.
Periodontal pockets present. Examined during examination of the oral cavity. The doctor measures their depth in the area of 4 surfaces for chewing teeth and 2 surfaces for frontal teeth. Each tooth must be measured. They use special periodontal probes that have special markings and a safe tip with a ball; The severity of the process is determined based on the maximum depth of the gum pocket.
Violation of the integrity of the cortical bone plate. The formation of periodontal pockets begins with inflammatory lysis of the dense layer of bone, which forms the upper part of the interdental septum, which distinguishes periodontitis from degenerative processes of a non-inflammatory nature.
Osteoporosis. In differential diagnosis, it is important to determine the degree of density and mineralization of bone tissue. With periodontitis, its rarefaction is observed, while periodontal disease is accompanied by osteosclerosis (bone compaction).

Treatment methods

There is a clearly defined set of measures that are used to treat periodontal pockets and prevent diseases that provoke their formation:

Removing solid deposits (at least once every six months).
, in which subgingival stone and granulation tissue are removed with special hooks. It can be open or closed. Applicable starting from degree 2 of disease severity.
. The teeth are stabilized in the bone by creating scar tissue in the gum, which holds the tooth in place. Indicated for grade 2-4 periodontitis severity.
Application of osteotropic materials. Vestibuloplasty with implantation of materials that induce bone tissue growth.
Vestibuloplasty using allografts.
. With grade 3 severity and the presence of tooth mobility, they are connected to each other for greater stability.
Selective grinding and rational prosthetics are indicated for grade 3 disease severity, when a traumatic bite is formed due to excessive mobility and restoration of the interalveolar height is necessary.

Treatment methods for periodontal pockets closely intersect with the prevention of their formation.

Available to everyone

It is also necessary to use a medium-hard brush 2 times a day during the chronic phase or a soft brush during an exacerbation period, and the use of special salt and antibiotic-containing pastes once a day during an exacerbation period. Additionally, it is recommended to use it for oral hygiene and to remove food debris from retention points.

You should approach it responsibly. It is necessary to rinse your mouth with herbal decoctions or antiseptic solutions after each meal or 5-6 times a day during exacerbations. It would not be superfluous to take antihistamines, vitamins, and immunomodulators to strengthen the body.

Primary prevention is to prevent the occurrence of the disease. To do this, the patient should engage in general strengthening procedures, create an adequate diet, carry out effective and regular individual and professional oral hygiene, and cure orthodontic pathology, if present.

For secondary prevention, it is important to follow the doctor’s recommendations, use special toothpastes and dental floss, irrigators, and regularly rinse your mouth.

With tertiary prevention, it is necessary to create conditions for fixing teeth in the bone. Immunomodulatory, antihistamine, vitamin therapy, vestibuloplasty, curettage, splinting are suitable.

As a conclusion or about consequences

Gum pockets lead to loose teeth, which prevents them from fully performing the function of grinding food. This is fraught with the development of gastrointestinal diseases. In addition, periodontitis is the main cause of early tooth loss. Due to the resorption of bone tissue after tooth loss, difficulties arise due to atrophy of bone formations in the oral cavity.

A sharp decrease in interalveolar height can lead to dystrophic, functional and inflammatory changes in the temporomandibular joint: arthritis, deforming osteoarthritis, Costen's syndrome.

The formation of periodontal pockets indicates the onset of a serious chronic disease (periodontitis), which requires constant monitoring of the condition of the oral cavity and treatment designed to slow down the inflammatory reaction and tooth loss as much as possible.

The changes are always irreversible, but with a responsible approach to treatment, the patient can significantly delay tooth loss and the transition to using removable dentures.

The depression that forms between the tooth and gum is called a gum pocket. In normal condition, the size of the depression does not exceed three millimeters. This allows it to clear itself of various epithelial remnants and food that accumulate in the space of the formed neck around the tooth.

Gum pocket is a reversible condition that can be cured with proper hygiene. If you have a disease, such as periodontal disease, you will need treatment from a dentist. Especially in the case of inflammation, pain, swelling of the gums with pus discharge, surgery may be used. Otherwise, it will lead to tooth loss.

In case of inflammation of the gum pocket, treatment is carried out in different ways. Therapeutic methods are used if the depth is no more than 4 mm. First of all, it is necessary to clean the tooth from plaque, tartar, microbes, and deposits so that the neck closes and the attachment of the gums to the teeth is restored.

In the early stages of the disease, rinsing with antiseptic solutions, medications, and careful hygiene procedures is carried out.

If bleeding occurs, you should consult a doctor. Treatment procedures are carried out using:

hand tools;
ultrasonic scaler;
photosensitizer;
surgical operation.

The pocket area is cleaned with an ultrasonic sclera, then the surface of the tooth root is treated with polishing. Excess growths are removed from the inflamed tissue. Thus, conditions are provided for the restoration process for normal attachment of the gums to the teeth.

Photodynamic therapy – a modern method with which advanced forms of the disease are treated without surgical intervention. The principle of the method is that after brushing your teeth, a special substance consisting of concentrated chlorophyll is applied to the surface of the gums.

Operating principle of the ultrasound device “Vector”

It is obtained from spirulina - seaweed. Photosensitizers develop in destroyed, inflamed cells under the influence of the drug, and after that, after a certain period of time, the specialist applies a laser beam to the gums. Its light affects photosensitizers with the release of oxygen. In this case, an active oxidative reaction occurs, as a result of which pathogenic flora and harmful bacteria die. When the affected tissue areas in the periodontal pocket are removed, it closes completely. With one procedure, you can completely cure the pocket and get rid of inflammation and bleeding. If the treatment is carried out with a laser, a protective formation is created on the mucous membrane, preventing germs from entering the gums, and also helps restore the normal state of the pocket. After procedures to remove infected gum tissue, bone tissue should be restored. Successful therapy will be in the case of complete restoration of dentogingival joints and gum functions.

If the pocket exceeds 4 mm, surgery will be required.

For this, a patchwork technique is used, in which the gums are peeled off in the area of several teeth located nearby. After opening the pockets, they are cleaned manually, and then the tooth root is treated and the gums are sewn on.

Surgical treatment of gum canal

This operation is almost always performed with a positive effect, but the only disadvantage of the procedure may be the difficulty in the psychological aspect for the patient himself. You can see the result of the dental pocket operation, the photo of which is presented above.

Many patients are interested in how to treat a pocket in the gum between the teeth using curettage technology, which is often recommended by specialists. It is considered effective and less painful. There are open and closed methods. During the procedure, the gum pockets are thoroughly cleaned of deposits, tartar, and altered tissues.

The dentist prescribes cleaning based on the degree of the disease.

Closed curettage carried out by laser, ultrasound at a small depth of formation, not exceeding 5 mm.
Open curettage represents a surgical operation that is performed using anesthetic drugs. The process involves making an incision in the gums in the area of the interdental papillae, then cleaning and applying an effective healing agent, after which the wound is sutured.

The result after curettage is noticeable after two weeks. Swelling, redness, and bleeding of the gums disappear, and the depth of the pocket is reduced. To find out how to treat pockets in the gums, which method will be better, you need to seek advice from specialists at the first signs of the disease.

Treatment, which will be carried out under the supervision of doctors, will prevent various complications.

Preventive measures

To prevent re-treatment in the dental pocket, preventive measures should be carried out in a timely manner. When a curettage procedure is performed, the doctor prescribes a number of preventive measures that should be performed regularly:

To prevent gum disease, you should visit the dentist at least twice a year.

brushing teeth;
use cleaning products and pastes that have an abrasive effect, where deposits are removed with the help of solid particles and polished teeth;
use floss (dental floss) to clean between teeth;
visiting a dental clinic for preventive maintenance at least twice a year;
Following additional doctor’s recommendations will reduce the growth of pockets and prevent complications of various types.

Treatment with folk remedies

Patients, when visiting a dentist, often ask whether a dental pocket can be treated at home.

Experts say that it is quite possible to treat with folk remedies if the disease does not have serious complications.

In this case, antiseptic solutions and decoctions of medicinal plants with a wound-healing effect can effectively help. Several recipes can be found below.

Walnut. The recipe uses green peel. Grind a tablespoon of peel and pour in warm olive oil - 0.25 ml. Pour the product into a jar and close tightly, then put it in the refrigerator for a week, shaking occasionally. After infusion, the resulting solution is filtered and lubricated on the gums five times throughout the day.
Plantain. Boiled water - 0.25 ml - pour 20 grams of crushed plantain leaves and leave for at least an hour. They rinse the mouth with it four times throughout the day. In summer, plantain juice helps a lot, for which you grind the leaves in a blender and squeeze out the juice using gauze. You can see the results of treating gum pockets with juice, photos of which are presented below. The positive effect is achieved on the third day.
Plantain juice is often used to treat gum pockets
Eucalyptus oil. Add 2 teaspoons of oil to 200 ml of boiled water, stir, then rinse at least three times a day for seven days. The product is excellent for strengthening gums.
Hydrogen peroxide. 1 teaspoon of peroxide is added to 100 ml of water. The mouth should be rinsed twice a day for a week.
Sugar beet. Grate the beets and wrap the resulting pulp in the amount of one teaspoon in gauze, without squeezing out the juice. The product is applied to the inflamed areas for fifteen minutes. The procedure is carried out at least three times a day with a new compress. The expected result can occur after two days of regular treatment.
Highlander. Using this remedy, treatment is carried out for a week. A spoon of highlander is filled with 0.25 ml of boiled water, then infused for 25 minutes. It is necessary to moisten a piece of cotton wool in the resulting tincture, apply it to the inflamed area, and hold for 10 minutes. The product is applied twice a day. The infusion is applied hot, but not boiled.
Leaves and stems of golden mustache. The leaves of the plant are applied to areas of inflammation, and the tincture of the stems is used to rinse your mouth. One spoon of the plant is brewed with half a liter of boiling water and infused for 30 minutes. Rinsing is carried out at least three times a day.
Lemon peel. Brew crushed lemon peel with a glass of boiling water, leave for half an hour and rinse your mouth three times a day for ten days.
F5 Infusion of lemon peels - a folk method for treating gum pockets
Calamus, propolis. The resulting product is effective for inflammation, as an analgesic and wound healing. Preparation is carried out in advance with the addition of vodka. To do this, you will need one liter of vodka of the best quality, crush the root in an amount of 250 g, and propolis - 20 g. Each component is taken separately, poured with five hundred milliliters of vodka and infused for ten days with daily shaking. After preparation, begin treatment. The treatment procedure is performed over four weeks. To do this, you need to mix calamus tincture with propolis tincture one teaspoon at a time.

In conclusion, it should be noted that self-treatment of gum disease without consulting specialists is not recommended. It is advisable to perform treatment procedures in combination with traditional methods and traditional medicine.