Who needs pocket curettage surgery?

This is an automatically translated article.

The article was consulted with Specialist Doctor I Nguyen Trung Hau - Doctor of Odonto-Stomatology - Department of Medical Examination & Internal Medicine - Vinmec Da Nang International General Hospital.
Periodontal pocket curettage is a commonly used procedure in the treatment of periodontitis. This technique helps to clean the inflamed soft tissue on the outer wall of the gum pocket, clean tartar on the inner wall and components located in the gum pocket,...

1. What is pocket curettage surgery?

Gums are part of the lining of the mouth, attached to the neck of the tooth (bone and collar bone). Anatomically, the gingiva consists of two parts, the free gingiva and the adherent gingiva. In which, the free gum is the part of the gum that hugs the tooth neck, together with the tooth neck to form a gap about 1mm deep (gum groove). Free gums and teeth form a shallow groove, the base is formed by many attached tissues - called physiological gingival pocket. Adhesive gums are gums that adhere to the root of the tooth (above) and the outer surface of the alveolar bone (below).
Preliminary statistics show that up to 90% of adults have periodontitis. Many cases of periodontitis are indicated surgical curettage of the gum pocket. This is a procedure done to treat periodontal disease (gingival area, periodontal ligament, bone and alveolar bone). This technique helps to clean the inflamed soft tissue on the outer wall of the gum pocket, clean tartar attached to the inner wall and components located in the gum pocket.
If you have dental disease, but if you don't scrape the gum pocket early, the patient may experience consequences such as:
Bad breath, sensitive teeth, sensitivity, tartar in the gum pocket, causing neck wear. ; Gum pockets develop deep, the ligaments in the gums become more inflamed, may break, causing the gums to separate from the roots; The gum pockets develop deeply, leading to the neck of the teeth being worn, penetrating deep under the gums, causing the patient to experience pain, alveolar bone loss, exposing the roots of the teeth due to receding gums, causing cosmetic loss. If the infection persists for a long time without prompt treatment, the patient can develop pulpitis, which can lead to more dangerous complications.

2. Indications/contraindications for periodontal pocket curettage surgery?

Persons assigned to curettage are:
People who need to reduce inflammation in gum pockets with medium depth, thick fibrous tissue; People with abscesses around the teeth; Reducing inflammation before performing other periodontal surgeries or in those with contraindications to surgery; Inflammation of the gum pocket after other periodontal surgery. Gum pocket curettage surgery is contraindicated for:
People with very thin gingival gingival wall; Gums are enlarged by phenytoin ; People with acute inflammatory manifestations; The gum pocket is too deep, has gone all the sticky gums (especially in the molar area).

3. The procedure to cure the pocket around the tooth

3.1 Preparation

Implementation personnel: Dentists and assistants; Means: Kit for periodontal surgery; Medicines and medical materials: anesthetics, antiseptic solutions, hydrogen peroxide, alcohol, physiological saline; Patient: Detailed explanation of the procedure, consent to treatment; Medical record: Prepared according to regulations, have X-ray film of jaw bone condition, performed basic tests.

3.2 Performing gingival curettage surgery

Checking medical records and examining patients, assessing local and systemic conditions; Disinfect the mucosa around the area preparing to cure the gum pocket; Local anesthetic injection to help patients reduce pain and discomfort during dredging of the gum pocket; With the gum pocket not too deep, the doctor only needs to scrape tartar and remove plaque for the patient. With deep gum pockets, more than 5mm, much bone loss, inflammation of the subbone pocket, it is necessary to dredge the deep gum pocket to clean the pus pocket, adjust the periodontal tissues, and restore the teeth. When performing, the doctor uses a curette to scrape the inflammatory tissue in the outer wall of the gum pocket. The doctor takes his finger to hold the outside of the outer wall of the gum pocket, then cleans the tartar, plaque in the root wall, the components in the gum pocket; Before suturing the wound, the doctor separates the gums from the bone, removing the damaged tissue; Pump to wash the gums with 3V hydrogen peroxide and 0.9% physiological saline. The doctor will instruct the patient how to stop bleeding, use anti-inflammatory gel to heal the wound faster.

3.3 Monitoring and handling after surgery

In case of bleeding after scraping the gingival pocket for a few days: Perform pumping to clean the gum pocket and apply a surgical bandage; In case of infection: Indications for the use of local antibiotics, anti-inflammatory in combination with systemic administration.

4. Some notes after curettage of the periodontal pocket

After scraping the pocket around the tooth, in the gum area that has just been treated, there will be a feeling of pain. To relieve pain, patients need to take the medicine exactly as prescribed by the doctor. In addition, the patient should adhere to the following instructions:
Gargle with physiological saline instead of brushing and flossing for the first few days to avoid affecting the wound; Eat soft foods such as porridge, soup, pureed rice, ... limit eating hard foods such as sugar cane, nuts,...; Limit spicy and hot foods, eat yogurt daily to increase the body's resistance. Periodic dental examination every 6 months to check and maintain oral health. Surgical curettage of the periodontal pocket is a simple procedure with a short time to perform. Before, during and after the procedure, the patient needs to strictly follow the doctor's advice, combined with regular dental check-ups.
Department of Dentistry - Maxillofacial - Facial, Vinmec International General Hospital is one of the major and important sub-disciplines of the clinical block. Is a specialty in charge of intensive and aesthetic pathological treatment of the entire tooth structure (teeth, bone, pulp,...), jaw (palatine, jawline, jaw joint, ...) and face (frontal bone, cheekbone, temporal bone,...).
Why should you choose to visit the Odonto-Stomatology Specialist - Vinmec International General Hospital?
Simple and quick procedure. Enthusiastic advice and support, reasonable and convenient examination process. Comprehensive facilities, including a system of clinics and consultations, blood collection room, dining room, waiting area for customers... The medical staff has high professional qualifications, style. Professional, caring way of working.

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