Often, non-surgical treatment with excellent patient home oral hygiene and regular periodontal maintenance appointments and dental checkups are enough to stabilize a patient to be within normal periodontal parameters. However, for patients whose disease does not abate and have periodontal pockets that continue to bleed when probed, there is a probability that not only will the disease persist, but continue to worsen.
The goal of periodontal surgery is to reduce pocket depth with the ideal result being pocket elimination, creating an ideal environment for the patient to practice good oral hygiene. If the bone under the gums has not been altered by infection, trimming excess tissue may be all that is required. Flap surgery, which gives the periodontist access to the bone underneath the gum, allows the periodontist to smooth and recontour the bone. This can allow for the gum to effectively attach to the bone and reduce the pocket. Smoothing and recontouring can allow the gum tissue to attach more effectively and reduce the pocket.
Occasionally the pockets are so deep that complete elimination is not possible and pocket depth beyond normal limits remain after surgery. The prognosis on these teeth may be guarded and the long term health be considered questionable. However, as long as these teeth are functional, do not cause discomfort, or jeopardize the surrounding teeth, they can be retained. Many questionable teeth can be retained for several years as long at the patient is able to maintain excellent oral hygiene and comply with an optimal maintenance program with their dental professionals.