Osseous Surgery (Dental Pocket Reduction): Types, Costs and More

Osseous surgery, also known as dental pocket reduction surgery, is a dental procedure typically performed by periodontists to treat moderate to severe gum disease, such as periodontitis, and to prevent further damage to the affected teeth roots and bone.¹

Normally, bone and gum tissue fit snugly around your teeth, “like a turtleneck," with a two- to three-millimeter depth, or pocket. These pockets may deepen over time, giving bacteria a larger area to accumulate, which can cause decay in bone and gum tissue. This, in turn, can lead to permanent tooth loss when the bone securing the tooth root is too weakened to support it.²

If the gap between the teeth and gums grows to five millimeters or deeper, it becomes difficult to properly clean away bacteria with at-home daily oral hygiene or professional cleaning.²

Osseous surgery aims to treat gum disease by removing the infection-causing bacteria, reducing the size of the pockets around the teeth where plaque accumulates and repairing any damaged bone.¹

Types of Gum Disease Surgery for Dental Pockets

There are several treatments available for dental pockets. The three most common types of gum surgery are:

• Open flap debridement
• Guided tissue regeneration
• Bone grafting

Open flap debridement

Your dentist may recommend this procedure, usually performed by a periodontist, to try to save the tooth if you have deep dental pockets or bone loss. The periodontist will make incisions in the gum tissue that allow the tissue to be folded or “flapped" back, exposing the tooth root for deep cleaning. Grooves in the bone may be scaled or planed away to reduce the area where bacteria can grow. The gum tissue is then sutured back into place.³

Guided tissue regeneration

Guided tissue regeneration (GTR) is a procedure that encourages the regeneration of bone and gum tissues around teeth affected by gum disease. As in open flap debridement, the gums are opened with incisions and pulled back to remove all bacteria and plaque from the diseased tooth or teeth. A biocompatible membrane is then placed over the cleaned and treated damaged bone, providing a barrier that gives the new bone the time it needs to form. The gums are stitched back together, and sutures and membranes are removed or dissolve later. New bone and gum tissue develop in about six months.⁴

Bone grafting

Your dentist may suggest bone grafting if gum disease has damaged the bone around your tooth root. The graft may be made from pieces of your own bone or from synthetic materials. Bone grafting serves to stabilize the affected tooth or teeth and allows for new bone and blood vessels to regenerate and synthesize with the grafting material.⁵

Gum Surgery Costs

The costs to treat dental pockets caused by gum disease can vary depending on several factors, including the severity of the gum disease, the number of teeth requiring treatment, the experience of the dental professional and the geographic location of the dental practice.⁶

In addition, the cost of the surgery might not include other expenses, such as additional procedures or treatments that might be performed alongside the surgery, pre-operative assessments, X-rays, anesthesia, prescription medications and postoperative follow-up.⁷

Different periodontal disease treatments can range from $4,000 to $6,000 on average, but may cost between $8,000 to $10,000 if the gum disease is severe.⁷

Dental insurance plans may cover the overall cost or a portion of the expenses associated with pocket reduction surgery if the procedure is considered medically necessary. However, many insurance plans will not cover cosmetic procedures.⁷

Periodontal Treatment Costs

The average cost of periodontal treatments when it comes to reducing dental pockets can range from as low as $120 per tooth and up to $3,000 per quadrant of the mouth, depending on the work that is necessary.⁶ The chart below outlines the costs for each treatment.⁶

Candidates for Dental Pocket Reduction Surgery

Your dentist may recommend pocket reduction surgery if the dental pockets around your teeth measure five millimeters or greater, and if traditional non-surgical methods of treating gum disease, such as planing and scaling, have not been successful.³

Dental pocket reduction surgery may not be appropriate for patients who are pregnant or have allergies to certain medications.⁸ In addition, poor oral hygiene habits and tobacco use can greatly affect the success of the surgical outcome.¹

A qualified dental professional, like your periodontist, can help determine if this surgery is the right treatment for you.⁸

How Does Dental Pocket Reduction Surgery Work?

If your dentist or periodontist recommends dental pocket reduction surgery, it's good to know what to expect before, during and after the procedures. Here's a look at how it works.

Before surgery

Unless your periodontist advises differently, continue to take your prescription medications as scheduled.¹ You might also need to:¹

• Temporarily stop taking blood thinners such as aspirin or warfarin.
• Arrange transportation with a trusted family member or friend after the procedure, particularly if you're opting for general anesthesia.
• Avoid tobacco and alcohol for 24 hours before and after the procedure.

Surgical procedure

Prior to the procedure, you'll be given local anesthesia to numb your teeth and gums, or other appropriate medications if you've chosen sedation.¹

The periodontist will make an incision along your gum line, folding back the gums to expose the roots of the affected teeth. They'll clean the dental plaque and bacteria from the root surfaces, then smooth and reshape the bone around the teeth to eliminate grooves and other damaged surfaces. If necessary, the surgery may include procedures to regenerate bone loss or replace tissue through bone grafting or guided tissue regeneration.¹

Your gums will be repositioned to their correct place and the incisions closed with sutures.¹

Potential risks and side effects

Like any surgical procedure, osseous surgery carries potential risks and side effects, which can include:⁸

• Excessive bleeding¹
• Infection
• A greater likelihood to develop root-based cavities in the teeth that were treated
• A receding gum line around the treated teeth, causing those teeth to appear longer
• Heightened sensitivity to hot or cold foods

Recovery

It takes an average of two to four weeks to recover from dental pocket reduction surgery, but recovery time depends on factors like the number of teeth treated and the extent of the gum disease. Patients may experience soreness, bleeding, swelling or bruising after surgery.¹

During recovery it's important to:¹

• Take all medications as directed.
• Avoid drinking through straws for a minimum of one week.
• Use an antibacterial mouthwash to prevent infection.
• Eat soft foods as recommended by your periodontist.

You can try the following for long-term prevention of gum disease, including dental pockets:³

• Brush twice daily with a fluoride toothpaste, using a soft-bristled brush or electric toothbrush.
• Floss daily, and use an antiseptic mouthwash to prevent the buildup of bacteria.
• Eliminate tobacco use.
• Cut back on sugary foods and drinks, and rinse your mouth thoroughly after eating them.
• Ensure your diet includes plenty of fruits, vegetables and foods high in vitamin C.
• See your dentist every six months for regular cleanings and to monitor your oral health.

It's important to consult with a dental professional who can diagnose and recommend appropriate treatments when it comes to evaluating various stages of gum disease, including dental pockets. Timely intervention can prevent the progression of gum disease and its complications, preserve healthy teeth and gums and promote better overall well-being.

Financing Dental Pocket Reduction Surgery With the CareCredit Credit Card

Whether you're getting dental pocket reduction surgery or you're simply paying for a dental exam, the CareCredit credit card can help you pay for costs not covered by insurance.^* Use our Acceptance Locator to find a dentist or oral surgeon near you that accepts CareCredit. Use the CareCredit credit card, again and again, to pay for your health and wellness wants and needs, and download the CareCredit Mobile App to manage your account, find a provider on the go and easily access the Well U blog for more great articles, podcasts and videos.

In addition to dental care, you can also use your CareCredit credit card for pet care, cosmetic, vision, hearing, health systems, dermatology, pharmacy purchases, spa treatments, and so much more within the CareCredit network. How will you invest in your health and wellness next?

Author Bio

Anne-Marie Kennedy is a freelance writer with more than 20 years of experience covering health and wellness, personal finance and real estate/investing.