Patient Guide for Osseous Surgery (Pocket Reduction Therapy)

Q: Why do I need this surgery? My gums don't hurt.

This is the most important question we can answer. Periodontal disease is a silent disease. The damage it causes—the loss of bone around your teeth—happens painlessly. The deep “pockets” we measured are like the foundation of a house being quietly eaten away by termites. You don’t feel it until the walls start to crumble. The purpose of this surgery is to get rid of these deep, uncleanable pockets and repair the foundation *before* the teeth become loose and are lost. It is a proactive step to prevent a future catastrophe.

Q: I'm worried about the discomfort. Is this going to be very painful?

We completely understand this concern, and it’s the main reason patients hesitate. Your comfort is our top priority. While you will have some soreness, most of our patients are surprised at how manageable the recovery is. By following our proactive pain medication protocol and taking it easy for a few days, the vast majority of patients are back to their normal routine very quickly. We are here to support you through the entire process.

Q: Will my teeth look longer or have gaps between them after this?

That’s a very insightful question. As the swollen, inflamed gums heal and become tight and healthy, they may shrink slightly. This can sometimes expose more of the root, making a tooth look a little longer, or reveal small spaces between the teeth that were previously hidden by the puffy, diseased tissue. It’s important to see this not as a cosmetic problem, but as a sign of health—the removal of unhealthy tissue and the creation of a cleanable, stable environment for your teeth.

Q: What happens if I choose not to do this surgery?

If we have recommended this procedure, it is because your deep pockets are at a level that cannot be managed with deep cleanings alone. If left untreated, the bacteria in these pockets will continue to destroy the bone that supports your teeth. The pockets will get deeper, the teeth will become loose, and eventually, they will be lost. Choosing not to proceed means accepting the inevitable progression of the disease.

Q: What is my role after the surgery is done?

Think of the surgery as 50% of the solution. The other 50%—the part that ensures the problem never comes back—is your lifelong commitment to your Periodontal Maintenance appointments every 3-4 months. When you decide to proceed with this surgery, you are also making a commitment to this new standard of care. This partnership is the only way to protect your investment and keep your teeth for life.

Surgical Care Instructions

Pain Management

Your comfort is our top priority. It is normal to experience some post-operative soreness, and we have a very effective protocol to manage it.

Standard Protocol: For the first 2-3 days, we recommend a scheduled regimen of 600mg of Ibuprofen AND 500mg of Tylenol (Acetaminophen) taken together every 6 hours. This proactive approach is highly effective at managing inflammation.
Important Disclaimer: Only take medications as specifically prescribed by our office, considering your unique health history. We will not recommend Ibuprofen if you have kidney disease or GI ulcers, nor Tylenol if you have liver disease.

Bleeding Control

Minor oozing of blood from the surgical site is normal for the first 24 hours.

Pressure: If you notice active bleeding, apply firm but gentle pressure to the area with a piece of moistened gauze for 30 minutes.
Avoid: Do not spit, use a straw, or smoke. Avoid vigorous rinsing, as this can disturb the healing site.
Pillowcase Pro-Tip: Use an old or dark-colored pillowcase for the first night. A small spot of blood is normal; a saturated pillow is not.

Swelling Management

Swelling and bruising are common and expected parts of the healing process.

Ice Packs (CRITICAL): For the first 24 hours ONLY, apply an ice pack to the outside of your face over the surgical area for 20 minutes on, then 10 minutes off.
Peak Swelling: Swelling will be at its worst on the third day after surgery, after which it will begin to gradually subside.
Elevation: Keep your head elevated with extra pillows when resting or sleeping to help minimize swelling.

Oral Hygiene/Site Care

The success of this procedure now transitions into a lifelong partnership to maintain your health.

DO NOT pull your lip or cheek back to look at the site. This can tear the delicate sutures.
The “White Patch” is Normal: It is completely normal for the surgical site to develop a soft, white layer. This is not an infection; it is a natural healing bandage your body creates.
Rinsing: Do not rinse for 24 hours. After that, you may begin gently rinsing with the prescribed medicated rinse or warm salt water after meals. Let the water fall out of your mouth; do not spit.
Brushing: You can and should brush the chewing surfaces of your teeth in the surgical area, but stay away from the gum line. Brush all other teeth normally. We will review specific hygiene techniques at your follow-up appointment.

Your Commitment: Protecting Your Investment

Think of this surgery as hitting the “reset button” on your gum health. The long-term success—the very reason you went through this procedure—is now dependent on your commitment to a new standard of care.

The deep pockets are now gone, but the bacteria that caused them can return. The only way to prevent this is with professional cleanings at a more frequent interval.
You are now on a Periodontal Maintenance schedule. This means cleanings every 3-4 months. This is not optional; it is the evidence-based standard of care required to keep the disease from coming back and to protect the foundation of your teeth for life.

Dietary Recommendations

Stick to a soft, non-chew diet for the first several days.
Do not chew on the side of your mouth where the surgery was performed.
Avoid hard, crunchy, or spicy foods that could irritate the surgical site.

Activity Restrictions

Avoid all strenuous physical activity, exercise, or heavy lifting for at least 3-5 days. Increased blood pressure can cause bleeding and pressure at the surgical site.