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Deep pocket causing pain. Done first part of RCT. Was it the right course?

I have a deep pocket on #36 and was told by a periodontist that it had very poor prognosis . She advised me either to have it extracted (which means she could offer an expensive implant) or to have a root canal done followed by a perio cleaning. My intuition told me it was not an endo problem because the tooth did not ache, only was slightly sensistive. However, later it started aching. I rushed to an endodontist, who did the first part of RCT (put some medication ). Questions: Was it the right thing to do? What is the next step? To have gum grafting? Can I have a gingival mask?
Asked On : Wed, 30 Jan 2013
Answers:  5 Views:  70
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Dentist 's  Response
The normal depth of gingival sulcus is 2mm.Periodontal pocket occurs in case of chronic gum inflammation. In case of periodontal pockets, there is loss of bone and ligament and the sulcus gets deepened. So you require pocket reduction surgery for this. Pocket reduction surgery is done to reduce the depth of the periodontal pockets and to allow less of plaque and calculus deposits and greater access for hygiene. Pocket reduction surgery reduces the bacterial spread, stops the bone loss and enhances the smile of the patient. If the surgery is not performed, then more destruction of gums can take place and the tooth may eventually become loose and fall. Get the surgery asap to avoid any complication. The surgery will be performed under local anesthesia or general anesthesia. The gums are pulled back from the teeth and bacteria and calculus will be eliminated. There will be significant reduction in periodontal pocket depth after the surgery and the condition of gums and teeth will improve significantly. Till the time you get surgery for pocket reduction done, maintain a good oral hygiene and brush and floss regularly.
Answered: Fri, 1 Feb 2013
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Orthopaedic Surgeon, Joint Replacement Dr. Saurabh Gupta's  Response
Feb 2014
Thanks for posting your query

You can do 4 days course of metrogyl safely.
Periodontitis results in deep pocket formations in gums which can be treated only by a trained dental doctor under local anesthesia.
Tell your doctor to perform periodontal surgery then 4 monthly follow ups to a treat your
periodontitis. excellent results can be obtained by periodontal surgeries.
Wishing you good health...

Dr Saurabh Gupta.
Answered: Fri, 1 Feb 2013
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Dentist Dr. Deepika Attresh's  Response
hello & welcome
as you said that there was deep periodontal pocket its quite obvious that an endoperio lesion has been flourished, so this is a right mode of treatment, even in such cases if tooth does not ache we prefer to do RCT for a better prognosis of tooth.
so have faith in your doctor this is for your benefit only.
next step will be to complete RCT & deep periodontal cleaning than tooth mobility will be checked & further treatment will be planned, you can have bone grafting & gingival flap surgery.
thanks & take care
Answered: Wed, 30 Jan 2013
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Dentist Dr. Deepthi Reddy's  Response

Thank you for the query.

Presence of deep pocket will lead to pain , sensitivity, foodlodgment and infection and bone loss.Take an x-ray to rule out the extent of boneloss and infection .Yes, root canal therapy is the right treatment.

As you have started with rootcanal therapy the infection and pain will be relieved and this should be followed by a course of antibiotic and analgesics. Curettage of the periodontal pocket should be doneif required a bone graft can be placed

Hope this information helps you.
Answered: Wed, 30 Jan 2013
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Dentist Dr. Farah Hussain's  Response
Hi and welcome to HCM,
Deep pocket formation is nothing but the loss of attachment of the tooth from the underlying periodontal apparatus, if not treated in time the pocket progresses deeper leading to alveolar bone loss , mobility of the tooth and finally the tooth is dislodged from the socket.
So i suggest you to go for a appropriate treatment soon as it is a molar tooth and plays important role in chewing and occlusion with the opposing upper molar.
As you mentioned there is no pain in the tooth , that means you have got problem with the gums or either its a combine tooth and gum related lesion called endoperio lesion. for this you have to go for root canal treatment of the tooth followed by deep curretage of the gingival tissue to restore the health of gums.
i hope this helps you , take care.
Answered: Wed, 30 Jan 2013
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