Why do I have a gum infection and deep periodontal pockets?

Question

Hello doctor,

I was having bleeding gums in one section of my teeth while flossing. So, I consulted a dentist who did a deep cleaning of that area. But after a week, I felt swelling and irritation in the area with bleeding on touching.

Then, I went to a periodontist who suggested having flap surgery. Instead, he did a LANAP procedure as it is a less invasive one. And I was on tablet Advil, as required.

I presume that the bacteria accumulated were eliminated through the LANAP procedure. After the production, I was on three-week follow-ups, and the area has resurfaced.

But I think it will bleed on flossing, as I feel an acute discomfort in the associated area, which is quite different from the pain felt after the surgery.

I have been dealing with this discomfort for the last two months and am very concerned about where to go after performing this LANAP procedure.

So I want an opinion that the bacteria are the main cause of discomfort, and I want to know whether the resurfacing issue was because of the deep pocket present under the gums, and if it is not the bacteria, then what is the cause of the resurfacing issue?

Kindly give your suggestions.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

As per the image provided (attachment removed to protect the patient's identity), it seems you have an infection that has not been eliminated after surgery. It is an edematous pocket that requires a gingivectomy or ENAMP (excisional new attachment procedure), so the surgery was not successful.

I think you should go for curettage with SDD (sub-antimicrobial dose Doxycycline 20 mg) as this local drug is delivered in a pocket.

I suggest you follow a few steps:

Gingivoplasty or re-contouring of the gingiva.
Apply SDD (sub-antimicrobial dose Doxycycline 20 mg) post-operatively.
Use mouthwash Chlorhexidine 0.2 percent twice a day for one week.
Use a proxa brush (embrasure type 2) after 15 days.

I hope this helps.

Thank you.