Q. Can bacteria under the gums lead to deep pockets?

Answered by
Dr. Bharat Joshi
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Feb 17, 2023

Hi 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 over 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 less invasive ones. And I was on a medicine tab Advil as per required. I presume that the bacteria accumulated was 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 am 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 opinion that is the bacteria the main cause of discomfort and want to know whether 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 resurfacing issue?



Welcome to

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 recommend a few steps:

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

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