by Rana Baroudi
Dr. Baroudi is a Board Certified Periodontist. She has successfully passed the American Board of Periodontology oral and written examinations covering all phases of periodontal disease, its treatment and dental implants. She is also an Associate Clinical Professor of Periodontology at UCSF where she enjoys teaching and lecturing on a bi-monthly basis.
Learn MoreWhen gum disease advances, the gums detach from teeth and form deep “pockets” where bacteria thrive. These spaces are difficult—often impossible—to clean at home, which accelerates inflammation, bone loss, and eventually tooth mobility. The goal of treatment is simple: restore a healthy, cleanable environment around each tooth so you can keep your natural smile. That journey starts with an accurate diagnosis and often succeeds with conservative therapy. When pockets remain, pocket reduction surgery becomes the decisive step that helps save teeth for the long term.
Every plan begins with a comprehensive periodontal exam. During this visit, Dr. Rana Baroudi charts pocket depths, evaluates bone support, reviews medical factors that affect healing, and pinpoints which areas are actively infected. If disease is in a mild or moderate stage, meticulous cleaning below the gumline—known as periodontal scaling and root planing—may reduce inflammation and tighten shallow pockets. When measurements remain 5 mm or deeper despite excellent home care and professional cleanings, Dr. Baroudi may recommend pocket reduction surgery to physically eliminate the spaces where bacteria hide.
Pocket reduction is a targeted, minimally invasive procedure designed to make your mouth cleanable again. After numbing the area, Dr. Baroudi gently lifts the gum tissue to access the root surfaces, removes infected tissue and hardened calculus, and smooths the roots so plaque can’t reattach easily. When needed, she reshapes small irregularities in the bone to create a natural, supportive contour before suturing the gum at a healthier level. By shortening the pocket, everyday brushing and flossing become effective again—an essential shift for long-term stability.
Many patients benefit from energy-based treatment to further reduce bacteria and preserve healthy tissue. Dr. Baroudi offers laser periodontal therapy in San Jose, and, when appropriate, techniques from laser gum surgery to enhance comfort and healing. Lasers selectively target diseased tissue inside the pocket and can help promote a cleaner, more favorable environment for reattachment.
If recession has thinned your protective gum tissue or exposed roots, pocket reduction can be paired with gum grafting to thicken fragile areas, reduce sensitivity, and improve the long-term ability to keep the site clean. For teeth hidden by excess gum or when a restoration needs better access, crown lengthening reshapes the gum and underlying bone to achieve a healthier architecture. If inflamed or overgrown tissue has created bulky, difficult-to-clean margins, gingivectomy/gingivoplasty can sculpt a more hygienic contour.
Your periodontal visit is also an opportunity to protect overall oral health. Dr. Baroudi performs an oral cancer exam to check for early changes you might not notice at home. Detecting concerns early typically leads to simpler, more successful treatment.
Recovery from pocket reduction is often more straightforward than patients anticipate. Mild tenderness and swelling for a few days are typical. You’ll receive clear home-care instructions, including how to keep the area clean without disturbing sutures. Over-the-counter pain relief is usually sufficient, and many patients return to routine activities within 24–48 hours. Follow-up appointments allow Dr. Baroudi to monitor healing and confirm that pocket depths are stabilizing.
The primary benefit of pocket reduction is control: controlling bacteria’s access to root surfaces, controlling inflammation, and controlling future bone loss. Patients often notice less bleeding, fresher breath, and easier home care. Clinically, shallower pocket measurements and improved attachment levels indicate that your teeth are safer than before. Most importantly, you gain the ability to maintain results at home, which is the cornerstone of keeping your natural teeth.
Advanced gum disease can create specific bone defects that respond well to regenerative therapy. In those cases, Dr. Baroudi may combine pocket reduction with bone grafting to support rebuilding around the tooth. If a tooth has lost too much support for a predictable outcome, extraction may be the healthiest choice. When that happens, planning ahead preserves options. Immediately after removal, ridge preservation helps maintain bone volume. For areas with greater loss, advanced procedures such as block grafting or sinus augmentation may be recommended to create the foundation for tooth replacement with dental implants. Depending on your goals and anatomy, Dr. Baroudi can restore function and confidence with implant-supported dentures or streamlined All-on-4 implants.
Surgery sets the stage, but your daily habits protect the results. After pocket reduction, focus on meticulous brushing, interdental cleaning with floss, picks, or a water flosser, and scheduled periodontal maintenance visits. If clenching or grinding contributes to gum stress, a custom nightguard can help. Lifestyle factors—like smoking cessation, diabetes control, and a nutrient-dense diet—also influence how well tissues heal and stay healthy. Think of pocket reduction as a powerful reset; partnering with your periodontist keeps that progress.
You may be a candidate if you have:
A thorough periodontal exam confirms your diagnosis and ensures the plan is tailored to your health, anatomy, and goals.
Will it hurt?
You’ll be thoroughly numbed, and most patients report only mild post-op soreness managed with over-the-counter medication.
How long does treatment take?
Many cases are completed in a single appointment, though complex sites may be staged over multiple visits.
Are results permanent?
Pockets can remain shallow long-term with consistent home care and professional maintenance. Without that, disease can return.
Is surgery always necessary?
Not always. If pockets respond to conservative therapy like periodontal scaling and root planing, surgery may not be needed. When deep pockets persist, pocket reduction surgery provides the definitive access required to stop progression.
Deep pockets don’t “self-correct.” The longer bacteria remain beneath the gumline, the more support your teeth lose—and the harder it becomes to save them. Choosing pocket reduction surgery—often enhanced with laser periodontal therapy or laser gum surgery—restores a healthy architecture, makes brushing and flossing effective again, and dramatically reduces your risk of tooth loss. If you’ve been told you have deep pockets or persistent bleeding, start with a thorough periodontal exam. Dr. Rana Baroudi will explain your measurements, review all options from conservative care to advanced procedures like gum grafting or crown lengthening, and, if needed, plan for supportive treatments such as gingivectomy/gingivoplasty or future tooth replacement with dental implants. Your path to healthier gums—and keeping your natural teeth—can begin today.
