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What Are Periodontal Pockets?

If you have a healthy mouth, you're probably not used to thinking about your gums. They fit snugly around your teeth and don't cause you pain or any other issues. But when the distance between your gum tissue and your teeth starts to widen, it's a sign of gum disease. Gum disease can lead to deeper spaces around your teeth called periodontal pockets. If untreated, these gum pockets can lead to tooth loss. But with early diagnosis and treatment, you can keep your teeth for a lifetime! Let's go over how periodontal pockets form, how they're diagnosed, your treatment options, and preventive measures you can take at home.

How Does a Pocket Form?

When the bacteria in your mouth is not regularly cleaned out, it will lead to the build-up of plaque (biofilm) on your teeth, especially around the edges of where your gums attach around the neck of your tooth. If not removed, this plaque eventually hardens into tartar, which you can't brush off on your own. You'll need a dentist or dental hygienist to remove it during a professional cleaning appointment. When left untreated, the toxins from bacteria will ultimately continue to stick to your hardened tartar and cause inflammation in your gum tissue. This will create a condition referred to as gingivitis, the first stage of periodontal disease.

Inflammation and swelling can cause your gum tissue to pull away from your teeth, forming pockets beneath the gumline. You can think of this phenomenon as a turtleneck sweater that begins to stretch out around your neck. These pockets create the perfect place for more plaque and tartar to hide, allowing bacteria to thrive. As gingivitis develops into periodontitis, the more severe form of gum disease, it can start to affect the connective tissues and bones that keep your teeth in place. When the tissue that attaches the gum to the tooth breaks down, the gum will recede, and bone support of the tooth will be lost, causing teeth to become loose.

Diagnosing Periodontal Disease

Suppose you're experiencing any warning signs of gum disease, such as bad breath, bleeding, red and swollen gums, or receding gum tissue. In that case, it's imperative to have your dental professional examine your mouth. Beyond a visual assessment of your gum tissue, your dental professional will conduct a periodontal exam. Using a tool called a periodontal probe, they'll gently probe six different sites around the tooth to measure the depth of the periodontal pockets.

This allows them to determine the presence of periodontal disease and establish how far it has progressed. The National Institutes of Dental and Cranial Research (NIDCR) says that periodontal disease is defined by at least one site with a pocket of 4 millimetres or more in depth and 3 millimetres or more in attachment loss.

How to Eliminate These Pockets

Like many oral health issues, the first step in treating gum disease is to see your dental professional and have your teeth professionally cleaned. Also referred to as scaling and root planing, this involves removing the tartar and plaque buildup, giving your gums a chance to tighten around your teeth again. If you have no significant bone loss, this may be the only treatment you need. However, in cases where deep pockets in your gums remain, your dental professional could recommend surgical treatment to stabilize your periodontal condition.

Beyond scaling and root planing, another non-surgical treatment is to use topical or oral antibiotics to get your bacterial infection under control. If you require more advanced treatment, several types of surgery can remove infection and reduce your gum pockets. These include flap surgery, soft tissue grafts or bone grafts, and guided tissue regeneration.

Home Care for Prevention

Periodontal disease is very preventable. By keeping up with regular dental visits and a consistent home-care routine, you're doing everything you can to reduce your chances of developing periodontal pockets. Healthy gums have a shallow pocket that is easy to keep clean, measuring only one to three millimetres in depth. Here's how you can keep your gum pockets shallow and easy to clean:

  • Use a soft-bristled toothbrush to clean your teeth twice a day, brushing carefully around your gumline where plaque tends to build up.
  • Replace your toothbrush every three months or when you see the bristles start to wear or when you recover from a cold or flu.
  • If tartar tends to build up quickly in your mouth, use an antigingivitis toothpaste and brush for two minutes at least twice a day.
  • Cleaning between your teeth once a day is as important as brushing to prevent gum disease. You can use floss, a water flosser, or other interdental cleaning tool.
  • Be sure to follow your dental professional's recommendations for professional cleanings and gum examination. They may recommend more frequent cleanings after treating a severe case of periodontal pockets.

Diagnosing and treating periodontal disease in its early stages can eliminate unhealthy periodontal pockets. Prompt treatment will stop it in its tracks before it progresses to severe bone loss. Luckily, there are plenty of at-home measures you can take to prevent periodontal disease. But if you do need treatment, there are several non-surgical and surgical options. Regardless of whether you're in the very early stage of gum disease or are at the point of requiring surgery, a lifelong commitment to a thorough oral care routine will be essential for your future smile!