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What Are Periodontal Pockets?

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Medically Reviewed By Colgate Global Scientific Communications


If your mouth is healthy, your gums should fit snugly around each tooth, with the distance between the gum tissue and its attachment to the tooth only one to three millimetres in depth. But gum disease can lead to deeper spaces around your teeth called periodontal pockets, and if untreated, these pockets can lead to tooth loss. With early diagnosis and treatment, you can keep your teeth for a lifetime.

How Does a Pocket Form?

The bacteria in your mouth continually form a sticky film of plaque on your teeth, especially around the gum area. If not removed, this plaque eventually hardens into tartar, which can't be brushed off without a dentist or dental hygienist removing it during a professional cleaning appointment. Ultimately, the toxins from this bacteria continue to form on the tartar and can cause inflammation in your gum tissue, creating a condition referred to as gingivitis.

The Singapore Ministry of Health (MOH) explains that plaque and tartar build-up at the gum line causes gums to be inflamed at this earliest stage of gum disease and pockets may begin to form below the gum line as the disease progresses to the periodontitis stage. As it pulls away from your teeth, this inflamed gum tissue is now the perfect venue for more plaque and tartar to hide, deepening the pocket and threatening the bone around your teeth. You can think of this phenomenon as a turtleneck sweater that begins to stretch out around your neck.

Diagnosing Periodontal Disease

If you're experiencing any of the warning signs of gum disease – such as bad breath, bleeding, red and swollen gums or gums pulling from your teeth – have your dentist examine your mouth following this discovery. Beyond a visual assessment of your gum tissue, your dentist will measure the pocket depth around each tooth with a periodontal probe, allowing them to determine the presence of periodontal disease or how far it has progressed.

According to Singapore Dental Surgery, measurements are taken of pocket depths (i.e. when the gums are not attached to the root-surface) during a periodontal examination. Measurements of four millimetres or more are an indication that some gum tissue has detached from the tooth or that there is the beginning of bone loss.

The Singapore Dental Health Foundation refer to advanced periodontitis as the last stage of gum disease when the fibres and bones supporting one's teeth are destroyed and the teeth will shift and are loosened, which may affect one's bite.

How to Eliminate These Pockets

The first step in treating gum disease is to have your teeth professionally cleaned; this is sometimes called scaling and root planing. By removing all tartar and plaque from your teeth and underneath your gums, the gums can heal and tighten around the tooth again. If there is no significant bone loss, this may be the only treatment you'll need. However, in cases where deep periodontal pockets still remain, your dentist may recommend a surgical treatment to stabilise your periodontal condition. And once you've completed periodontal treatment, your dentist or periodontist will surely want to keep you on a more frequent cleaning schedule.

Home Care for Prevention

Periodontal disease is very preventable, and by keeping up with regular dental visits and a consistent home care routine, the subsequent periodontal pockets will be something you only have to read about. Here's how to keep your pocket depths at one to three millimetres. Use a soft-bristled toothbrush to clean your teeth twice a day, brushing carefully around your gum line where plaque tends to accumulate. Replace your toothbrush every three to four months or when you see the bristles starting to wear. If your mouth tends to build up tartar quickly, use a tartar-control toothpaste.

Flossing once a day is just as important as brushing when it comes to preventing gum disease, but be sure to follow your dentist's recommendation for professional cleanings and gum examination. Diagnosing and treating periodontal disease in its early stages can eliminate unhealthy periodontal pockets and curb the effect before it progresses to severe bone loss.