What are Periodontal Pockets and How Can You Fix Them?

As part of a routine dental examination, your dentist will check for something called periodontal pockets. Using a dental probe, a small skinny instrument, they’ll press gently in the space between your tooth and gums to gauge how deep it is. In health, this “pocket depth” usually registers between 1mm and 3mm.   Readings of 4mm and higher can indicate trouble – gingivitis or full-blown gum disease (periodontitis).

Measuring periodontal pockets is routinely done at your cleaning appointment and is a quick way for your dentist to make sure you’re maintaining good gum health. When periodontal pockets start to creep into 4mm+ territory, it’s a sign that your dentist needs to investigate further to determine the cause.  And if necessary, to act to prevent periodontitis from taking hold. The good news is, 4-5mm pockets can heal if they are cared for the right way.

Why do periodontal pockets get deeper?

Gum disease causes inflammation about the supporting structures of the tooth which can cause those structures to detach from the root, exposing the root to plaque and tartar. The deeper a periodontal pocket is, the more opportunities there are for hard-to-clean plaque to get into the pocket and cause problems. Even with diligent flossing and regular brushing, it’s very hard to keep deep pockets clean.

Once problem areas develop, they’ll continue to get worse without a dentist or a hygienist’s intervention. A dentist not only identifies 4mm and deeper pockets for you, they’ll instruct you on what needs to be done and how to clean them to help protect at-risk areas.

Fighting back against deep pockets at home

If you’ve got a 4+mm periodontal pocket that your dentist is concerned about, you’ll need to step up your oral care at home. Don’t worry, though – proactive gum care is easier than you think and stopping periodontitis is worth it. Here are a few things your dentist might advise, in addition to good brushing and flossing habits:

• Irrigate your gums with a water Pik or water flosser after brushing
• Use an interdental brush to clean between teeth with deeper pockets
• Rinse with mouthwash after brushing and after meals, to flush out debris
• Change to a soft-bristle brush and thoroughly (but gently) brush the gum line

All these things help prevent food and plaque from building up in the pockets, while keeping them free of bacteria. These oral care steps aren’t the only way to address problematic periodontal pockets, either! Ease up on sugary foods and eat more foods with fiber (fruits and veggies) to help rejuvenate your gums.

If periodontal pockets get worse…

If those “pockets” continue to bleed or get worse and dip into the 5mm+ range, your teeth are at risk and you may develop systemic complications associated with gum disease. It’s very difficult to clean deep periodontal pockets at home, which means they’ll continue to get worse without a dentist’s intervention. Thankfully, there are options for combatting periodontitis once it’s taken hold:

• Root scaling and planing – removes plaque buildup in deep pockets to promote healing.
• Antibiotics – in-conjunction with root planing can help prevent gum inflammation and infection from worsening and allow your supporting tissues to heal.
• Flap surgery – also called pocket reduction or regeneration surgery.
• Bone regeneration – to help regain the jaw bone you’ve lost due to disease

The effects of periodontitis can get nasty quickly, which makes diagnosis and intervention as early as possible important. Your dentist may refer you to a periodontist – a dentist that specialized in gum disease. If you’ve been diagnosed and treated for periodontitis, make sure to follow up with supportive periodontal therapy from dental professionals.

Stay on top of those 4mm periodontal pockets before they get deeper and you’ll save yourself a lot of pain and frustration!  The only way to protect your gums (and your oral health) is to take the right approach to managing the problems.  Levenson Periodontal Associates are available for you, if you have questions or concerns or would like a second opinion.