Periodontal Pocket Depths

April 23, 2020 in Dentistry,Periodontal Treatment by McCarl Dental Group

As part of our ongoing efforts to help patients achieve and maintain their healthiest smiles, we recommend regular preventive dental checkups and teeth cleanings. During these visits, you have probably heard your dentist calling out numbers as they check your smile. They are measuring the depths of your gum tissue pockets. This is called periodontal charting, and it helps us keep track of your gum health. This important measure of periodontal (gum) health tracks the depth of the pockets around each tooth. The top of gum tissue does not attach directly to teeth. There is a space or pocket between the gum and the tooth before it attaches. This pocket deepens in the presence of bacteria, plaque, and tartar build up that lead to gum disease. To monitor and evaluate gum health, the pocket depth must be measured, recorded, and monitored over time. In this blog, we’ll walk through what periodontal pockets are, how they are connected to gum health, and why it’s so important to regularly monitor periodontal pocket depths.

What are Periodontal Pockets?

When gums are healthy, they sit snuggly against teeth, creating a healthy smile. While the soft tissue may look as though it’s connected to the teeth, there is actually a space between the smile and gum tissue. This is the periodontal pocket, and in a healthy smile, these pockets are between two and three millimeters in depth. In smiles where the pocket is deeper, food debris, bacteria, and acidic plaque buildup damage the soft tissue, increasing the depth of the periodontal pockets and causing inflammation and swelling. Overtime, this causes the soft tissue to pull further away from the teeth, creating an even larger space. Without treatment to address the damage, these pockets will continue to grow, leading to numerous oral health concerns, including gum disease.

Why do We Measure Periodontal Pocket Depth?

Like many diseases that impact the whole body, oral health concerns are not obvious without testing. Just like a medical doctor screening for high blood pressure, high cholesterol, and high blood sugar levels, many oral health concerns need to be screened for with testing during routine dental checkups. By measuring the pocket depth around each tooth, we can often diagnose periodontal disease in the earliest stages and keep your smile healthy.

As part of regular dental checkups twice a year, the dentist will measure and compare the pocket depths to see if gum health is improving, maintaining, or getting worse. Gum disease is sometimes called “the sneak thief of teeth.” You may not know you have it until it is too late. People may assume their gums are fine because “they don’t hurt,” but if the pockets haven’t been measured, you can’t know for sure. The dentists and hygienists at McCarl Dental Group work to monitor these levels closely for each patient in our Greenbelt, MD dental office.

Connective tissue loss is also a sign that there is bone loss. When our hygienists and dentists measure periodontal pockets regularly, we can monitor bone and tissue attachment levels. These measurements should be taken once or twice a year, or more often in patients with active or previous periodontal disease.

How do We Measure Periodontal Pockets?

To measure a periodontal pocket we use a periodontal probe. The probe allows us to measure from the top of the pocket to the bottom of the pocket. The bottom of the pocket is the area where the tissue is connected through ligaments to the tooth’s root. This measurement is taken very gently and causes no damage to the delicate gum tissue. The recordings taken during periodontal probing are recorded in a chart. There are six measurements taken for each tooth, three on the facial side and three on the tongue side. By monitoring the recordings against each other at every visit, the dentists and hygienists at our dental office in Greenbelt, MD are able to make sure no areas become progressively worse and note improvement where treatment has occurred.

How Does Increased Periodontal Pocket Depth Indicate Gum Disease?

Each person’s mouth contains thousands of oral bacteria that are part of the natural digestive process. When we eat or drink, oral bacteria consume and digest part of our meal, producing a sticky, acidic film called plaque. The plaque builds up on teeth, and if it’s not removed, the plaque hardens into calculus (also called tartar). Plaque can harden into tartar in as little as twelve hours, and if it’s not removed before it hardens, the tartar will need to be professionally removed during your six month dental exam. In the meantime, this acidic substance will lead to irritation, inflammation, and destruction of soft tissue and underlying, supportive bone structures of teeth.

In the early stages, this leads to mild gum disease called gingivitis. In most cases, gum disease is caught at this early stage as part of biannual dental checkups, but if plaque and tartar aren’t removed routinely, the inflammation and destruction of hard and soft tissue will progress to the more serious periodontitis stage of gum disease. At this point, gum disease can do serious, irreversible damage to oral health and may even lead to tooth loss.

What Treatment Options are Available to Repair Periodontal Pocket Depth?

When several deep pockets are evident during periodontal charting, we will recommend scaling and root planing, or “deep cleaning.” The deep cleaning is more involved than regular professional teeth cleanings during six month exams. The focus is to remove the tartar from all pocket areas, since that is the bacteria’s “hiding place.” Not even diligent brushing and flossing can remove the tartar from a deep pocket. These professional deep cleaning treatments are necessary at this point. The root planing part of the treatment is actually a smoothing of the tooth’s root structure to reduce the number of nooks and crannies where bacteria and plaque can accumulate, preventing continued damage to oral health. Additionally, we may prescribe oral and/or topical antibiotics to reduce the number of oral bacteria. In more advanced cases, surgical intervention, including bone and gum tissue grafting, may be necessary to reverse the damage.

Can You Prevent Deep Periodontal Pockets?

In most cases, yes! In fact, the McCarl Dental Group team always prefers to help our patients keep their smiles healthy rather than addressing the damage after it’s already done. The best way to prevent deep periodontal pockets from developing is to maintain good oral health and hygiene habits, including:

  • Brushing teeth twice a day for at least two minutes at a time – brush after each meal for best results
  • Flossing teeth at least once each day
  • Use a soft bristled toothbrush (replaced every three to four months) and gentle brushing motions to avoid damaging gum tissue
  • Use a mouth rinse to help reduce the number of oral bacteria and limit your risk for gum disease
  • Visit your dentist at least twice a year for dental checkups and professional teeth cleanings

Frequently Asked Questions About Periodontal Pocket Depths

If you’ve been diagnosed with gum disease or you’re concerned about the depths of your periodontal pockets, you likely have some questions. The McCarl Dental Group team would love to hear from you. You can also find the answers to some of the frequently asked questions we hear about periodontal pocket depths below.

What is the Normal Depth of Periodontal Pockets?

When a tooth has periodontal disease, this tissue becomes detached past 3mm deep. Under 3mm deep a pocket is considered healthy, while 4mm or deeper it is considered unhealthy.

Why Does Gum Disease Make Periodontal Pockets get Deeper?

Gum disease is caused by oral bacteria that damage the soft tissue and supportive bone structures around teeth. This damage creates the deep periodontal pockets that are often our first warning sign that a person is struggling with gum disease.

How Deep do Periodontal Pockets Get?

Using a periodontal probe, we can track the depth of periodontal pockets. Anything over 3mm in depth can indicate a gum disease diagnosis. With proper treatment and preventive care, most people only see periodontal pocket depths between 4mm and 6mm. In extreme cases where gum disease is left untreated, periodontal pocket depts can reach 10mm or deeper, and at this point, the damage will likely need to be repaired with surgical grafting procedures.

Can You Reverse Gum Pocket Damage?

Depending on the level of damage, we may be able to significantly improve the depth of periodontal pockets. In most cases, the damage will not be completely reversible, but if you follow the treatment and prevention plan laid out by your dentist, you should be able to see significant improvement. Most people are able to reclaim a 4mm to 5mm pocket depth with proper treatment and ongoing periodontal maintenance.

If Pocket Depth is Repaired, Does Gum Disease go Away?

Decreasing the depth of periodontal pockets will limit the amount of plaque and bacteria that are able to build up at and below the gum line. By repairing the periodontal pockets and following your dentist’s recommend treatment plan, you can significantly reduce the effects of gum disease on your oral health and prevent gingivitis from developing into the more severe periodontitis. If gum disease has already developed into periodontitis, the condition can’t be completely cured, but many of the adverse effects on your oral health can be undone.

What will Happen at My Dentist’s Appointment to Repair Gum Pocket Depth?

During your gum disease treatment visit, you should be prepared to answer your dentist’s questions about your periodontal disease symptoms, including:

  • How long have you experienced these symptoms?
  • Are symptoms constant or sporadic?
  • What is your tooth brushing and flossing routine?
  • When is the last time you visited the dentist?
  • Do you use tobacco products?
  • What current and past medical conditions have you been diagnosed with?
  • What medications (prescription and over-the-counter) do you take each day?

Meet the McCarl Dental Group Team

The Dentists at McCarl Dental Group in Greenbelt, MD believe in the benefits of early intervention and prevention. By recording periodontal measurements at regular recall appointments, we can detect small problems before they turn into large ones. We will work together with our patients to help them understand where these deep periodontal pockets are, and what we can do to help them heal. If you’re looking for a dentist in the Greenbelt, MD area, please feel free to call and schedule an appointment. We’re available six days a week to help you achieve and maintain a healthy smile.