Periodontal Pockets Explained

At your last dental exam, you may have noticed the hygienist or dentist calling out a series of numbers, such as “4, 3, 3, 6, 3, 8, 4…”. These measurement were taken for all of your teeth (and possibly dental implants). In the absence of wisdom teeth, there are 168 site-specific measurements. That’s six measurements on each of your remaining 28 teeth.

What is Periodontal Probing?

The measurements are the depth of the sulcus or periodontal pocket around each tooth. The bottom of the “pocket” is where the gums attach to the root of your tooth. A probe with millimeter increments marked onto it is slid just under the gums until it rests at the bottom of the pocket. We call this process a periodontal exam or probing.

In addition to probing other measurements are taken. Areas with gum recession (receding gums where the roots of the tooth are visible), furcations (spaces between roots of your molars-back teeth), mobility (looseness of teeth), and how thin or thick your gums are, and whether the probing leads to bleeding.

Does it Matter How Deep My Gums Are?

A healthy gums can have measurements of 2-4 mm in the absence of bleeding. But when plaque bacteria, inflammation, and disease start setting in, the tissues at the bottom of the pocket begins to detach from the tooth. At this point a periodontal pocket is created, which leads to a host of other symptoms, including:

• Bone loss

• Redness and swelling

• Bad breath (halitosis)

• Tooth mobility

Depending on the depth of your periodontal pocket, the treatment protocol will be different. Moderate attachment loss (pockets 6+ mm) requires periodontal scaling and root planing (“deep cleaning”) to remove infectious bacteria. Severe pocketing requires deep scaling and more frequently required periodontal surgery and may even require tooth removal (extraction).

Health Implications of Deep Dental Pockets

While tooth loss is typically the biggest concern associated with periodontal pockets, the infection poses a significant risk to your overall health. There are reported links between periodontal disease and systemic health conditions like:

• Heart attack

• Stroke

• High blood pressure

• Diabetes

• Infertility

• Erectile dysfunction

• Preeclampsia