By Shelly Fesler, RDH, BSDH
Why all the fuss about pockets?
Gum pockets are the space between your teeth and gums.
Everyone has them but your dentist may only mention them when they are too deep.
Deep pockets are worrisome because they are a sign of gum disease.
How do you know if yours are too deep?
Your hygienist uses a periodontal probe to gently measures them. Though a probe looks scary, it is just a tiny ruler:) When used properly it won't hurt you.
Healthy pockets typically are 1-3 millimeters (mm), are not red or swollen, and don't bleed or hurt when they are measured correctly.
4-6 mm pockets are an indication of early to moderate gum disease.
Gingivitis can cause your periodontal pockets to measure in this range.
Early periodontal disease that involves some bone loss can also be seen with these measurements.
Pocket depths that are deeper than 6mm are usually an indication of more advanced gum disease.
Periodontal disease that has progressed far enough to cause moderate to severe bone loss will result in pockets that measure 6mm or more.
Gum pockets that measure deeper than 3mm may require some type of periodontal disease treatment.
Because gum disease is not obvious in the early stages, it is important to have a periodontal exam and periodontal charting at least once a year.
Early diagnosis makes treatment easier, less expensive and more successful.
Once they are measured, your hygienist or
dentist should review their findings and
make treatment recommendations. Treatment for mild cases can be a simple as changing what you do at home.
History ~ A gum pocket that has recovered from 7mm to 4mm and doesn't bleed should be monitored but doesn’t need treatment. One that was previously 3mm and suddenly measures 6mm or more is a concern.
Bleeding ~ No matter how deep the pocket, one that bleeds when measured is more worrisome than one that doesn't.
Appearance ~ The way your gum tissue looks should be considered when determining treatment options...red or swollen vs pink and firm.
Other factors~ Some pockets measure too deep for other reasons
and don't indicate gum disease or require treatment. Teeth that erupt out of position or have too much gum tissue are two examples.
If you think it sounds complicated...you're right! There are many variables and gray areas that cause gum disease to be easily misdiagnosed, over-treated or neglected.
Your dentist and hygienist should keep an accurate periodontal chart and carefully consider all factors and then choose the most appropriate treatment plan to ensure optimal health.