Your gums form a sort of “turtleneck” around your teeth. When you wear a turtleneck shirt, you can slide a finger between the cloth and your neck. The same thing happens on a smaller scale with your teeth and gums. There’s an area where floss and your toothbrush’s bristles can slide between your teeth and gums to clean. This is true even for healthy gums! We call this space a periodontal pocket. Perio means around and dontal refers to the teeth (gums are around your teeth, right? There’s also bone around your teeth, which is covered by your gums).
We measure your periodontal pocket in millimeters (mm). What we have found is that depths of 0-3 mm are ones where your toothbrush and floss are able to keep the pocket clean. Depths of 4-5 mm indicate early gum disease and depths of 6 mm or higher indicate advanced gum disease.
What’s happening as the periodontal pocket measurement numbers are getting larger is that the bone around your tooth reacts to long-term inflammation of your gums. The bone moves away from the biting surface of your tooth and toward the root of your tooth when this happens—this means there is less bone around your tooth to hold it in your jaw. Once this happens, your gums have three choices:
- Follow the bone down the root of your tooth.
- Stay at the height it was before.
- A combination of the above (it follows the bone some of the way toward the root but not all the way toward the root.)
If the gum stays at the height it was before the bone changed, the space we can measure gets larger. (We’ll often say the periodontal pocket gets deeper.) The larger, deeper space traps more bacteria and food—and as the pocket gets deeper, your toothbrush and floss can no longer clean it out effectively, so the process becomes self-perpetuating. (It will keep getting worse until you have periodontal treatment of some kind.)
(Just as a side note—if your gum follows the bone down the root of your tooth, we call that gingival recession. Gingiva is the fancy name for your gums.)
I like to explain the periodontal pockets like clothes pockets. When I was in school, the popular jeans had a tiny little pocket inside the pocket on the right hand side. This pocket was about the size of a quarter or half-dollar coin—you could probably only get one or two fingers into it at a time—this is the ultra-healthy periodontal pocket.
The regular pockets on jeans or your pants where you can put your hands in and easily find your keys or whatever you’re looking for are the 1-3 mm or maybe even the 4 mm periodontal pockets.
Pockets on cargo pants—those deeper pockets that are harder to reach into and pull out what you need—are like the 5 mm and larger pockets.
I hope this explanation of periodontal pockets makes sense to you and allows you to better understand what your dentist means when she or he discusses periodontal pockets or does a periodontal charting.
*Note: Information in this article is not meant to replace the clinical judgment of your healthcare professionals.
Dr. Jennifer Robb is a general dentist who treats both adults and children.
1612 Cooper Foster Park Rd.
Lorain, OH 44053