What is a periodontal pocket?

Periodontal pocket is the outcome of periodontal disease (also known as gum disease). It is a chronic infection in the gums and jawbone surrounding the teeth. It is proven to be a health risk and lead to dental problems, teeth loss and other potential systemic issues. However because the symptoms can be very subtle, many don’t realize they have gum disease until it starts to take a serious tall. When the bone and gum tissue doesn’t fit snugly around the teeth anymore, we start seeing “pockets” around the teeth. Over time, these pockets become deeper, providing perfect environment for bacteria to live in, resulting in gum and bone loss. Eventually the teeth will need to be extracted.

What is the cause of periodontal pockets?

There are detected local and systemic causes. Localized plaque and tartar hidden under the gums start infecting your gums. This is considered to be the first level of periodontitis, named gingivitis. Following symptoms describe gingivitis: redness and gums swelling, bleeding when flossing and brushing, occasional bad breath, periodontal pockets 2-4mm when the dentist is probing. This stage is complete reversible and it effects only the gums, it does not involve bone loss yet.

The main treatment for gingivitis is to maintain a good oral hygiene, regular check-ups and dental cleaning (every 6 months) with an experienced dental hygienist.

If gingivitis is not treated, the infection protrudes deeper under the gums and goes to the next level of slight periodontitis (2nd stage). It is very similar to gingivitis with deeper pockets 3-5mm. the transition from stage 2 to 3rd stage can happened unnoticed to the patient. Same symptoms can accurre : gum redness and swelling , bleeding while brushing and flossing , halitosis ( bad breath) ,but it involves bone loss . Your dentist detects periodontal pockets 6-7mm. At this point, infections periodontal bacteria enter the blood stream and stress the immune system. Treatment can include deep cleaning (scaling and root planning) in order to remove all the bacteria deposits, more often visits (3-4months or depends on the treatment plan).

And the last stage is advanced periodontitis that involves 50-85% of bone and gum loss, periodontal pockets depth more than 7mm, severe bad breath, gum redness and swelling, advanced teeth mobility. Patient starts to see gups between their teeth, exposed teeth roots due to bone loss.

Usually this stage marks the end of teeth life expectancy, teeth should be extracted and replaced with dental implants or any other restorative replacement.

Periodontal disease is often associated with systemic diseases or they have a bidirectional relationship. That has been described in many studies (references below). The authors link periodontal disease with autoimmune diseases : type 1 diabetes mellitus ( there is compelling evidence showing association between poorly controlled type 1 diabetes , higher HbA1c levels – it is lab test that shows the sugar levels in the last 3 months) ; rheumatoid arthritis , osteoporosis .

Other pathological conditions correlated with periodontitis are cardiovascular disease, cerebrovascular disease, respiratory diseases, peripheral arterial disease and complication during pregnancy. Additionally, genetical predisposition and chronic environmental insults such as exposure to stress; poor diet, alcoholism, smoking, drug abuse could trigger periodontal disease. All the treatment plans should be discussed with the patient’s physician.

In conclusion, periodontal disease can be treated if detected at early stage. If you have any questions about periodontal disease or treatment please do not hesitate to ask your dentist or us.

References:
“Periodontal disease and Its Systemic Associated Diseases “ J.Fernandes-Solari , P.Barrionuevo , C.A.Mastronardi

Dr. Irina Bratu

General Dentist

Dr Irina qualified as a Dentist in Republic of Moldova at State University of Medicine “Nicolae Testemitanu”.

She completed her extensive three years postgraduate program on Dental Therapy & one year advanced educational program on Implantology and Oral Rehabilitation at New York University College of Dentistry (USA). She is a member of Emirates Medical Association EMA, has a passion for the prevention of oral disease, and works to promote a healthy lifestyle for all of her patients.