The periodontal pocket

poche parodontale

If you are here, you have a periodontal pocket. It is important to know that a periodontal pocket is the advanced stage of periodontitis. Periodontitis is an inflammation of the entire periodontium. It starts with gingivitis, which affects only the gums. When it is not treated, periodontal pockets are dug between the gum and the tooth, the inflammation spreads.

Here is a guide to help you understand what a periodontal pocket is and how to treat it.

What is a periodontal pocket?

A periodontal pocket is one of the components of periodontal disease. It is located deeper than the gingival pockets and therefore at the level of the bone. It is caused by the destruction of the supporting tissues of the tooth, including the bone. When a pocket develops due to a disease, the probe reveals an increased depth of sulcus. This periodontal pocket is present on one side of the tooth or affects the sides that make up the alveolar bone. If it progresses, it can extend to the root of the tooth, resulting in tooth mobility and loss. 

The origin of a periodontal pocket 

Pathogenic agents are at the origin of periodontal pockets. These are caused by the appearance of dental plaque and tartar on the teeth. These infiltrate under the gums, creating inflammation and making the oral environment susceptible to the induction of periodontal pockets. Plaque bacteria are responsible for these periodontal pockets.

Certain genetic conditions can favor the creation of periodontal pockets and the development of general interrelated diseases. Indeed, we count diabetes, stress, smoking and hormonal changes, among others. Periodontal pockets make it more difficult for diabetics to manage their blood sugar levels, while high blood sugar levels promote the development of periodontal pockets. Smoking does not worsen the disease, but it does interfere with healing during various treatments. 

Symptoms and pain of a periodontal pocket

There are many symptoms and pains that you can easily spot if you think you have a periodontal pocket. The symptoms are different depending on how advanced this oral problem is.

Here are the symptoms and pains related to a periodontal pocket. 

  • Inflamed gums that may bleed in places
  • The presence of small abscesses that cause bad breath
  • Localized pain or a feeling of pressure
  • Bleeding when brushing your teeth or when using interdental floss or brushes
  • The presence of pus coming out of the gum
  • A change in the color, shape, texture and position of the gums
  • Potentially red and swollen gums
  • A bad taste felt inside the mouth
  • Radiant pain inside the bone that may worsen
  • A very strong sensitivity to heat and cold
  • Dental pain: toothache even though there are no dental cavities  

To take care of your gums, you can use the Y-Brush toothbrush. It is a toothbrush that has different sonic vibrations depending on your dental sensitivity. 

Periodontal pocket treatments at the dentist

It is important to manage this oral problem as soon as possible to treat it properly. The most effective method of eliminating a periodontal pocket is to reduce its depth to that of a normal gum line. There are different methods depending on the severity of the patient's oral situation and the progression of the condition to periodontitis.

Here are the different possible treatments of the periodontal pocket:

Scaling and root planing


Root planing is used as a complement to scaling during periodontitis. It is a kind of deep scaling designed to remove all tartar and bacterial plaque from all tooth surfaces, including under the gum, along the roots of the teeth. Scaling requires the use of ultrasonic equipment to remove bacterial plaque by vibration. It removes tartar, plaque and biofilm from the teeth.

Flap surgery


Flap surgery is a surgical technique that involves cleaning out pockets, tartar and periodontal pockets before suturing the pockets so that the gum can bond back to the tooth. It provides tissue to repair a loss of substance. Unlike the graft, the flap is vascularized (blood arrives through an artery and leaves through a vein, this artery/vein combination is called a pedicle and may contain a nerve).

The graft


It consists in taking off the gum as for the periodontal surgeries of debridement. This allows to see directly the tartar under the gum and the inflammatory tissues which must be eliminated. The safest technique for this type of periodontal surgery is the use of an autogenous bone graft. This is bone recovered during the procedure that allows for the reconstruction of lost bone.

The different medications available for treatment

Doxycycline gel

This gel contains doxycycline. It treats periodontal disease, destroys bacteria and prevents them from forming again. It also reduces pockets caused by periodontal disease. It is an antibiotic that is released gradually over a period of about a week. It adapts to the contours of the gums and solidifies inside them. It becomes waxy when it comes into contact with saliva.

The chlorhexidine tablet


It is used as an additional local antibacterial and analgesic treatment for limited affections of the oral mucosa. It is possible to put this lozenge in a cloth after scaling so that it releases its antibacterial active ingredients over a given period of time. You should place this microbial gelatin pellet in a tissue pocket near the gum margin after scaling and root planing. This microbial agent is released gradually over time.

Minocycline microspheres


In this type of periodontal disease treatment, the periodontist inserts tiny particles containing the antibiotic minocycline into the tissue pockets after a scaling/root planing procedure. It is used only as a last resort when other types of treatment are not possible. Do not stop your treatment before the end of the prescribed time without medical advice.

Home solutions after treatment at the dentist

The dental jet

To improve the cleaning of periodontal pockets, you can use a dental jet with a soft rubber tip for therapeutic rinses at low pressure. It is easy to use and will allow you to gently clean up to 90% of the depth of a 6 mm periodontal pocket. The operation of the dental jet is very simple. All you have to do is understand the steps.

  • With the Hydropulser turned off, select the lowest pressure setting.
  • Place the soft tip against the tooth at a 45 degree angle and gently place the tip under the gum in the pocket.
  • Turn on the Hydropulper and proceed with the cleaning.

Mouthwash therapy

Dentists often prescribe therapeutic mouthwash as a non-surgical way to treat gum disease and clean periodontal pockets. These prescription solutions usually contain chlorhexidine gluconate which is much more effective than other therapeutic mouthwashes. It is generally recommended to use it 2 to 3 times a day.

We hope that this guide has helped you understand what a periodontal pocket is. We hope that you have understood its origin but also the symptoms and pains to recognize this oral problem each time it appears. The most appropriate treatment for you will depend on the advice of your dentist.  

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