What do "periodontal pockets" mean?

When dentist's refer to "periodontal pockets" they are referring to measurements of teeth's gingival crevices of more than 3 mm. Commonly dentists and periodontists become concerned when measuring pockets that are 5 mm or more since these are thought to be more likely to develop further breakdown that can result in loss of bone supporting teeth.

Pocket measurements of three mm or less are thought to be OK and are considered normal. In fact a more significant finding is 'bleeding on probing' since this indicates the presence of inflammation. Inflammation is a more predictable predictor of either gingivitis or active periodontal disease. In fact pockets of any depth may or may not exhibit bleeding on probing.

The goal of most periodontal therapy is to try to cause pocket shrinkage, institute frequent recall schedule and coach the patient in methods of keeping their mouth cleaner at home, Using good brushing techniques, interproximal cleaning and possibly the use a water pik. The first two help remove plaque from the surfaces of the teeth and the latter is a help in causing fluid exchange of the sulcular fluid. Sulcular fluid, especially in periodontal pockets can be 'seeded' with harmful bacteria 'floating in solution' and these may in part be responsible for the inflammation found in pockets. The water pik, although not very good at removing plaque adhering to tooth surfaces can be effective at removing contaminated sulcular fluid and can help eliminate inflammation in pockets deeper than 3 mm.