Periodontal Pocket – Signs, Cause, Types, Diagnosis, Treatment & Prevention

Poor oral hygiene and bad food habits lead to the formation of a biofilm of bacteria called as plaque. The presence of bacterial plaque on the tooth surface causes inflammation of the marginal gingiva.

As a result, gingiva sulcus deepens due to enlargement of the gingiva or gums and create a periodontal pocket. Food particles and microbes tend to get trapped in the periodontal pockets and leads to further infection. (1)


Negligence towards proper oral hygiene has led to the occurrence of periodontal diseases in millions of people around the world.

In periodontal diseases the pathological deepening of gingival sulcus (space between teeth and gums) becomes prominent.

In healthy gums, a gingival pocket measure less than 3 millimeters. But if the size is beyond 3 millimeters, then it is an indication of gum disease. Over time, these periodontal pockets drop deeper and may eventually lead to tooth loss.

What is a periodontal pocket?

A periodontal pocket forms due to the inflammation and swelling of gums. Enlargement of gums creates spaces or pockets, which further trap food debris.

Inflammation of gums happens when there is an accumulation of film of bacteria or plaque, especially near the gum line. If this plaque is not removed in time, then it hardens and forms tartar.

Tartar produces toxins which cause inflammation of gums. The condition is also known as gingivitis.

The gums pull away from teeth and make more space for tartar or food debris to trap. If the periodontal pocket deepens then it causes danger to the bone around the teeth.


Infection of gums lead to a periodontal pocket and sometimes even loss of a tooth. So, it is vital to know the leading causes for the occurrence of infection in gums.

  • Poor oral habits
  • Smoking or chewing tobacco
  • Specific conditions of viral and fungal infections
  • Poor nutrition, especially vitamin C deficiency
  • Genetics
  • Diseases that decrease immunity such as AIDs or cancer treatment
  • Hormonal changes during pregnancy, menstrual cycle or while taking birth control pills

Signs and symptoms

  • Localized pain near the infected teeth
  • The sensation of pain or pressure while eating which gradually reduces
  • Swollen, bluish red marginal gingiva
  • Bleeding gums and suppuration
  • Receding gums exposing root surface
  • Sensitivity to hot and cold foods
  • Tooth mobility
  • Itching in the gums


The dentist will analyze your signs and symptoms before diagnosing the condition. The dentist will also ask for your medical and dental history. Signs like bad breath, bleeding gums or bad taste in your mouth can be an indication of gum disease.

Besides the visual examination, your dentist will check the depth of a periodontal pocket with the help of a periodontal probe. The periodontal probe has calibration in millimeters.

More millimeters mean more loss of attachment of gums. Measurement around 7 to 10 mm indicates advanced periodontitis. (3)

Types of periodontal pockets

The periodontal pockets are classified into various categories according to –

  • Morphology
  • Number of surfaces involved
  • Nature of soft tissue trail of the pockets or concerning the base of the socket
  • Crest of the remaining alveolar bone

Here are some of the forms of periodontal pockets –

  1. Suprabony periodontal pocket – The base of the pocket is more towards the crown of the tooth. The pattern of destruction of underlying bone is horizontal.
  2. Infrabony periodontal pocket – The base of the pocket is more towards the apical portion of the crest of alveolar bone, and the bone-destructive pattern is vertical. (2)
  3. Simple pocket – Involves only one tooth surface.
  4. Compound pocket – It involves two or more tooth surfaces.
  5. Complex pocket – It is also known as a spiral pocket. In this type of periodontal pocket, the base of the pocket is not in direct communication with the gingival margin.

Conventional treatment for periodontal pocket

Your dentist will suggest a path forward based on your dental condition. Usually, the very first step would be to go for cleaning of your teeth, which is also known as scaling and root planning.

This technique involves removal of all of the tartar and plaque from your teeth and between the gum pockets. Post cleaning, the gums will heal and tighten around the tooth, reducing the periodontal pocket. (4)

Antibiotics are sometimes recommended to reduce inflammation and help control the bacterial growth underneath the gum line. Antibiotics are most often directly applied inside the periodontal pocket. (5)

If a periodontal pocket is too deep to be treated with non-surgical procedures, surgery may be required to reduce the size of the pocket. This surgical procedure is often done by a periodontist (a dentist who deals with gums and supporting structures) with professional surgical tools. (6)

Home remedies to treat a periodontal pocket

Once the gums are destroyed they don’t grow back on their own. Taking care of your gums is very essential to prevent them from forming pockets.

Periodontal diseases are very much preventable by regularly visiting your dentist and performing effective home remedies. Here are some simple home-based remedies you can follow to prevent or improve a periodontal pocket –

  • Rinse your mouth with warm salt water to reduce the inflammation and kill the bacteria
  • Use mouthwash containing hydrogen peroxide
  • Drink green tea, as it has certain antioxidants that can reduce the inflammation
  • Oil pulling and gum massage can reduce the plaque buildup
  • Apply turmeric mixed with water to your inflamed gums as turmeric kill bacteria and reduce inflammation
  • Eat foods rich in vitamin C like guava, mango, and various other citrus fruits
  • Apply the juice of Indian lilac to your gums. Indian lilac is also known as neem and it has the ability to fight against the bacteria involved in periodontitis


Periodontal diseases are the most common oral health problem around the globe. But you can prevent it with good oral hygiene and proper food habits.

Prevention gum diseases can also save you from spending loads of money on your gum disease treatment.

  • Brush after meals with a soft bristled brush, and don’t forget to brush around the gum line.
  • Floss your teeth once a day.
  • Replace your toothbrush within 3 to 4 months.
  • Avoid smoking or chewing tobacco.
  • Use mouthwash to remove extra food debris.
  • Visit your dentist every six months for cleaning your teeth.


A periodontal pocket is one of the major signs of gum diseases. The depth of the periodontal pocket is used as the measure to test the health of gums. Healthy gums have a depth less than 5mm for periodontal pockets.


Good oral hygiene along with regular dental checkups can be very helpful in preventing periodontal disease and decreasing the chance of reoccurrence of the disease.

Avoid several bad habits like smoking, consuming tobacco products, drinking sugary sodas or acidic foods and beverages.

If you experience any of the symptoms of gum diseases, then do not hesitate to contact your dentist. Start your treatment without neglecting since if it is left untreated, it can lead to tooth loss or other severe problems.


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