Gum Pockets

What they are and why they are formed

The gum pockets are produced by an increase in the gingival sulcus.

The so-called gingival sulcus represents a narrow and shallow canal, located at the sides of the tooth and bounded on one side by the tooth surface and on the other by the sulcare epithelium of the marginal gingiva. Under normal conditions this furrow is one to three millimeters deep, but in the presence of periodontal disease, it is deepened to reach and exceed four or more millimeters.

In certain pathological conditions the gingival sulcus can increase its depth, forming a pocket called the gum pocket. The causes of this phenomenon are mainly to be found in plaque deposition, which, if not removed, causes the destruction of the sulcare epithelium, which migrates lower to defend itself.

Bacterial toxins cause gingivitis, which is manifested by gum bleeding produced by minimal trauma (eg when brushing the teeth). The irritated gingival tissue withdraws, moving away from its original location and leaving unaesthetic and often sensitive root exposure. After the gum moves away from the tooth, the bone is also reabsorbed, creating bony pockets in which the plaque accumulates more easily, which when calcified becomes tartar.

The presence of subgingival plaque and tartar is responsible for the progression of the disease. Bacteria not removed from teeth and gums lurk in the periodontal pockets and produce toxins that kill osteoblasts (the cells used for bone reproduction). Consequently there is a bone resorption which causes tooth mobility and, in the absence of appropriate treatment, the fall of the same (even when they are perfectly healthy). The risk of tooth loss is therefore not related to the gingival pocket itself, but rather to bone resorption that occurs in the absence of treatment (due to bacterial infection).

The formation of the gum pockets is closely linked to the presence of bacterial plaque, but in its origin various factors come into play, such as smoking (its cytotoxic substances destroy the cells used to maintain the tissues supporting the teeth), stress (which when severe decreases the immune defenses), pregnancy and puberty (the strong hormonal fluctuations favor the onset of gingivitis), pharmacological therapies (contraceptives, antidepressants, antihypertensives, cortisone and other drugs), genetic predisposition, diabetes and other systemic pathologies.

Symptoms that should make you suspect a periodontal disease

• swollen and reddened gums;
• bleeding gums;
• halitosis (in about 90% of cases it comes from the oral cavity with poor hygiene, as the bacteria are able to produce volatile sulfur compounds);
• appearance of spaces between the teeth;
• gingival recessions with root exposure;
• dental mobility.

Symptoms of gum pockets

The gum pockets can deepen in the absence of obvious symptoms. Consequently, one often notices periodontal disease only when it reaches an advanced stage, characterized by an increase in tooth mobility, gum bleeding, halitosis and diffuse pain.

Diagnosis gingival pockets

The diagnostic procedure, called periodontal probing, is carried out by gently inserting a millimeter probe between the tooth and the gingival margin. Measurements are detected at different points in each tooth, in order to detect the presence of periodontal pockets and to quantify their depth. If the gums are healthy, the depth of the groove is 1-2 mm. Values ​​greater than 4 mm in depth are to be considered pathological.

The patient should consider that in response to local inflammation the gums tend to become swollen, edematous, masking gastrointestinal tracts and pockets, which can sometimes appear less deep; therefore, in the presence of symptoms or abnormal signals, even in the absence of pain, it is advisable to consult your trusted dentist.

Prevention and therapy

To prevent the formation of gum pockets, a toothbrush and toothpaste are not enough, but can become so if combined with the use of dental floss. Oral rinses with anti-plaque and mouth watering mouthwashes are not necessary, but can help when the dentist recommends them. Everything must be combined with a professional cleaning every six to eight months in the dental office.

Treatment of gum pockets and periodontal disease depends on the stage of the disease. Mucogingival surgery includes the set of procedures for correcting morphology, position and / or quantity defects of periodontal soft tissues (gums). The main indications are the coverage of the exposed root surfaces, obtained by simple traction of the existing gingiva in the area in which it is missing, up to the actual gum graft, which is taken from the palate in the event that it becomes necessary to cover large gingival pockets.