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Periodontal Pockets Classification, Symptoms and Treatment

Periodontal Pocket Definition

Periodontal pockets are caused by microorganisms and their products, which produce pathological tissue changes that lead to the deepening of the gingival sulcus. Pocket formation starts as an inflammatory change in the connective tissue wall of the gingival sulcus.

Periodontal pocket symptoms and treatment

Periodontal pocket formation

Periodontal pockets are formed when your gum breaks down and separates from the teeth, forming deep spaces between gums and teeth. The space formed between teeth and gums is called a sulcus, where bacteria, food particles, and microorganisms will start forming plaque between teeth and gums.

When we neglect cleaning the spaces or with the improper cleaning of the sulcus, Plaque formed in the spaces hardens into tartar which can’t be removed with usual brushing techniques or flossing. Bacteria toxins continue to form on the tartar and start causing inflammation in gum tissue causing gingivitis.

We might feel swelling or observe reddish gums which are caused by tartar or plaque around the gums and teeth resulting in pocket formation. Once the sulcus gets deeper, gums pull away from your teeth deepening the pocket causing loss of bone and gum tissue attachment beneath the gum line, destroying the structure which holds teeth in place.

We can easily diagnose periodontal pockets by observing the gum line and teeth, any presence of plaque or tartar is between gums and teeth can be considered as the early sign of periodontal pockets.

Classification of Periodontal Pockets

Gingival Pocket

It is also known as a pseudo pocket or relative pocket or false pocket. It is formed by gingival enlargement, without destruction of the underlying periodontal tissues. The sulcus is deepened because of the increased bulk of the gingiva.

Periodontal Pocket

It is also known as an absolute or true pocket. Periodontal Pockets causes the destruction of the supporting periodontal tissue; progressive Periodontal Pockets pocket deepening leads to the destruction of the supporting periodontal tissues and loosening and exfoliation of the teeth. Periodontal Pockets are two types which are Suprabony and Intrabony pockets.

Suprabony Pocket also known as supracrestal or supra alveolar pocket occurs when the bottom of the pocket is coronal to the underlying alveolar bone. The bone destruction pattern is horizontal in Suprabony pockets. Infrabony pockets also known as subcrestal or interalveolar pockets. The bottom of the pocket is apical to the level of the adjacent alveolar bone. The bone destruction pattern is vertical.

Pockets can involve more than one tooth surfaces and depths can vary and occur on one tooth surface and twisting around the tooth to involve one or more additional surfaces

Periodontal Pockets also classification based on tooth surfaces involved as Simple pocket( only one tooth surface involved), complex pockets (involves more than one surface), and compound or spiral pocket (originating on one tooth surface and twisting around the tooth to involve one or more additional surfaces.).

Periodontal Pockets Signs and Symptoms

Periodontal pockets identification is hard for common people and only dentists can identify the problem. But few signs would help us in suspicion of Periodontal Pockets which are mentioned below.

  • Gingival bleeding ( Gum Bleeding)
  • Gingival suppurations
  • Tooth mobility
  • In some cases, pus may be expressed by applying digital pressure.
  • Localized pain or deep pain in the bone.
  • There may be a bluish red vertical zone from the gingival margin to the alveolar mucosa.

Other signs include the below but it is suggested to consult a dentist to understand and confirm the occurrence of periodontal pockets.

  • Bleeding while brushing
  • Bleeding while flossing your teeth
  • Swollen or puffy gums
  • Bright red, dusky red or purplish gums
  • Pain when gums are touched
  • Gums that bleed easily
  • Bloodstains on toothbrush
  • Bad breath
  • Pus between your teeth and gums
  • Loose teeth or loss of teeth
  • Painful chewing
  • New spaces between your teeth
  • Gums that pull away from your teeth
  • Pain in the tooth while biting

Periodontal Pockets Treatments

Treatment for Periodontal pockets depends on various factors like the depth of pockets and the formation of tartar or plaque around your teeth along with other symptoms. Usually, the treatment involves the removal of bacteria formed in the pockets and reducing the gaps between gums and teeth either with medication or surgical procedure.

  • Reducing pocket depth and eliminating existing bacteria are important to prevent damage caused by the progression of periodontal disease and to help you maintain a healthy smile.
  • Eliminating bacteria alone may not be sufficient to prevent disease recurrence. Deeper pockets are more difficult for you and your dental care professional to clean, so it’s important for you to reduce them.
  • Reduced pockets and a combination of daily oral hygiene and professional maintenance care increase your chances of keeping your natural teeth – and decrease the chance of serious health problems associated with periodontal disease.
  • pocket irrigation- devices like squeeze bottles and blunt hypodermic needles can be used to irrigate the pocket with chemotherapeutic agents.
  • Flap surgery to eliminate pockets.

There are different treatment methods for Periodontal pockets as mentioned below

Scaling and Root Planing: Scaling removes the plaque and tartar from the below gum line and root planing smoothes the tooth root and helps the gums to reattach to the tooth, removing the spaces formed between tooth and gums.

Flap Surgery: Dentists would recommend for flap surgery as you might have deeper space between your gums and tooth. Flap surgery is especially helpful for people who have tartar deposits in deep pockets. Dentists would remove calculus in deep pockets, tartar will be removed by lifting the gums and then sutured back into place to fit close to the tooth. Within a week’s time, gums would start healing and stick tightly around the tooth.

Pocket Irrigation: With the help of Pocket irrigation, bacteria in the periodontal pockets will be removed and prevents the destruction of the surrounding soft tissue and bone. Food particles, debris, or bacteria toxins are washed with pocket irrigation. Also, antimicrobial medications are applied to gums to remove the bacteria strains.

Bone and Tissue Growth: if bone or gum tissues are destroyed, then dentists would suggest bone and tissue grafts that will regenerate the bone or add tissue in gum lines.

Home Remedies for Periodontal Pockets( Precautions)

Good oral hygiene is the best precaution for any kind of dental problem. Below are some of the precautions as well as home remedies to stop periodontal pockets from occurring.

  • Brush your teeth twice a day at least
  • Use Dental floss to clean between micro spaces
  • Use Mouthwash every day after brushing your teeth
  • Use fluoride toothpaste for brushing
  • Wash your brush and replace it every 2 – 3 months.

Reducing Periodontal Pockets Naturally

Many search for “how to reverse periodontal disease naturally” and try to find shortcut home remedies to cure or get rid of periodontal pockets which are not possible. If you are really want to cure naturally, below are some of the natural methods to reverse/stop the formation of periodontal pockets.

Brushing Your Teeth: One of the best ways to cure pockets is to brush on a regular basis in the morning and evening. If you feel the risk of periodontal pockets, try to brush after having every meal to keep oral hygiene and get rid of food particles or any other bacteria.

Electronic Toothbrushes: Use electronic toothbrushes for effective cleaning. Continue to brush your teeth on the four quadrants for at least 2 minutes. Electonic toothbrushes will reach much deeper than traditional toothbrushes and very effective in cleaning teeth.

Water Flossers: Using Water Flossers is more efficient than doing regular flossing. Water flossers machines shoot water between teeth and gums to remove any debris or particles stuck in the spaces.

Salt Water Cleaning: Mix half spoon saltwater in lukewarm water and take some into your mouth and swish it around. This will help in cleaning and healing gum pockets. Do this daily 3 to 4 times to keep your gum spaces clean and healthy. This is one of the best home remedies for periodontal pockets which can be followed very easily and safely at home.

Essential Oil Mouth Wash: Using essential oils for teeth and gum health is recommended by many dentists. Add 2-3 drops of tea tree, clove, aloe vera, guava leaf, lemongrass, or basil essential oil to a 240 ml cup of warm water and swish it around your mouth and spit it out.

Oil Pulling: One of the oldest and ayurvedic method for many benefits. It is suggested to take coconut oil(Pure) of 2 spoons in your mouth and move it around your teeth without swallowing. Swishing around teeth and gums pulls toxins and bacteria out of the periodontal pockets in your gums, allowing them to heal more effectively. Considering the availability it is also the best home remedy for periodontal pockets.

Supplements to improve gum health: Nutrients like omega-3 fatty acids, probiotics, and calcium would help in improving your gum health. it is suggested consult the dentist before taking any supplements as it is a must to know the suitable quantity and kind of supplements you need.

Do Not Do: Smoking or Drinking alcohol is one of the reasons for gum diseases and increases the risk of periodontal pockets. It is strongly suggested to avoid smoking, drinking alcohol, and any other sugary foods or drinks.

Eat Healthily: Healthy foods would surely help in oral health. It is suggested to eat green leafy foods and anti-inflammatory foods to reduce the risk of gum problems and periodontal pockets. omega-3 fatty acids, probiotics, and calcium including dairy products, lean proteins, and fermented foods, like kimchi, and sauerkraut foods will help in improving your oral health and overall health. Drink at least 2 liters of water to keep your mouth dry and your body will also get hydrated. By drinking water, we can avoid dry mouth kind of problems and improve our oral health.

Dentist Consultation: it is the most ignored routine for everyone. Like regular health checkups, it is important to get your dental health checkup also every 3 months. This will help in identifying any kinds of dental diseases at the beginning and undergo treatments without complications.

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Dental Health Guide, Providing information on dental care and dental hygiene along with detailing the most common dental diseases with symptoms and treatment methods. Readers should use the dental articles as reference only and consult a dentist and visit a dental clinic for dental health problems.

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