A periodontal pocket is an unusually deep hole in the gums beside a live tooth. The depth of perio pockets often prevent proper cleaning and health, and allow food and bacteria to build up against the tooth. This buildup can weaken tooth fibers and result in lost or damaged teeth. If the perio pocket hasn’t yet ruptured the tooth fibers, it’s called a gingival pocket and the damage can be reversed without surgery.


Causes and Symptoms

The space between gum and tooth is called the sulcus, and acts as a constantly flexing moat catching bacteria and food debris, and allowing the immune system to respond to them. Its natural depth is about 2mm. If this space increases beyond 3mm, it becomes harder to treat with toothbrushes and other home care and may result in damage to the periodontal ligament (PDL) fibers that attach the gums to the tooth. This is called a sulcus.


If site irritation and inflammation occur, it’s called a gingival pocket. From this point, a bacterium continues to destroy the PDL fibers and the gap becomes 4mm or more deep, a periodontal pocket has been produced. Sometimes the alveolar bone, the ridge of bone that supports the teeth socket, can also be damaged. Abscess and inflammation can make the perio pocket painful and prone to bleeding. The tooth may come loose or even fall out.



The damage to PDL fibers that are the result of a periodontal pocket is irreversible. The depth will be measured and put in a patient’s file so it can be regularly monitored for periodontal disease. If an abscess is formed, it will need to be opened and drained. Systemic antibiotics are applied to reduce localized septicity. In some cases, tissue and tooth damage is so vast, extraction is the best solution.