How to Treat Periodontal Pockets

What are periodontal pockets?

When you have healthy gums and teeth, your bone and gum tissue fit tightly around your teeth. However, when you have periodontal disease, this supporting tissue and bone get destroyed, and it creates “pockets” around the teeth.

Over time, the periodontal pockets can get deeper, making a larger space for bacteria. As bacteria grows around the teeth, they can accumulate under your gum tissue. Then these deep pockets will collect even more bacteria, which results in further tissue and bone loss. Eventually, the tooth might need to be extracted. However, eliminating bacteria alone may not be enough to prevent the disease from coming back. Deeper pockets are more challenging to clean.

Therefore, it’s essential to do all you can to reduce them. Reduced pockets combined with daily oral hygiene and professional dental maintenance optimize your chances of keeping your natural teeth – and decrease the probability of more severe health problems.

A pocket reduction procedure may be recommended if you have pockets that are too deep to clean with daily oral routine.


A periodontist or dentist may perform the periodontal treatment. The aim is to clean the pockets around teeth completely and to prevent further damage to the surrounding bone. You should also adopt a good daily oral routine, and manage health conditions that may affect your dental health.

 Nonsurgical treatments

If periodontal disease isn’t advanced, treatment may involve less invasive procedures, such as:

  • It removes bacteria from your tooth surfaces and from beneath your gums. It can be done using instruments such as an ultrasonic device or a laser.
  • Root planing. It smooths the root surfaces, preventing any further buildup of bacteria, and removes the byproducts that contribute to inflammation.
  • Antibiotics can help control the infection. They can include antibiotic mouthwashes or gels with medicines that get between your teeth and gums or into dental pockets after the deep cleaning.

 Surgical treatments

If you have advanced periodontitis, you may need dental surgery, such as:

  • Flap surgery (pocket reduction). In this procedure, the periodontist holds back the gum tissue and removes the bacteria before fixing the tissue into its place. Then the gum tissue can reattach again to the healthy bone. Because periodontitis can cause bone loss, the underlying bone may have to be recontoured before the gum tissue is put back in place.
  • Soft tissue grafts. When you lose gum tissue, your gum line withdraws. You may have to have some of the damaged soft tissue reconstructed. This is typically done by removing a tiny amount of tissue from the roof of your mouth or using tissue from a donor. This can prevent further recession, cover the roots, and give your teeth a more pleasing look.
  • Bone grafting. This procedure is done when periodontal disease has destroyed the bone around your tooth root. The graft may consist of small fragments of your bone or a synthetic or donated bone. The bone graft helps prevent losing your tooth by holding it in place. It also makes the regrowth of natural bone possible again.
  • Guided tissue regeneration. This also allows the bone that was destroyed by bacteria to regrow. The dentist puts a special piece of biocompatible fabric between the existing bone and the tooth. This material stops unwanted tissue from entering this area, allowing your bone to grow back.
  • Tissue-stimulating proteins. This method involves applying a special gel to an affected root. This gel stimulates the growth of healthy bone and tissue because it is made of the same proteins that can be found in developing tooth enamel and bones.