What they are and why they are formed
Gum pockets are produced by an increase in the gingival sulcus.
The so-called gingival sulcus represents a narrow and shallow canal, located on the sides of the tooth and delimited on one side by the tooth surface and on the other by the sulcus epithelium of the marginal gingiva. Under normal conditions this groove is from one to three millimeters deep, but in the presence of periodontal disease it deepens until it reaches and exceeds four or more millimeters.
Bacterial toxins cause gingivitis, which is manifested by gum bleeding produced by minimal trauma (for example when brushing the teeth). The irritated gum tissue withdraws, moving away from its original location and leaving unsightly and often sensitive root exposures. After the gum moves away from the tooth, the bone also resorbs, creating bony pockets in which plaque accumulates more easily, which calcifying 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 periodontal pockets and produce toxins that kill osteoblasts (the cells used to reproduce bone). As a result, there is a bone resorption that causes mobility of the teeth and, in the absence of a appropriate treatment, the fall of the same (even when they are perfectly healthy). The risk of tooth loss is therefore not linked to the gingival pocket itself, but rather to bone resorption that occurs in the absence of treatment (due to bacterial infection) .
The formation of gum pockets is closely linked to the presence of bacterial plaque, but various factors come into play in its origin, such as smoke (its cytotoxic substances destroy the cells used to maintain the supporting tissues of the teeth), stress (which when severe decreases the immune defenses), pregnancy and puberty (the strong hormonal fluctuations favor the onset of gingivitis), drug therapies (contraceptives, antidepressants, antihypertensive drugs, cortisone and other drugs), genetic predisposition, diabetes and other systemic diseases.
Symptoms that should lead to suspicion of periodontal disease- swollen and red gums;
- bleeding gums;
- bad breath (in about 90% of cases it comes from the oral cavity with poor hygiene, as the bacteria are able to produce volatile sulfur compounds);
- the appearance of gaps between the teeth;
- gingival recessions with exposure of the roots;
- dental mobility.
Symptoms of gum pockets
Gum pockets may deepen in the absence of obvious symptoms. As a result, periodontal disease is often noticeable only when it reaches an advanced stage, characterized by increased tooth mobility, gum bleeding, halitosis and widespread pain.
Gum pocket diagnosis
The diagnostic procedure, called periodontal probing, is carried out by very delicately inserting a millimeter probe between the tooth and the gingival margin. The measurements are taken in different points of each tooth, in order to detect the presence of periodontal pockets and quantify their depth. If the gums are healthy, the sulcus depth is 1-2 mm. Values greater than 4 mm in depth are to be considered pathological.
Prevention and therapy
To prevent the formation of gum pockets, a toothbrush and toothpaste are not enough, but they can become so if combined with the use of dental floss. Oral rinses with anti-plaque mouthwashes and irrigations are not necessary, but they can help when the dentist recommends them. "be combined with professional cleaning every six to eight months in the dental office.
Treatment of gingival pockets and periodontal disease depend on the stage of the disease. Mucogingival surgery includes the set of procedures aimed at correcting defects in morphology, position and / or quantity of periodontal soft tissues (gums). The main indications are the coverage of exposed root surfaces, obtained by simple traction of the gum existing in the area. in which it is missing, up to the actual gum graft, which is taken from the palate in case it is necessary to cover large gingival pockets.
