This depth is the difference in height between the level of your gumline and the point at which the gum actually attaches to your tooth. 2-3 mm is considered healthy and physiologic and anything over 5 mm usually indicates that the bone that supports your tooth has begun to be destroyed by the disease.
Per CDC/AAP, severe periodontitis is defined as having 2 or more interproximal sites with clinical attachment loss (CAL) 6 mm or greater (not on the same tooth) and 1 or more interproximal sites with periodontal probing depth (PPD) 5 mm or greater.
4mm gum pockets and what you can do about it
If your gum pockets reach the 4 mm range, your dentist or hygienist will let you know, because that's a sign you have early gum disease.
When a tooth has periodontal disease, this tissue becomes detached past 3mm deep. Under 3mm deep a pocket is considered healthy, while 4mm or deeper it is considered unhealthy.
Periodontal pockets with a 4-5 mm depth can be conveniently treated with a professional dental cleaning and an aggressive at-home oral hygiene routine.
There are 3 stages of periodontitis
Moderate periodontitis: where most teeth have around 5 mm pockets and slight mobility of some teeth. Severe/very severe periodontitis: where most teeth have 5mm+ pockets with great mobility and some furcation involvements/abcesses in the bone.
In advanced cases, there has been extensive bone loss, and pocket depth may be 8mm and more. In these cases complete removal of the pocket is often not possible, due to limitations on how far the gum can be moved.
For deep pockets over 7mm, surgery may be needed. Pocket reduction surgery requires making small incisions in the gum to peel back the gum tissue. Deep cleaning is completed and any underlying bone loss is addressed. Finally, stitches are inserted.
Only the first stage of gum disease, known as “gingivitis” can be reversed. After it progresses into the second stage (periodontitis), it's no longer possible to completely eliminate it.
Score 4. 4 indicates gum disease, if you are diagnosed with gum disease we can work with you to create a thorough plan on how to best treat this. On the other side we can move to health. The latest thinking shows clinicians need to be more proactive when we find 3 scores and revisit why they are there.
In its early stages, gum recession may not require treatment. But chances are, by the time you notice longer teeth, you'll be past that point. You'll need extra dental care to stop the progression. The precise treatment depends on your case and its causes, and, typically, it will involve several strategies.
5-7mm with bleeding means that there has been some gum tissue damage. In some cases, it can also be bone loss around the area. This will require more hygiene visits and special treatment along with good at home oral care. 7mm and above with bleeding is the advanced stage of periodontal disease.
Stage 3: Moderate Periodontitis
Gum recession can make the teeth sensitive and uncomfortable. As the gums pull away from the teeth, the teeth lose their natural support system and they can become loose.
Advanced periodontitis is the fifth and final stage of gum disease, and it is likely that you will lose teeth or at least loosen teeth during this phase without immediate dental intervention. The infection impacts the jawbone, so teeth may be lost regardless.
How Far Can Gums Recede? Gums can recede to the extent at which the uppermost portion of the root becomes visible. Damage can also extend to the ligament and the bone, where it cannot be seen. Prompt care for receding gums is important to avoid significant consequences.
As gum disease progresses, this area starts to widen, creating a larger pocket where your toothbrush can't reach and bacteria can flourish. Once a pocket measures 4 to 5 mm deep, gum disease has started to develop. As the pocket size progresses between 7 and 12 mm, the condition becomes more difficult to treat.
The key thing to reversing gum disease is removing the tartar that's present on both the root of your teeth and under your gum line. Periodontitis can't be reversed, only slowed down, while gingivitis can be reversed.
In a healthy mouth, the pocket depth is usually between 1 and 3 millimeters (mm). Pockets deeper than 4 mm may indicate periodontitis. Pockets deeper than 5 mm cannot be cleaned well with routine care.
Advanced periodontitis
Tooth roots are only 10 – 12 mm long, so when the pockets between your teeth and gums are 7mm or greater, your teeth are in severe danger of being lost.
Patients may feel some pressure or vibration during the procedure, but shouldn't experience any pain. After the procedure, some patients may experience mild discomfort, but this can usually be managed with over-the-counter pain medication.
Advanced Periodontal Disease (Stage III)
Severe periodontitis involves pockets 6mm or greater and the loss of up to four teeth.
According to the Community Periodontal Index for Treatment Needs (CPITN) [39] for PD the following definition for periodontitis was used: PD 0-3 mm as no/mild periodontitis, at least one pocket ≥4 mm and <6 mm as moderate and with at least one pocket ≥6 mm as severe periodontitis.
Advanced periodontitis – At this stage, expect severe infection that spreads beneath the gums, tooth loss leading to abscesses, and increasing discomfort.