A diagnosis of 6-millimeter gum pockets indicates advanced periodontal disease. This measurement refers to the depth of the periodontal pocket, the space between the gum tissue and the tooth surface, which is measured with a probe. Healthy gum depths are typically 1 to 3 millimeters, so a 6-millimeter pocket signifies an infection destroying the supporting structures around the tooth. While true “reversal” to a healthy state is unlikely, the goal of treatment is to achieve a significant reduction in depth and stop progressive bone loss. Success depends heavily on professional intervention and committed long-term maintenance.
What 6mm Pocket Depth Means
A measurement of 6 millimeters places the condition squarely in the range of moderate-to-severe periodontitis. This depth indicates that the bacterial infection has breached the gum line, leading to the destruction of the periodontal ligament and the underlying alveolar bone that anchors the tooth. At this point, the disease is classified as a chronic condition, often correlating with Stage III or IV periodontitis.
Pockets this deep are impossible to clean effectively with standard brushing and flossing, creating a protected environment for harmful bacteria to thrive. Since the supporting bone structure is already compromised, true reversal to the original 1–3 millimeter depth is generally not possible. The objective shifts to pocket reduction, aiming for depths of 3 millimeters or less, to create an environment maintainable with routine home care.
Initial Professional Treatment
The first line of defense against 6-millimeter pockets is a non-surgical procedure called Scaling and Root Planing (SRP), often referred to as a deep cleaning. This procedure focuses on mechanically removing hardened plaque (calculus) and bacterial toxins from the tooth surfaces far below the gum line. SRP is typically performed under local anesthesia to ensure patient comfort while working in sensitive, infected areas.
During scaling, specialized instruments, including ultrasonic tools, scrape away deposits from the crown and root surfaces. Root planing involves smoothing the root surfaces, eliminating rough spots where bacteria could easily reattach. Smoothing the root encourages the gum tissue to reattach more firmly to the tooth, which achieves pocket depth reduction.
Following the procedure, a re-evaluation appointment is scheduled, usually four to six weeks later, to measure the gum pockets again. This follow-up determines the success of the non-surgical treatment and whether remaining depths require further, more advanced intervention.
When Surgery Is Required
If the re-evaluation shows that pockets remain at 5 millimeters or greater after Scaling and Root Planing, surgical intervention becomes the next logical step. The primary reason for surgery is to gain direct visual access to deep pockets that non-surgical methods could not fully clean. These advanced procedures are designed to thoroughly eliminate bacteria and reduce the depth of the pockets permanently.
One common surgical technique is flap surgery, often combined with osseous surgery. The periodontist gently lifts a section of the gum tissue back, creating a flap, to fully expose the root surfaces and damaged bone. This access allows for meticulous removal of all remaining tartar and infected tissue. The procedure may also involve reshaping the underlying bone (osseous surgery) to eliminate uneven surfaces that trap bacteria, or incorporating grafts to encourage regeneration. The gum tissue is then sutured back into a position that fits more snugly around the tooth, effectively reducing the pocket depth.
Preventing Recurrence
Periodontitis is a chronic inflammatory condition, meaning susceptibility to the disease remains even after successful treatment. Preventing recurrence requires a strict, lifelong commitment to professional and home care. This professional management is known as periodontal maintenance, which replaces the standard six-month cleaning schedule.
Maintenance visits are typically scheduled every three to four months, depending on the severity of the initial disease and the patient’s risk factors. During these appointments, the dental team performs a deeper cleaning, specifically targeting areas below the gum line to remove any newly formed bacterial deposits. Equally important is a rigorous daily home care routine, which must include meticulous flossing or the use of interdental brushes to disrupt bacterial biofilm. The use of an electric toothbrush and sometimes prescription antimicrobial rinses are also important components in maintaining reduced pocket depths.