Periodontal pockets, often called “gum pockets,” are spaces that form between the tooth root and the surrounding gum tissue. In a healthy mouth, this space is shallow, creating a tight seal that protects underlying structures. When bacteria accumulate, inflammation causes the gum attachment to detach from the tooth surface, deepening the space and trapping more plaque and calculus. A measurement of 7 millimeters (mm) signifies advanced periodontitis, a serious infection that destroys the bone supporting the teeth. This depth suggests significant destruction has occurred, and treatment focuses on pocket reduction to stabilize the teeth and prevent further damage.
Understanding Periodontal Pockets and Severity
Periodontal professionals measure pocket depth using a small ruler called a periodontal probe. The probe is gently inserted between the tooth and gum, and the measurement indicates disease severity. Depths between 1 and 3 mm are considered healthy, showing secure gum attachment.
A depth of 4 to 5 mm indicates early or mild periodontitis. Pockets reaching 6 mm or more, including 7 mm, are classified as advanced periodontitis and are usually accompanied by noticeable loss of the supporting jawbone.
This bone loss makes reversing a 7mm pocket challenging, as lost structure is not easily regained through non-surgical methods. These deep spaces allow harmful bacteria to thrive, requiring specialized professional intervention to clean the area and encourage gum tissue reattachment at a shallower depth.
Initial Non-Surgical Treatment Strategies
The standard initial treatment for deep periodontal pockets is Scaling and Root Planing (SRP). This non-surgical intervention is a meticulous, deep cleaning performed below the gum line to remove bacterial plaque, calculus, and toxins from the root surfaces. The primary goal is to create a clean, smooth surface, allowing inflamed gum tissue to heal and reattach more tightly to the tooth.
For 7mm pockets, SRP is a demanding procedure requiring highly skilled practitioners, often using ultrasonic instruments or manual curettes. SRP alone can achieve significant pocket depth reduction, shrinking the depth to a level easier for patients to maintain at home.
In some cases, the periodontist may use local antimicrobial agents, such as antibiotic gels, placed directly into the deepest parts of the pocket following SRP. These adjunct therapies kill remaining bacteria, boosting the healing process. Since SRP may not fully resolve a 7mm pocket, a follow-up evaluation is necessary to determine if further treatment is required.
Advanced Surgical Interventions for Deep Pockets
When non-surgical treatments fail to reduce 7mm pockets to a healthy depth of 3–4 mm or less, surgical intervention is necessary to fully access and clean the deep infection. The primary approach is Flap Surgery, also known as pocket reduction surgery. This procedure involves the periodontist making small incisions to lift the gum tissue away from the tooth, exposing the entire root and underlying bone.
Direct visibility allows the surgeon to thoroughly remove all plaque, tartar, and diseased tissue, which is impossible to reach in a deep, closed pocket. Damaged bone may also be reshaped and smoothed to eliminate irregular areas where bacteria could collect. After cleaning, the gum flap is stitched back into place at a lower position, effectively shortening the pocket depth.
Regenerative Procedures
For areas with severe bone loss, Regenerative Procedures may be performed alongside flap surgery. These techniques use materials like bone grafts, tissue-stimulating proteins, or specialized membranes to encourage the regrowth of lost bone and ligament tissue. The graft material acts as a scaffold, providing a framework for the body’s natural healing processes. The goal of regeneration is to restore the actual supporting structure of the tooth, which is the most complex form of reversal possible in advanced periodontitis.
Long-Term Management and Pocket Depth Maintenance
Reducing a 7mm pocket is only the beginning of the treatment journey. Periodontal disease is a chronic condition requiring continuous, long-term management to prevent deep pockets from returning. This ongoing care is formalized as periodontal maintenance, a specialized professional cleaning that differs from a standard dental check-up.
Maintenance appointments are typically scheduled every three to four months, rather than the usual six, to disrupt bacterial colonies before they cause new damage. During these visits, the dental professional thoroughly cleans areas above and below the gum line, focusing on previously treated deep pockets. The frequency is tailored to the patient’s risk factors and pocket stability.
Meticulous home care is the necessary complement to professional maintenance. Patients must adhere to a strict regimen of brushing twice daily and using interdental cleaners or floss to remove plaque. Without this consistent commitment, bacteria will repopulate the area, causing pockets to deepen again and risking tooth loss.