Tissue Health 101

Tissue Health 101

When our patients tell us they floss we know that they either do or don’t. How? The tissue health tells us. When a guest arrives into our practice either initially or on a recurring basis for cleanings we assess the health of the tissue. This assessment is scored much like a report card. We look generally at three things: recession, pocket depths and bleeding.

When our patients tell us they floss we know that they either do or don’t. How? The tissue health tells us.Recession

People need to understand that tissue follows bone. Where there is tissue recession there is bone loss first. When the forces of the bite are incorrect the bone is what must sacrifice. When the forces are incorrect, the bone resorbs and the tissue recedes. Again, tissue follows bone. Recession is not caused by poor brushing techniques as so many patients are told. Tissue recession should be measured at each cleaning appointment and documented to assure that tissue levels are maintaining a healthy position.

Pocket Depths

At every cleaning interval (3,4 or 6 months) your hygienist should measure six pocket depths per tooth. We explain to our patients that measurements that are 1, 2, or 3mm are healthy. Fours, 5s and 6s are not as healthy with a 6mm pocket being more difficult to shrink to a healthy 3 than a 4 or 5 mm pocket. A periodontal pocket is a space that has developed between the tooth and tissue. This space, or pulling away of the tissue, is a response to bacteria building up in and around the tissue. Pockets typically develop between the teeth. A lack of flossing or lack of Waterpik use are common reasons for pocket depth development. Pockets that are unhealthy are most commonly treated by seeing a hygienist, flossing and Waterpik use.


Bleeding is a sign of infection. Healthy tissue does not bleed. It is important to note the number of bleeding sites in the mouth. A bleeding 4 mm pocket is less healthy than one that is not bleeding. Resolving bleeding tissue is important for overall systemic health. Infection in the mouth is an infection in the body. Watch this video to learn more about bleeding gum tissue: Click Here.

Our recommendations for maintenance of healthy tissue involve brushing twice daily, flossing and Waterpik use. Our favorite maintenance products are Waterpik, the Sonicare toothbrush, and Dr. Tung’s floss. We also recommend seeing your hygienist at least twice a year.

More Dental Articles

Complimentary Consultation