What defines true pockets in relation to periodontal disease?

True pockets in periodontal disease are defined by their depth, specifically when they measure greater than a certain threshold, generally recognized as 3-3.5 mm. This depth indicates that there has been some degree of attachment loss, which is a critical factor in diagnosing periodontal disease.

When probing depths exceed this measurement, it suggests the presence of a pathological condition affecting the supporting structures of the teeth, often associated with inflammation or infection. This distinction is essential because while shallow pockets or gingival inflammation can occur without true periodontal disease, pockets deeper than 3-3.5 mm reflect more significant changes in the periodontal tissues, indicating a need for evaluation and possible treatment.

The alternative classifications, such as pockets without bone loss, those arising solely from gingival swelling, or that always cause pain, do not accurately reflect the true nature of periodontal disease as they do not capture the loss of attachment that characterizes true periodontal pockets. It's essential to understand that periodontal pockets may not always be associated with pain, further differentiating them from other oral conditions.