Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination.  This type of exam should always be part of your regular dental check-up.

A periodontal probe (small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums.  The depth of a healthy sulcus measures three millimeters or less and does not bleed.  The periodontal probe helps indicate if pockets are deeper than three millimeters.  As periodontal disease progresses, the pockets usually get deeper.

WHAT IS PERIODONTAL DISEASE?

Your gums are an important foundation for your teeth and provide stability for ALL of your dental work—so it’s important to keep them healthy. Periodontal disease is the most common chronic bacterial infection in adults, and if not treated properly, it can spread rapidly throughout your entire foundation.

This sometimes silent infection occurs when harmful bacteria grow beneath the gums and create "pockets"-spaces or gaps in the gums around the teeth. Left untreated, periodontal bacteria can lead to bone and tooth loss that can threaten your foundation-and overall health.

The facts about periodontal disease

Periodontal disease is a persistent bacterial infection that:

• Attacks the gums and bones that hold the teeth in place
• Can return and spread if left untreated
• May lead to surgery or tooth loss
• Affects 3 out of 4 American adults

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into a category below:

Gingivitis

Gingivitis is the first stage of periodontal disease.  Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.

Periodontitis

Plaque hardens into calculus (tartar).  As calculus and plaque continue to build up, the gums begin to recede from the teeth.  Deeper pockets form between the gums and teeth and become filled with bacteria and pus.  The gums become very irritated, inflamed, and bleed easily.Slight to moderate bone loss may be present.

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed.  Unless treated, the affected teeth will become very loose and may be lost.  Generalized moderate to severe bone loss may be present.

WHAT ARE THE SYMPTOMS?

Because periodontal disease attacks beneath the gum line, you could have an infection and not know it. And while there are usually a few signs and symptoms of the disease-red, swollen, or bleeding gums; bad breath; loose teeth; gums that bleed upon brushing-some people experience no symptoms at all.

Pockets that measure 4 or more millimeters (mm) in depth, and/or gums that bleed during probing, may mean that infection is present.