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

A periodontal probe (a small dental instrument) is gently used to measure the sulcus (pocket or space) between the tooth and the gums. 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, these pockets typically become deeper.

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Your dentist or hygienist will use various factors such as pocket depths, amount of bleeding, inflammation, tooth mobility, and other indicators to make a diagnosis that will fall into one of the following categories:

Gingivitis

Gingivitis is the initial stage of periodontal disease. Plaque and its toxin by-products irritate the gums, causing them to become tender, inflamed, and prone to bleeding.

Periodontitis

In this stage, plaque hardens into calculus (tartar). As calculus and plaque continue to build up, the gums start to recede from the teeth. Deeper pockets form between the gums and teeth, becoming filled with bacteria and pus. The gums become highly irritated, inflamed, and bleed easily. There may be slight to moderate bone loss.

Advanced Periodontitis

In advanced periodontitis, the teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Without treatment, the affected teeth may become very loose and could be lost. Generalized moderate to severe bone loss may be present.