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.

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 bacterial toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed. At this stage periodontitis is completely reversible with dental care or intervention and a change in the patients home care.

Periodontitis

Plaque hardens into calculus (tartar).  As calculus and plaque continue to build up, so does bacterial colonization or the number of bacteria. Then deeper pockets form between the gums and teeth and become more filled with bacteria and possibly pus.  A chronic oval infection is present now and the gums bleed easily. Slight to moderate bone loss may be present.

 At this stage, periodontitis is not reversible, but is treatable and manageable with the correct diagnosis, treatment intervention and consistent dental care following the initial periodontal treatment. Only a dental professional can determine the difference between gingivitis and periodontitis during a periodontal examination.                 

Advanced Periodontitis

The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed.  Again, at this stage, periodontitis is irreversible, difficult to manage and the long-term prognosis more unpredictable.  The affected teeth often times become very loose and will be lost.  Generalized moderate to severe bone loss present.