Periodontal Diagnosis
How gum disease is diagnosed — measuring pocket depths, assessing bone level on x-rays, and establishing how far it has progressed.
Diagnosis is about measurement rather than impression. Healthy gum attaches closely to the tooth; diseased gum detaches and forms a pocket. How deep those pockets are, and how much bone remains, is what determines both the diagnosis and the treatment.
What is assessed
- Pocket depth around each tooth, measured with a fine calibrated probe
- Whether the gums bleed when probed, which indicates active inflammation
- Bone levels on x-rays, compared with previous images where available
- Gum recession, and how much root is exposed
- Whether any teeth have become mobile
Recording these gives a baseline. The value of a baseline is comparison — it turns "your gums look about the same" into an actual answer.
More about this
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 is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and likely to bleed.
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.
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.
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