Periodontal Disease Diagnosis, Treatment & Maintenance


Periodontal disease is diagnosed during a periodontal examination and should always be part of your regular dental check-up. A periodontal probe (small dental instrument) is used to measure the sulcus (pocket or space) between the tooth and the gums and helps indicate if pockets are deeper than three millimeters for a healthy sulcus, as pockets usually get deeper with the progression of periodontal disease.

The categories of diagnosis are:

  • Gingivitis  – This is the first stage of periodontal disease, with plaque and its toxin by-products irritating the gums and making them tender, inflamed and likely to bleed.  
  • Periodontitis  – As calculus and plaque continue to build up, the gums begin to recede from the teeth because plaque hardens into calculus (tartar).  Deeper pockets form between the gums and teeth and become filled with bacteria and pus. Slight to moderate bone loss is possible.
  • Advanced Periodontitis  – Teeth lose more support as the gums, bone and periodontal ligament are damaged and, unless treated, the affected teeth become very loose and may be lost. Moderate to severe bone loss is possible.


As the sulcus between the tooth and gums gets filled with bacteria, plaque and tartar, causing irritation to the surrounding tissues, periodontal disease progresses.  If the disease is caught in the early stages of gingivitis and no damage has been done, one to two regular cleanings will be recommended. However, if the disease has progressed to more advanced stages, a special periodontal cleaning, called  scaling and root planing  (deep cleaning,)  is performed to remove tartar, plaque and toxins from above and below the gum line ( scaling ) and rough spots on root surfaces are made smooth ( planing ). This procedure helps gum tissue to heal and pockets to shrink.


When periodontal treatment has been completed, you will need to have regular maintenance cleanings ( periodontal cleanings ), where the pocket depths will be carefully checked to ensure that they are healthy. Any plaque and calculus will be removed from above and below the gum line.

Your appointment normally includes:

  • Examination of diagnostic x-rays (radiographs): Necessary tor detect of decay, tumors, cysts and bone loss and to help determine tooth and root positions.
  • Examination of existing restorations:  Check current fillings, crowns, etc.
  • Examination of tooth decay:  Check all tooth surfaces for decay.
  • Oral cancer screening:  Check the face, neck, lips, tongue, throat, cheek tissue, and gums for any signs of oral cancer.
  • Oral hygiene recommendations:  Review and recommend oral hygiene aids as needed. (Electric toothbrushes, special periodontal brushes, fluorides, rinses, etc.)
  • Teeth polishing:  Remove stain and plaque that is not otherwise removed during tooth brushing and scaling.
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