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 pocket or space between the tooth and the gums. The depth of a healthy sulcus measures three millimeters or less and does not bleed. In general, the deeper the pocket the greater spread of periodontal disease. Pockets greater than 3 millimeters are a sign of periodontal disease. As periodontal disease progresses, the pockets usually get deeper.
Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, and xrays, 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 continue to fill up with bacteria. The gums become very irritated, inflamed, and bleed easily. This bacteria causes the surrounding bone to deteriorate. Once the bone is lost, it never grows back.
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 have to be removed. Generalized moderate to severe bone loss is present on xrays.