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.
During the exam, a periodontal probe—a small dental instrument—is gently used to measure the sulcus, the pocket or space between the tooth and gums. In healthy gums, the sulcus measures three millimeters or less and does not bleed. Deeper pockets can indicate the presence of periodontal disease.
Your dentist or hygienist evaluates pocket depths, bleeding, inflammation, tooth mobility, and other signs to determine the stage of periodontal disease:
Gingivitis
This is the earliest stage of periodontal disease. Plaque and its toxins irritate the gums, causing them to become tender, inflamed, and prone to bleeding.
Periodontitis
If plaque hardens into calculus (tartar), the gums begin to recede from the teeth. Deeper pockets form, harboring bacteria and pus. The gums become inflamed, bleed easily, and slight to moderate bone loss may be present.
Advanced Periodontitis
In this stage, the destruction of gums, bone, and periodontal ligaments progresses, leading to loose teeth and, if untreated, tooth loss. Moderate to severe bone loss is usually observed.