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, which is the pocket or space between the tooth and the gums. A healthy sulcus measures three millimeters or less and does not bleed. The probe helps determine if pockets are deeper than three millimeters, which can indicate periodontal disease. As the disease progresses, these pockets usually deepen.

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Your dentist or hygienist will assess pocket depths, bleeding, inflammation, tooth mobility, and other factors to make a diagnosis. Periodontal disease can fall into the following categories:

Gingivitis

Gingivitis is the first stage of periodontal disease. Plaque and its toxin by-products irritate the gums, making them tender, inflamed, and prone to bleeding.

Periodontitis

As plaque hardens into calculus (tartar), the gums begin to recede from the teeth. Deeper pockets form between the gums and teeth, often filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.

Advanced Periodontitis

In advanced stages, teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. If left untreated, affected teeth may become very loose and could be lost. Generalized moderate to severe bone loss is typically present.