Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination, which should always be part of your regular dental checkup.
A periodontal probe (a 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 determine the exact depth. As periodontal disease progresses, the pockets usually get deeper.
Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, and so forth, to make one of the following diagnoses:
Gingivitis is the first stage of periodontal disease. Plaque and its toxin byproducts 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, then 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 are further destroyed. Unless treated, the affected teeth will become very loose and may be lost. Generalized moderate-to-severe bone loss may be present as well.