A periodontal examination is a detailed assessment of your gums and the surrounding structures that support your teeth. Its purpose is to identify signs of gum disease, which can lead to tooth loss if not addressed early. This examination helps maintain oral health by detecting potential problems before they become severe.
Initial Assessments
A periodontal examination begins with preliminary steps to gather information about your oral health. The dentist performs a visual inspection, observing the color, texture, and contour of your gums. They look for signs of inflammation, redness, swelling, bleeding, and gum recession. Visible plaque and calculus (hardened plaque) buildup on your teeth are also assessed.
A thorough review of your medical and dental history follows. This includes inquiring about systemic conditions like diabetes, which can affect gum health, and any medications that might impact your gums. Your smoking status and any past dental treatments relevant to your gum health are also discussed. The dentist evaluates your current oral hygiene habits, such as brushing and flossing techniques.
Detailed Periodontal Measurements
A central component of the periodontal examination involves precise measurements of the gum tissues around each tooth. A small, ruler-like instrument called a periodontal probe is gently inserted into the sulcus, the space between the tooth and the gum. The depth of this space, known as the pocket depth, is measured in millimeters.
Healthy gum pockets typically measure between 1 and 3 millimeters. Measurements of 4 millimeters or deeper can indicate inflammation and potential gum disease, as deeper pockets are more challenging to clean and can harbor bacteria. Bleeding on probing, which occurs when the probe gently touches inflamed gum tissue, suggests active inflammation and possible disease progression. The examination also includes measuring gum recession, where gum tissue has pulled away from the tooth.
Diagnostic Imaging and Stability Checks
Beyond visual and probing assessments, other diagnostic tools provide a comprehensive view of periodontal health. Dental X-rays reveal the condition of the bone supporting the teeth. Since bone loss around teeth is not visible during a standard visual exam, X-rays detect this sign of advanced gum disease and can also show calculus below the gum line. These images help determine the extent of disease progression and guide treatment planning.
The dentist also checks for tooth mobility, which refers to any looseness or movement of the teeth. Increased tooth mobility can signal significant bone loss around the tooth, indicating a more advanced stage of gum disease. An occlusal or bite assessment evaluates how the upper and lower teeth meet when you chew. An improper bite can sometimes contribute to periodontal issues by placing undue stress on certain teeth and their supporting structures.
Understanding the Findings
After gathering all information, the dentist synthesizes findings from the visual inspection, periodontal measurements, X-rays, and patient history to form a diagnosis. This comprehensive analysis helps determine if the gums are healthy or if conditions like gingivitis or periodontitis (different stages of gum disease) are present. The dentist then explains these findings to the patient in an understandable manner.
Based on the diagnosis, personalized recommendations are provided for ongoing care. These might include specific oral hygiene instructions, such as improved brushing and flossing techniques, or the use of antimicrobial mouthwashes. Professional cleanings, such as scaling and root planing (deep cleaning), may be advised to remove plaque and tartar below the gum line. For more advanced cases, a referral to a periodontist, a gum specialist, might be recommended for further evaluation and specialized treatment. Regular follow-up periodontal examinations monitor gum health over time, track the effectiveness of treatment, and prevent recurrence of disease.