What Is a Periodontal Examination and What Should I Expect?

Periodontal disease, commonly referred to as gum disease, is one of the most common chronic diseases known.  The more severe form of the disease, periodontitis, causes bone loss around teeth and is the major cause of tooth loss in adults.  Currently it is estimated that almost 50% of the adult population over the age of 30 has some form of periodontitis.  Gum disease in the earliest stage, and before the loss of bone around teeth (gingivitis), is reversible. 

It is therefore important that every adult receive a comprehensive periodontal examination at least annually.  For this examination you should expect to receive the following from your dentist (the dental hygienist may collect some of this information also):

1. An oral cancer screening.  Consists of a thorough check of the areas of your head and neck, along with the inside of your mouth, for any abnormalities in tissue color or texture.
2. Full periodontal probing.  Consists of taking measurements of the space between your tooth and gum which is an indication of where the tooth, gum, and bone all come together to attach.  Normally the depth of this measurement is between 2-4mm below the gum line.
3. Recession measurements. Even though your probing depths may be normal, you can still have recession of the gum tissue causing your tooth to have some of the root surface exposed making the tooth appear longer.
4. Bleeding on probing.  During your periodontal examination, it will be noted if areas of bleeding occur during the taking of the measurements.  This is a sign of inflammation and/or infection.  Healthy gums should NEVER bleed during the examination or when you brush and floss your teeth.  If your gums are tender during the exam that is another sign that they are inflamed.
5. A complete set of x-rays.  To assess the level of bone that supports your teeth. 
6. Assessment of your bite.  Called occlusion, to evaluate how your teeth come together.  Sometimes in people with periodontal disease, teeth can move and separate changing your bite.
7. Plaque control assessment.  The primary cause of periodontal disease is bacteria.  We do know however that there are genetic factors that may make you especially susceptible.  An important role of a dental hygienist is to educate and help improve your personal home care to minimize the accumulation of bacterial plaque.

Following a periodontal examination (based on the severity of disease and risk factors), the dentist may refer the patient to a periodontist who is a specialist in managing periodontal disease.