At your initial exam and at every recall appointment we are evaluating your mouth for periodontal disease. We do this with a combination of radiographs (X-rays), clinical examination, and taking measurements around all of your teeth. We measure 6 different spots around each tooth to monitor for bone loss. Bone loss occurs from calculus (tartar) build-up sitting on your teeth below your gum line. Daily brushing and flossing helps to prevent calculus build-up, therefore preventing periodontal disease. If we determine that you are suffering from periodontal disease we will recommend a deep cleaning (scaling and root planning). The goal of scaling and root planning is to remove the build-up that is adhered to your teeth under the gum line. We use a combination of ultrasonic instrumentation, hand instrumentation, and irrigation to remove this build-up and stop the bone loss from progressing further. Signs of periodontal disease include bleeding when brushing or flossing, mobility of teeth, and gum recession.