Diagnosis & Treatment

Macedon Family Dentistry: Dentist Dr. Lisa Spinello


A Periodontal exam will always be part of your regular dental check-up at Macedon Family Dentistry. It includes gently measuring the sulcus (pocket or space) between the tooth and the gums. The depth of a healthy sulcus should measure three millimeters or less and should not bleed. If pockets are deeper than three millimeters, gum disease may be present. As periodontal disease progresses, the pockets usually get deeper.

We will use pocket depths, amount of bleeding, inflammation, tooth mobility, etc., to make a diagnosis that will fall into one of categories of periodontal disease:

  • Gingivitis: The first stage of periodontal disease with gums that irritated making them tender, inflamed, and likely to bleed.
  • Periodontitis: 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 and become filled with bacteria and pus. The gums become very irritated, inflamed, and bleed easily. Slight to moderate bone loss may be present.
  • Advanced Periodontitis: The teeth lose more support as the gums, bone, and periodontal ligament continue to be destroyed. Unless treated, the affected teeth will become very loose and may lead to tooth loss. Generalized moderate to severe bone loss may be present.


Periodontal treatment methods depend upon the type and severity of the disease. Our dentists and dental hygienist will evaluate for periodontal disease and recommend the appropriate treatment.

If caught in the early stages of gingivitis, and no damage has been done, one to two regular cleanings will be recommended. You will also be given instructions on improving your daily oral hygiene habits and having regular dental cleanings.

If the disease has progressed to more advanced stages, a special periodontal cleaning called scaling and root planing (deep cleaning) will be recommended to remove the tartar, plaque, and toxins and smooth out any rough spots on root surfaces. This procedure helps gum tissue to heal and pockets to shrink. Medications, special medicated mouth rinses, and an electric tooth brush may be recommended to help control infection and healing.

If the pockets do not heal after scaling and root planing, periodontal surgery may be needed to reduce pocket depths, making teeth easier to clean. At this point, our dentists may also recommend that you see a Periodontist (specialist of the gums and supporting bone).

If you have questions or concerns about periodontal (gum) disease treatment or are looking for a Macedon dentist, Fairport dentist or Palmyra dentist, please give us call.