Periodontal disease is diagnosed by your dentist or dental hygienist during a periodontal examination. This type of exam should always be part of your regular dental check-up.

A periodontal probe (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 indicate if pockets are deeper than three millimeters. As periodontal disease progresses, the pockets usually get deeper.

Your dentist or hygienist will use pocket depths, amount of bleeding, inflammation, tooth mobility, and bone levels, to make a diagnosis that will fall into a category below:


Gingivitis is the earliest form of periodontal disease. The bacteria and toxins that live in the biofilm (plaque) cause the gums to become red, swollen and bleed easily. There may be some discomfort at this stage but it is typically little to none. Gingivitis is usually caused by inadequate oral hygiene. Other contributing factors to gingivitis include diabetes, pregnancy, stress, hormonal fluctuations and certain medications.

Gingivitis can typically be easily reversed with a professional dental cleaning followed by good homecare habits and regular dental health visits. The interval for dental health visits for a person with gingivitis is usually every 4 to 6 months and will be determined for your based on homecare habits, your body’s response to bacterial toxins and additional factors such as pregnancy or orthodontic appliances.

Periodontal Disease (Periodontitis)

Over time, untreated gingivitis may advance to periodontal disease. The biofilm (plaque) spreads below the gumline and the toxins produces within the biofilm irritate the gums. This in turn stimulates an inflammatory response in the body and the tissues and bone that support the teeth are broken down. As the disease progresses, the pockets become deeper and more gum tissues and bone are destroyed. Most of the time, periodontal disease is NOT painful. If left untreated, periodontal disease will likely lead to loss of teeth as more and more bone and tissue is destroyed.

To our valued patients,

We hope this letter finds you and your family in good health. Our community has been through a lot over the last few months, and all of us are looking forward with hope.

While many things have changed, one thing has remained the same: our commitment to your safety. Infection control has always been a top priority for our practice and you may have seen this during your visits to our office. Our infection control processes are designed to keep you safe and comfortable.

We want to tell you about the infection control procedures we follow in our practice to keep patients and staff safe. Our office follows infection control recommendations made by the American Dental Association (ADA), the U.S. Centers for Disease Control and Prevention (CDC) and the Washington Industrial Safety and Health Act (WISHA).  We follow the activities of these agencies so that we are up-to-date on any new rulings or guidance that may be issued.

We’ve made a few changes to help protect our patients and staff.
For example:

  • Please plan to arrive 10-15 minutes prior to your scheduled appointment time.
  • Use hand sanitizer that will be available when you enter the office.  Each patient will be asked to complete a Covid-19 screening questionnaire upon check-in, after sanitizing.
  • Our waiting room no longer offers magazines, children’s toys and so forth, since those items are difficult to clean and disinfect.
  • We ask that you not bring additional guests with you so we can reduce the number of people in the reception area with respect to social distancing recommendations.  If your appointment requires you have a driver, your companion will be asked to wait in the car and we will notify them when your appointment is nearing completion.
  • Air purification units have been installed in treatment rooms that create the potential for aerosols.  This is a new sound around here, you are welcome to listen to music on your own device if you would like.

We look forward to seeing you again and are happy to answer any questions you may have about the steps we take to keep you, and every patient, safe in our practice. To make an appointment, please call our office at 509-468-1685 or visit our website at

Thank you for being our patient. We value your trust and loyalty and look forward to welcoming back our patients, neighbors and friends.


Dr. Brent L. Child and Team