The two images on top demonstrate the condition that the patient presented to us when he came into the clinic. The images beneath them show what the same teeth looked like one hour after the hygienist finished the periodontal debridement, better known as a “gross scale”.
As a rule, the dentist will not bill for an exam at this visit, because the tissues are too inflamed to examine properly. Usually, the dentist will talk to the patient and work up a preliminary treatment plan based on a visual examination and the full series of x-rays, but we generally wait for one or two weeks for the gums to heal before doing a full periodontal exam, and working up a final treatment plan based on the clinical examination.
Looking at the before and after shots, you can see how much the gums have receded over the years that this accumulation of calculus built up.