New patients receive a comprehensive examination which includes a screening for oral cancer gum and bone disease, blood pressure, and systemic disorders. A routine oral exam is performed on established patients to determine any changes in dental and health status since the previous visit. Your gum tissue is measured with a fine instrument ruler to calibrate in millimeters pocket depth between the tooth and the connective gum tissue around the tooth. Pockets measuring 4, 5, 6 millimeters and up is cause for concern and requires immediate attention. The deeper the pocket, the greater the extent plaque bacteria collects and infection in gum disease develop. X-rays are taken as needed. Tooth scaling and root planing occur as needed. Routine cleanings also include a professional polishing (prophy) that removes only the soft sticky plaque that is above the gum line.