Often odor or bad breath is the first indication of a problem. Lift up the upper lip and inspect the outer surface of the upper teeth. 

Stage #	Indication	Action
1	Gingivitis- Plaque, Inflammation	scaling, polishing, sealing
2	Mild Periodontitis, Swollen gums that may lead to bone loss, infection and pain. Bad breath noticable.	scaling, root planing, polishing, sealing
3	Moderate Periodontitis, Increased infection, pain, gums bleeding, increased periodontal pockets and possible loosening of teeth.	above, plus apical reposition flap surgery if indicated
4	Severe Periodontitis, Extensive infection, teeth are at risk of being lost.	above, plus gingival surgery to try to save teeth, or extraction