If any of the following indicators are observed or reported by the patient, there will usually be an underlying periodontal problem. The patient may well require both treatment and advice.

• a red or pink tinge on the toothbrush after brushing the teeth
• a taste of blood or other peculiar tastes in the mouth
• swollen, bruised or tender areas of gum, especially in between the teeth
• blood in the mouth, or on the teeth, especially on awakening
• areas around the teeth from which it is difficult or painful to remove food
• loosening teeth
• teeth changing position or drifting out of alignment
• swellings on the gums or any discharges such as pus occurring in or around the gums
• increasing sensitivity to temperature change
• receding gums