An oral exam is performed on both new and existing patients to determine their dental and health status. New patients receive a more comprehensive exam that includes x-rays and checks for gum and bone disease, systemic disorders and oral cancer. A more routine exam is done for existing patients to see if there have been any changes in health since their last visit. In order to look for gum disease, the gum tissue is measured with a small ruler to measure the pocket depth between the tooth and connective tissue. A measurement of over 4mm could indicate disease or infection. Gum disease can develop easier in deeper pockets due to the extent that plaque collects in these deep pockets. If the oral exam reveals the need for tooth scaling or root planing, these services are performed in lieu of or in addition to the routine cleaning.