At every exam, we visually check for gum disease and ask about your symptoms. Common signs of gum disease include red or bleeding gums, tender or sore gums, loose teeth, and pockets in the gums.
We also use a phase microscope to help us identify gum disease. The bacteria that cause decay and periodontal/gum disease (pathogens) are mobile, meaning they move around a lot. Healthy bacteria, ones that are neutral or beneficial, look like they are standing still under the phase microscope, not moving. We will know that you have gum disease if we look at a sample of bacteria from your teeth under the gums (bacterial plaque) and see if the bacteria are still moving.
Without a microscope you have no idea what is going on and whether what you are doing in terms of oral home care has any value. How much dental disease you get in the future becomes luck.