What is meant by clinical attachment loss (CAL)?

Clinical attachment loss (CAL) refers specifically to the distance between the gingival margin and the base of the periodontal pocket. This measurement is crucial in assessing periodontal health because it provides insight into the extent of periodontal tissue destruction. When there is attachment loss, it indicates that the supporting structures of the teeth, including fibers and bone, have been compromised, reflecting the severity of periodontal disease.

While the depth of the pockets is related to CAL, it does not encompass the complete picture, as pocket depth alone does not account for the position of the gingival margin. Measurement of inflammation is also important in periodontal assessment, but CAL is fundamentally a structural measurement, focusing on the loss of attachment rather than the presence of inflammation itself. Therefore, the correct interpretation of clinical attachment loss is best captured by the measurement of the distance between the gingival margin and the base of the pocket.