Which clinical sign is NOT typically associated with periodontal disease?

The choice reflecting improved oral hygiene is correct because improved oral hygiene is generally associated with a decrease in periodontal disease severity rather than indicating the presence of the disease. In healthy periodontal conditions, proper oral hygiene practices lead to a reduction of plaque accumulation and inflammation, which consequently helps in healing and maintaining periodontal health.

In contrast, gingival bleeding, increased pocket depth, and persistent bad breath are all clinical signs typically associated with periodontal disease. Gingival bleeding is an indication of inflammation and is often one of the first signs noticed in cases of gingivitis or periodontitis. Increased pocket depth results from the breakdown of the supporting structures of teeth due to periodontal disease, reflecting more severe tissue loss. Persistent bad breath, or halitosis, can also occur due to the presence of bacteria and inflammation associated with periodontal infections. Each of these signs points to an ongoing issue within the periodontal tissues that necessitates attention and treatment.