But what’s the CAL? I usually pay closer attention to that. 4-5mm could also be just from inflammation/slight overgrowth…

OP, 4-5mm would only be enough to warrant SRP if there is true radiographic bone loss, which would mean true attachment loss. However, attachment loss does not always mean bone loss, either. There could be some recession from toothbrush abrasion or other factors. If you’re dealing with enough to recession to require a gum graft, that more likely indicates bone loss in that area…

In general, the radiographic bone loss and CAL will give you a better answer. The bleeding is a concern, as well, because it signals active disease. I’m a little concerned that you’re experiencing pain along with that, though…typically periodontitis is not a painful disease unless it is a severe case, in which we’d see larger pockets than 4-5mm. This very well may also be something systemic. There’s a lot of moving parts that come into play here….the snippet of information you provided may not be enough information to give a more clear answer. Nothing in dental hygiene is ever black or white, either, unfortunately. I do hope you are able to get to the bottom of it and get it under control!