Periodontal treatment methods depend upon the type and severity of the disease. If the disease is caught very early (when it is gingivitis), and no damage has been done, you may simply be given instructions on improving your daily oral hygiene.

Even with these measures, some patients develop more severe periodontal diseases that must be treated. The first step usually involves a special cleaning, called scaling and root planning. This procedure removes plaque and tartar deposits on the tooth and root surfaces. This helps gum tissue heal and pockets to shrink, which makes it more difficult for plaque to accumulate along the root surfaces. This is sometimes referred to as “periodontal” or “deep cleaning” and may take more than one visit.

A local anesthetic may be given to reduce any discomfort. Using an instrument called a small scaler or an ultrasonic cleaner, plaque and tartar are carefully removed down to the bottom of each periodontal pocket. The tooth’s root surfaces are then smoothes or planes.

Your dentist also may recommend medications to help control infection and pain, or to aid healing. These medications could include a pill, a mouthrinse, or a substance that the dentist placed directly in the periodontal pocket after scaling and root planning. Your dentist may also stress the need to control any related systemic disease, like diabetes At the next visit, the dentist checks the pocket depth to determine the effect of the scaling and root planning. If the disease has advanced to the point where the periodontal pockets are deep and the supporting bone is lost, additional treatment may be necessary. You may be referred to a periodontist.