When treating periodontal disease, the first steps should be non-surgical unless the disease has progressed to a very severe stage. The initial therapy used will be scaling and root planning. This is a deep cleaning applied to the root surfaces in order to remove plaque and bacteria from the periodontal pockets that have been formed by the disease. Depending on the case, this might be followed by the use of local antibiotics or even laser therapy. If occlusion (the manner in which your teeth come together) is causing problems, this can be treated as well. For the vast majority of patients, this is as much active therapy as they will require. Most patients will still require maintenance therapy to maintain their health.
In progressed cases, these non-surgical methods may not be enough to establish good periodontal health. When this is the case, periodontal surgery will be used to help restore the damaged structures and return the patient to good health.