How is Periodontal Disease Treated?

Periodontal disease is a bacterial infection that gets under the gums and into the bone around your teeth, causing inflammation. Periodontal inflammation leads to tooth loss and may contribute to other medical conditions. Once a patient is diagnosed with gum (periodontal) disease, more involved procedures are required to treat the disease. In the early stages of gum disease, most treatment involves non-surgical procedures; however, in more advanced stages, surgical procedures are often required. The following are detailed descriptions of these procedures.

Scaling & Root Planing

Non-surgical Therapy

Scaling and Root Planing

Scaling and root planing: While a regular dental cleaning is for the visible portion of teeth, scaling and root planing is a special cleaning that removes plaque and tartar (also known as calculus) from under the gumline (in periodontal pockets) and smoothes the root surfaces to promote healing. A scaling procedure is the only way to remove calculus from this area. For many patients, this procedure is done under local anesthesia and is quite different from the routine dental cleaning.

In some cases, antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, scaling and root planing in addition to continued daily cleaning at home will achieve a satisfactory result of reversing gum disease.

Laser Assisted Periodontal Therapy

A laser can be used to treat the periodontal pocket. Lasers are essentially focused beams of light used to perform precise tasks. In periodontics, lasers are ideal for detailed, minimally invasive and virtually painless procedures. Laser light has been shown to significantly reduce bacterial levels within the pocket and can contribute to a reduction in inflammation, bleeding and disease activity.  The laser can also be used during scaling and root planing and maintenance procedures to remove diseased, infected and inflamed soft tissue within a deep periodontal pocket below the gums. The goal of laser periodontal therapy and laser bacterial reduction is to eliminate the harmful bacteria that cause periodontal disease and encourage reattachment of the gum fibers to the root surface to reduce pocket depth.

We use the Millenium PerioLase MVP-7 laser and Picasso Diode laser for procedures involving the periodontal pocket and soft tissues to ensure patient comfort and quick recovery. The PerioLase MVP-7 is specifically designed to treat periodontal disease. Not only can the laser precisely remove diseased tissue, it also kills bacteria, sterilizes the treated area and promotes healing and regeneration. Because the laser only targets soft-tissue surrounding teeth, implants and other hard structures are unaffected during the procedure. Generally, the laser can be used without local anesthetic.

Special training is required to operate a Diode Laser for dental purposes. We are fully certified and focused on providing safe, efficient care to each patient.

Periodontal Maintenance/Supportive Periodontal Therapy

Following periodontal treatment, maintenance care appointments are important to monitor health and clean teeth and pockets as required to minimize the recurrence or progression of gum disease.

Surgical Therapy

If your condition is of the moderate to advanced nature with pocket depth measures in the 5-9mm range, surgical procedures may be required to gain access to the deeper root surfaces for thorough calculus removal and reduction of pocket depth in order to optimize periodontal health.

LANAP Laser Procedures

The periodontist will use a laser to access the gum pocket, remove inflamed/infected gum tissue and ablate/vaporize disease-causing bacteria.  Deep cleaning is then done to remove calculus build-up.  The laser is then used to seal the gum to the teeth instead of sutures.  This allows the gum tissue to reattach to a clean tooth surface during healing. Once healed, these areas are easier to keep clean and the pocket is reduced to a more manageable depth that is at less risk of persisting or progressing. 

Pocket Depth Reduction Procedures

The periodontist will create a "flap" to open up the affected gum tissue so that disease-causing bacteria and calculus build-up can be removed. Some cases may require smoothing and recontouring the damaged bone and root surfaces to allow the gum tissue to reattach to healthy bone during healing. The gum is then sutured into a slightly recessed position so that once healed, these areas are easier to keep clean and the pocket is reduced to a more manageable depth that is at less risk of persisting or progressing. 

Periodontal Regeneration

In some cases, an attempt can be made to recover or repair the damaged bone around the teeth by using membranes, bone grafts and/or tissue-stimulating proteins to stimulate the body’s natural ability to regenerate healthy bone and gum tissue.

Extraction of Hopeless Teeth

If the periodontal disease has progressed to a degree that cannot be treated or repaired, extraction may be necessary. Teeth that are lost due to periodontal disease can be replaced with implant retained restorations if the periodontal disease has been controlled and there is sufficient bone to accommodate them.


scaling and root planning Graphic of Scaling and Root Planing
scaling and root planning on x-ray X-ray Showing Scaling and Root Planing

Conservative Treatment For Periodontal Disease

before scaling and root planing Prior to Scaling and Root Planing
after scaling and root planning After Scaling and Root Planing

Conservative Treatment For Periodontal Disease

ortho hyperplasia and inflammation Post Ortho Hyperplasia and Inflammation
gum reduction and contouring After Gum Reduction and Contouring

Surgical Treatment For Post Orthodontic Hyperplasia

severe gum disease treatment Pre Treatment Severe Gum Disease
gum surgery and extraction Post Scaling, Gum Surgery and Extraction

Treatment For Moderate to Severe Periodontitis