Treatment for periodontitis is customized for each patient and to the severity of the disease. In all forms of periodontitis, we try to treat the disease with the simplest and least time-consuming treatment option. With more established periodontal infections, the calculus that forms beneath the gum line requires that the patient's teeth and gums be anesthetized with a local anesthetic in order to thoroughly remove it without discomfort. This procedure is called scaling and root planing , which is considered non-surgical treatments. Sometimes locally applied, time released antibiotics are placed in the pockets to further improve the results obtained with root planning by controlling the growth of bacteria that lead to periodontal disease.

     It should be understood that to stop periodontal disease, it is essential to remove the calculus from the teeth. This cannot be done with drugs, baking soda, toothpaste, or nutritional supplements. Currently, the only method proven to rejuvenate diseased, infected root surfaces involves calculus removal with specialized instruments. When a patient has very deep pockets (beyond 5 millimeters), non-surgical root planing cannot consistently reach the accumulated calculus. In these cases, other procedures, often including minor gum surgery, become the treatment of choice to restore periodontal health. If left untreated, continued bone deterioration and increasing pocket depths will occur resulting in eventual tooth loss.

     Pocket reduction can be successfully accomplished through a procedure known as osseous surgery or surgical periodontal therapy. To allow for complete removal of calculus and toxins in deep pockets, the patient's gums and teeth are anesthetized. The gums are elevated so the periodontist can see and treat the entire root surface and surrounding areas. Sometimes, the underlying bone is reshaped and smoothed to allow the gum to heal and reattach properly without forming new pockets. In some circumstances, the lost bone can be regenerated to strengthen the support for the teeth. This is an exciting and rapidly improving possibility in our field, particularly with substantial research and development activity in the biotechnology industry. After final healing, the treated areas can be more easily cleaned by the patient and hygienist to prevent future bone loss.