Nonsurgical treatment

Scaling and root planing: Scaling removes tartar and bacteria from your tooth surfaces and below your gumline. This is done using hand instruments and an ultrasonic device. Root planing smooths the root surfaces. This helps prevent further buildup of tartar and bacteria. It also helps your gums reattach to your teeth.

Surgical treatments

Pocket reduction surgery: Your periodontist makes cuts in your gums to carefully fold back the tissue. This exposes the tooth roots for more effective scaling and root planing. Because periodontitis often causes bone loss, the underlying bone may be reshaped before the gum tissue is stitched back in place. After you heal, it’s easier to clean the areas around your teeth and maintain healthy gum tissue.

Soft tissue grafting: When you lose gum tissue, your gumline gets lower, exposing some of your tooth roots. You may need to have some of the damaged tissue reinforced. This is usually done by removing a small amount of tissue from the roof of your mouth and attaching it to the affected site. This can help reduce further gum loss, cover exposed roots and give your teeth a better appearance.

Bone grafting: This procedure is performed when gum disease destroys the bone around your tooth root. The graft is made of synthetic or donated material. The bone graft serves as a platform for the regrowth of natural bone.