Scaling and Root Planing
The initial stage of treatment is usually a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line.
The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth. In some cases, the occlusion (bite) may require adjustment.
Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, an antibiotic containing substance may be placed in the periodontal pockets after scaling and planning. This may be done to control infection and to encourage the healing process.
When deep pockets between teeth and gums are present, it is difficult to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque, which creates an environment where the damage gets progressively worse. Consequently, surgery may be needed to restore periodontal health.