Treatment options for periodontal disease may vary depending on the extent and severity of tissue destruction. Usually it is divided into surgical and non-surgical treatment. The main objective of periodontal therapy is to eliminate all the disease causing bacteria and regenerate the supporting structures of the affected tooth.

Non-surgical pocket therapy, also called scaling and root planing, is the initial procedure that reduces the signs of infection. The result of this initial phase is a noticeable improvement in the clinical condition. This includes a significant reduction in swelling and bleeding as well as reduction in pocket depth.

Surgical pocket therapy is indicated in more advanced cases where scaling and root planing alone are not sufficient. If it is not possible to eradicate all the bacteria colonizing the deep pockets, visual surgical access is then necessary.

Types of surgical treatment commonly prescribed include:

Resective pocket reduction procedures
Periodontal pockets are the result of the separation of the gum from the affected tooth. A space will develop where bacteria will colonize and infect the underlying supporting bone. Over time these pockets become deeper allowing more bacteria and more destruction. If too much bone is lost, the teeth will need to be extracted. The periodontist measures the depth of the pocket and determines that a flap procedure is necessary. This includes the separation of the gum from the tooth under local anesthetic and the removal of the disease causing bacteria. The infected tissues are then removed before securing back the gums, usually with sutures.

Regenerative Procedures
These procedures could reverse the destructive process by regenerating lost bone and tissue. This includes the separation of the gum from the tooth under local anesthetic and the removal of the disease causing bacteria along with the infected tissues. Bone graft or growth stimulating proteins could be applied to help regenerate the bone. The gums are then repositioned and secured back in place with sutures.