Nonsurgical therapy controls the growth of harmful bacteria by removing plaque and calculus. It treats conditions that encourage gum disease. This type of treatment may be all that is needed, especially when periodontal disease is caught early. As your periodontist, I may communicate with your general dentist, who may provide some forms of dental therapy such as replacing old and worn fillings that can enhance the accumulatton of plaque, before periodontal therapy can begin or after it is completed.

- Scaling and Root Planing
- Antibiotics
- Bite Correction
- Splinting

Surgical therapy on the gums treats infection that is too advanced and pockets that are too deep to reach by scaling and root planing alone. The gums are opened to clean the pockets. We then reposition your gums so that they will be easier to keep clean during home care and follow-up appointments. To achieve this goal, the gumline often must be lowered exposing more tooth.

- Flap Surgery
- Gingivectomy
- Bone (Osseous) Surgery
- Guided Tissue Regeneration
- Bone Graft
- Soft Tissue Graft

Scaling and Root Planing

Scaling is a type of cleaning that removes plaque and calculus from the teeth at and slightly below the gumline. Root planing smooths and decontaminates root surfaces, so the supportive tissues can better re-attach to the tooth surface. We may use local anesthesia because this procedure goes deeper than regular cleaning.


Because periodontal disease is caused by bacteria, you may receive antibiotics. These may be in pill form or be applied directly to the infected area. An antibacterial mouth rinse also may be prescribed to help control plaque.

Bite Correction

An imbalanced bite may increase bone destruction. You may be given a bite guard, a removable device that fits over upper and lower teeth, to protect teeth surfaces and relax tense jaw muscles. Or your bite may be adjusted so that your teeth meet properly and function better.


If treatment has saved your teeth, but they are still loose as a result of of bone loss, they may be splinted. This technique joins weak teeth together, combining them into a stronger single unit, making them more stable and making you feel more comfortable.

Flap Surgery

As your periodontist I gently separate the gum from the tooth, creating a "flap" and access to the infected pocket. This allows me to remove deep deposits of plaque and calculus. It also reduces the size of the pocket and the areas where bacteria can grow. Little or no gum tissue is removed.

Calculus forms in a deep pocket where scaling and root planing cannot reach.

During surgery, the gum is lifted to allow root plaing and removal of diseased tissue.

The new gumline may be lower, which eliminates the pocket and makes cleaning easier.

Gum may be replaced at or near the original gumline to expose less of the tooth.


This procedure involves removing an overgrowth of gum tissue. Removing excess gum tissue eliminates the space in which bacteria can collect, making it easier for you to keep teeth and gums clean. This procedure also creates a less "gummy" smile when performed for cosmetic reasons.

Bone (Osseous) Surgery

This procedure is used to smooth shallow craters in the bone due to mild or moderate bone loss. After gaining access to the damaged bone with flap surgery, we reshape the bone around the tooth to decrease the craters. This makes it harder for bacteria to accumulate and grow.

Supportive bone around the root is diseased and partially destroyed.

First, plaque and calculus are removed from the infected pocket and the root is planed.

The bone is smoothed and reshaped, reducing the number of spaces where bacteria can grow.

The gum is then closed over reshaped bone at or below the gumline.

Guided Tissue Regeneration

This technique helps keep unwanted gum tissue away from the tooth and bone, allowing ligament fibers to regrow so that the tooth is better supported.

1. After a cleaning, a special membrane is inserted between the gum and bone.
2. The membrane blocks unwanted tissue, allowing ligament fibres to grow.
3. Once strong ligament fibres attach root to bone, the membrane desolves or is removed.

Bone Graft

Tiny fragments of either your own bone or some from a bone bank are placed into areas of lost bone. These grafts act as a platform on which your bone can regrow, restoring stability to your teeth. Click
here for more information on bone grafting.


1. The graft material is packed into the area where bone has been lost.
2. The gum is then closed and new bone growth is stimulated by the graft.
3. New bone tissue fills in the crater, providing strong support for the tooth.

Soft Tissue Graft

Soft tissue is added to reinforce thin gums or to fill in areas where gums have receded. Graft tissue, usually taken from the roof of your mouth next to the teeth or obtained from a tissue bank, is sutured in place over the affected area.