In the earlier stages of periodontal disease, treatment often involves a thorough cleaning of the surface of the tooth or root under the gums. This procedure is usually performed with local anesthetic to maintain comfort and is usually performed in sections. Scaling refers to the removal of deposits on the tooth/root surface. These deposits include calculus(tartar) which is a hard material that accumulates irritating the tissue, bacterial plaque which is an accumulation of bacteria that find this area under the gum as a home to grow and raise a family, toxic byproducts of the the bacteria that can trigger a response by the immune system that allows the disease to advance.
As periodontal disease advances, it often chooses to do so in some areas of the mouth and not others. Therefore, after scaling and root planing is completed, another evaluation is normally performed to determine the success of the procedures and identify the more advanced areas. These advanced areas are then addressed with other procedures. Sometimes, antibiotics are used and can now be delivered locally to the affected area. Other times when the periodontal disease process has affected the bone around the teeth, surgical procedures are utilized to protect the remaining bone from further damage and protect the teeth.
And as with most dental procedures, a good maintenance program supports the effects of the procedures. Good oral hygiene habits, a recall cleaning program and regular periodontal exams should be planned.