Periodontal treatment may be done by a dentist or a periodontist. A periodontist is a dentist who specializes in gum disease. A dental hygienist may work with your dentist or periodontist as part of your treatment plan. The goal of treatment is to thoroughly clean the pockets around teeth and prevent damage to surrounding gum tissue and bone. You have the best chance for successful treatment when you also have a daily routine of good oral care, manage health conditions that may impact dental health and stop tobacco use.

Nonsurgical treatments
If periodontitis isn’t advanced, treatment may involve less invasive procedures, including:

Scaling
Scaling removes tartar and bacteria from your tooth surfaces and below your gumline. It may be done using instruments, a laser or an ultrasonic device.

Root planing
Root planing smooths the root surfaces. This helps prevent further buildup of tartar and bacteria. It also helps your gums attach to your teeth again.

Antibiotics
Topical or oral antibiotics can help control bacterial infection. Topical antibiotics can include antibiotic mouth rinses or putting gel containing an antibiotic into gum pockets. Sometimes oral antibiotics are needed to get of bacteria that cause infections.

Surgical treatments
If you have advanced periodontitis, you may need dental surgery, such as:

Flap surgery, also called 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 grafts
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 or using tissue from another donor source 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 periodontitis destroys the bone around your tooth root. The graft may be made from small bits of your own bone, or the bone may be made of artificial material or donated. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.

Guided tissue regeneration
This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special type of fabric between existing bone and your tooth. The material prevents unwanted tissue from growing into the healing area, allowing bone to grow back instead.

Tissue-stimulating proteins
Another approach involves applying a special gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue.