The initial treatment of periodontal disease consists in the deflation and disinfection of the gum with scaling and root planning in order to eliminate accumulated bacteria on the surface of the tooth and under the margin of the gums. This technique is carried out inside the dental cabinet by the dentist or the hygienist. It may require anesthesia and/or several sessions and must be accompanied by a thoroughly brushed home cleaning.
Scaling and Root Planing is a technique that requires great skill and is performed with and little ultrasound machine and also manually with specific curettes. If it is not carried out in a very meticulous manner, it will not be possible to eliminate all the bacteria below the gum, and gingival inflammation, bleeding and progression of periodontal destruction will persist.
In a more advanced state of the disease it is possible that deep shoulder pockets or deformities of the gum persist after the initial periodontal treatment. In these cases, the remaining pockets should be eliminated with surgery to avoid reinfection and progression of periodontal disease.