Scaling is procedure that meticulously removes contamination toxins, micro-organisms, plaque, tartar, cementum, dentin that is rough and/or permeated by calculus from around, below and under the gum line down to the bottom of the pocket. This is done to remove biofilm, calculus, and toxin down to the bottom of each periodontal pocket in order to obtain a healing response.

Root Planing Root planing involves smoothing the root surfaces of your teeth with thin curettes so gum tissue can more firmly reattach to roots that are clean and smooth to prevent tooth loss and sensitivity problems. The procedure makes it more difficult for plaque to accumulate along the root surfaces. Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. The cleaning may take two visits to complete. Depending on the extent of the disease you may need one or more sections (quadrants) of the mouth to be treated with scaling and root planing. Treatment may require one or more visits.

Periodontal Flap Surgery is recommended in many cases where pocketing depths have reached a level that makes maintenance or cleansing difficult. It is often associated with areas of bone loss and inflammation of the gum tissue around the teeth.

When scaling and root planing have been unsuccessful in eliminating the entire pocket of decay, or when there has been bone loss that needs to be surgically corrected, then a dentist may perform periodontal flap surgery. In flap surgery, under local anesthesia, small incisions are made in the gum, so that it can be lifted back to expose the tooth and bone. The entire area is carefully cleaned and all tarter and infected granulation tissue are removed and the bone is examined. Because periodontal disease causes bone loss, often the bone will need to be re-contoured in order for the gum to heal properly.
After scraping away the bacteria-laden plaque and tartar, the dentist removes diseased tissue and smoothes the surface of damaged bones. Then the dentist sews the tissue back into place. Removing or smoothing damaged tissue allows the gum tissue to better reattach to healthy bone.
Periodontal flap surgery is sometimes necessary to treat advanced periodontal disease if scaling and root planing proves ineffective. Deep pocketing along with underlying bone defects can prevent the gum tissues from fully healing and staying healthy. The procedure involves the loosening of the gums from around the teeth in order to fully expose and the clean the parts of the teeth which were previously covered by the gums.

Soft tissue grafts can be used to cover roots or develop gum tissue where absent due to excessive gingival recession. A thin piece of tissue is grafted from the roof of the mouth, or gently moved over from adjacent areas, to provide a stable band of attached gingiva around the tooth. The gingival graft may be placed in such a way as to cover the exposed portion of the root. During this procedure, the periodontist takes gum tissue from your palate or another donor source to cover the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

A soft tissue graft can reduce further recession and bone loss. In some cases, it can cover exposed roots to protect them from decay. Soft tissue grafts and other root coverage procedures are a predictable way to cover unsightly, sensitive or exposed root surfaces, to prevent future gum recession and restore healthy gum tissue. This will reduce further bone loss and recession, make the tooth less sensitive, protect the root from root cavities, and look more natural when you smile. If you are unhappy with the appearance of short unsightly teeth this can be greatly improved by a combination of periodontal procedures by our Periodontic dentist.