Typically it is preferable to explore any non-surgical routes of treatment for mild-moderate periodontal disease, such as root scaling and planing, sometimes also paired with medications. Ideally the disease can be both treated and maintained non surgically with proper care.
Scaling and root planing: This is a deep-cleaning, nonsurgical procedure, done under a local anesthetic, whereby plaque and tartar from above and below the gum line are scraped away (scaling) and rough spots on the
tooth root are made smooth (planing). Smoothing the rough spots removes bacteria and provides a clean surface for the gums to reattach to the teeth. Scaling and root planing is done if your dentist or periodontist determines that you have plaque and calculus (hardened plaque, also called tartar) under the gums that needs to be removed.
However, some cases require a more aggressive approach to ensure that all of the harmful bacteria has been reached, removed, and treated. One such treatment would be flap surgery to ensure a deeper clean.
Flap Surgery: Surgery might be necessary if inflammation and deep pockets remain following treatment with deep cleaning and medications. A dentist or periodontist may perform flap surgery to remove tartar deposits in deep pockets or to reduce the periodontal pocket and make it easier for the patient, dentist, and hygienist to keep the area clean. This common surgery involves lifting back the gums and removing the tartar. The gums are then sutured back in place so that the tissue fits snugly around the tooth again. After surgery the gums will heal and fit more tightly around the tooth. This sometimes results in the teeth appearing longer.