Non-surgical Therapy:
The initial type of treatment for periodontal disease is through  a non-surgical type of periodontal therapy.  This includes scaling and root planing , which is a cleaning of the root surfaces to remove plaque and tartar from the periodontal pockets and to smooth the tooth root  to remove bacterial toxins.  Throughout this process, antimicrobial medicaments are also used to kills more bacteria as an adjunct to the scaling.  Many patients do not require further active treatment after this as long as ongoing maintenance therapy is performed.  However when the non-surgical therapy does not achieve periodontal health, surgery may be indicated.

Surgical Therapy:
These types of procedures, which include pocket reduction procedure and regenerative procedures, are often performed by board certified periodontists.  When the diseased gum tissue does not respond well to the scaling and root planing, then it is physically removed with surgery and the remaining healthy tissue is kept and sutured in place around the teeth.  This type of procedure reduces the pockets formed around the teeth and therefore will make it easier to keep the gums and teeth clean.