For many patients the initial stage of treatment is a thorough cleaning that may include scaling to remove plaque and tartar deposits beneath the gum line.

The tooth roots may also be planed to smooth the root surface allowing the gum tissue to heal and reattach to the tooth.

Antibiotics or mouth rinses may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, antibiotics may be placed in the periodontal pockets after scaling and root planing. This may be done to control infection and to encourage normal healing.

When deep pockets between teeth and gums are present, it is difficult to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.