If your periodontal disease is severe, you might be advised to undergo a surgical procedure to thoroughly clean out bacteria that are too deep to be removed through scaling and root planing. You might also require surgery to restore tissue and bone that has been destroyed by periodontal disease.

This procedure involves cutting into the gum and revealing the bone and teeth underneath so the area can be carefully and completely cleaned. The disease-causing bacteria and any pieces of calculus are removed, and then the gum tissue is sewn securely back into place around the teeth.

If you have severe tissue and bone destruction from periodontal disease, you might need another procedure after flap surgery called a graft. During a graft, your dentist or dental specialist may remove a bit of tissue or bone from another area of your body, and attach it to areas in your mouth that need new tissue or bone growth. Alternatively, there are two other sources of graft tissue. One is a material harvested from donors called an allograft, the other is a biosynthetic graft material. In addition to grafting procedures, a tiny bit of mesh material may be placed between your gum and bone. This technique prevents the new gum tissue from growing into the area where bone should be.