If your dentist decides you will benefit from antimicrobial treatment, he or she will likely start with root planing and scaling. This process removes plaque from the periodontal pockets using either a scaler, an ultrasonic cleaner or a dental laser. In severe cases where there is periodontal pockets greater than 5 mm deep, the practitioner might perform gum flap surgery to clean the periodontal infection around the teeth and root surfaces. These procedures typically take place using local anesthesia to reduce the patient's discomfort.

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