Surgery may be necessary if deep pockets between your tooth and bone persist after the initial, thorough scaling appointments with the dental hygienist. When deep pockets between the teeth and gums are present, it is difficult to remove plaque and tartar. Despite your best efforts and those of the hygienist it is difficult to get these pockets clean and free of the harmful bacterial colonies that result in periodontal disease. Even if most of the bacteria is cleaned off, these deep pockets are a niche or environment that is favourable to harmful bacteria, thus, soon after a cleaning or scaling appointment, the bacteria grow back.
To interrupt this cycle of scaling followed by re-growth of bacteria then scaling and so forth, a surgical phase may be indicated. The primary purpose of surgery is pocket depth reduction. By reducing or eliminating the deep pockets three main objectives are achieved: the niche or environment favoured by harmful bacteria is eliminated, the resulting shallow pockets are easier for the hygienist to scale and the shallow pockets are more easily kept clean by good home-care.