A routine prophylaxis cleaning is a professional removal of plaque and tartar from tooth surfaces above and just below the gumline performed on patients with healthy or stable gum tissue. It's the cornerstone of preventive dental care and your best defense against gum disease before it starts. We also use this visit to assess gum health, screen for early signs of disease, and reinforce your home care habits.

What Happens

Ultrasonic and hand scalers remove deposits from teeth and just beneath the gumline. Teeth are polished to remove surface staining. Gum pocket depths are measured and charted. Oral hygiene reviewed and personalized tips given.

How Often

For patients with healthy gums, every 6 months is the standard recommendation. Patients with a history of gum disease or higher risk factors are placed on a 3–4 month maintenance schedule instead.

Appointment

A standard cleaning takes 45–60 minutes, including the periodontal assessment. New patient visits are slightly longer as we build a complete baseline record of your gum health for future comparisons.

⚑  Already been diagnosed with gum disease? A standard prophylaxis is not the same as a periodontal maintenance visit. We will place you on the appropriate maintenance program to ensure your gum health is managed correctly.

Scaling and root planing, commonly called a "deep cleaning" is the gold-standard non-surgical treatment for gum disease. When bacterial deposits extend below the gumline into periodontal pockets, a routine cleaning can no longer reach them. Scaling and root planing removes these deposits from the root surfaces and smooths the root to discourage bacterial reattachment and promote healing of the gum tissue.

What's Involved

The mouth is divided into quadrants or halves and treated over 1–2 appointments. Each area is thoroughly anesthetized before treatment begins. Ultrasonic and hand instruments are used to clean deep into pockets — reaching areas that regular cleaning cannot. Root surfaces are then smoothed (planed) to create an environment less hospitable to bacteria.

• Performed under local anesthetic — comfortable
• Ultrasonic scaling for efficiency and reach
• Root planing smooths surfaces to aid healing
• Pockets reassessed 4–6 weeks after treatment

Your Visit Schedule

Most patients complete scaling and root planing in 2 appointments — each covering half the mouth — scheduled 1–2 weeks apart. A re-evaluation appointment follows 4–6 weeks later to measure pocket depths and assess healing. From there, a personalized maintenance schedule is established.

• 2 treatment appointments (one per arch or quadrant)
• Each appointment: 60–90 minutes
• Re-evaluation: 4–6 weeks post-treatment (~45 min)
• Ongoing maintenance: every 3–4 months

Perio Maintenance: The Step That Follows

After completing scaling and root planing, patients transition to a periodontal maintenance program — more frequent cleanings (typically every 3–4 months) that monitor pocket depths, re-clean below the gumline, and protect the progress made during active treatment. Perio maintenance is not optional; it is what keeps gum disease from returning.

1 - 2

TREATMENT visitS

60-90 MINS

aPPOINTMENT DURATION

01

Periodontal Exam

Full pocket charting, X-rays, and disease staging. Treatment plan presented.

~45 - 60 MINS

02

Deep Cleaning ×2

Scaling and root planing completed in one to two appointments.

~60 - 90 MIN

02

Re-Evaluation

Pockets re-measured 4–6 weeks later. Healing assessed. Additional treatment or maintenance planned.

~45 MINS

04

Perio Maintenance

Every 3–4 months ongoing. Includes cleaning, charting, and monitoring.

~45–60 MINS

In cases where periodontal pockets remain deep or bacteria are particularly persistent, localized antibiotic placement delivers medication directly into the pocket, right where it's needed. This adjunct therapy is used alongside scaling and root planing or maintenance visits to enhance the effectiveness of mechanical cleaning and support tissue healing.

How it works

A slow-release antibiotic most commonly minocycline microspheres or doxycycline gel, is placed directly into the periodontal pocket immediately after scaling and root planing. The medication releases over several days, targeting the bacterial load within the pocket in a concentration that oral antibiotics cannot achieve. No prescription or pharmacy visit is needed, everything is placed chairside.

What to expect

Placement is quick and painless added to a scaling appointment with no additional anesthetic needed. Patients are advised to avoid flossing the treated area for about 10 days to allow the medication to remain in place. The treatment may be repeated at subsequent maintenance visits for pockets that remain resistant to healing.

When It's Recommended

Not every patient requires antibiotic placement. We recommend it for pockets that are 5mm or deeper, sites with recurring bleeding on probing, areas where bone loss is active, or cases with systemic factors such as diabetes or immune compromise that impair healing. It is always used as an adjunct to mechanical treatment, not a replacement.

• Deep or persistent pockets (5mm+)
• Recurrent bleeding despite treatment
• Active bone loss detected on X-ray
• Systemic conditions affecting gum healing

Visit Details

Antibiotic placement is performed at the same appointment as scaling and root planing or a maintenance cleaning, adding minimal time to the visit. No separate appointment is typically needed. Results are evaluated at the next re-evaluation or maintenance visit by reassessing pocket depths.

• Added to existing scaling or maintenance visit
• Adds 5–10 minutes to appointment
• No additional anesthetic required
• Avoid flossing treated sites for ~10 days
  

When non-surgical treatment scaling and root planing, does not fully resolve periodontal disease, surgical intervention may be necessary to access and clean areas that instruments cannot reach from above the gumline. Periodontal flap surgery involves gently reflecting (lifting) the gum tissue to expose the root surfaces and underlying bone for direct cleaning, reshaping, and treatment.

Why Surgery

Recommended when pocket depths remain at 5–6mm or greater after scaling and root planing, when bone defects or irregular contours trap bacteria, or when the tissue architecture itself prevents proper healing and home care access.

The Procedure

Performed under local anesthetic, the gum tissue is gently lifted away from the teeth to expose roots and bone. Root surfaces are thoroughly cleaned under direct vision. The tissue is sutured back, often repositioned to reduce pocket depth and improve access for home care.

Recovery

Mild to moderate soreness for 2–5 days, managed with prescribed or over-the-counter pain relief. Soft diet for 1 week. Sutures removed at 7–10 days. Most patients return to normal activity within 1–3 days of surgery.

01

Pre-Surgical Eval

Assessment & Planning

Pocket charting, X-rays, and surgical plan discussed. Non-surgical treatment completed first to optimize tissue health before surgery.

~60 MIN

02

Surgery Day

Flap Procedure

Gum reflected, roots and bone cleaned under direct vision, tissue sutured. One area or quadrant at a time.

60-120 MIN

03

Suture Removal

1-Week Follow-Up

Stitches removed, healing inspected, home care reinforced. Any discomfort by this stage is typically minimal.

~20 MIN

04

Ongoing Care

Perio Maintenance

Maintenance visits every 3 months for the first year post surgery. Pocket depths monitored to confirm lasting improvement.

EVERY 3 MONTHS

1 Per Area

Surgical visit per quadrant

60-120 MINS

Procedure duration

"Surgery is not a failure of earlier treatment, it's the next appropriate step for areas where disease has progressed beyond what non-surgical care can fully resolve."

Periodontal disease can destroy both the gum tissue and bone that support your teeth. Grafting procedures rebuild this lost support, protecting roots, restoring a healthy gumline, and in some cases regenerating bone around teeth. There are two primary types: soft tissue (gum) grafts to address recession, and bone grafts to fill defects left by periodontal destruction.

Soft Tissue Grafting

Gum Recession Coverage

When gum tissue recedes exposing roots, increasing sensitivity, or compromising aesthetics a soft tissue graft covers and protects the exposed area. Tissue is typically sourced from the palate or from donor tissue, and sutured over the recession site. Results are long-lasting and dramatically improve both comfort and appearance.

Bone

Grafting

Periodontal Bone Defects

When periodontal disease destroys the bone supporting a tooth, a bone graft can fill the defect and stimulate regeneration. Performed at the time of periodontal surgery, graft material is placed into the bony defect and covered with a membrane. Over months, new bone forms restoring support to the tooth and improving its long-term prognosis.

Guided Tissue Regeneration

Membrane-Assisted Regrowth

A specialized barrier membrane is placed over a bone graft to prevent soft tissue from growing into the defect and allow bone cells to regenerate first. This technique is used for deeper, more complex periodontal defects and offers the best chance of true bone regeneration rather than simple repair. Often used in combination with bone grafting materials.

1

Surgical visit per Site

60-90 MINS

Procedure duration

What Your Visit Looks Like

Grafting procedures are performed under local anesthetic, often combined with a periodontal flap surgery appointment. The surgical area is small and precise. Most patients experience moderate soreness for 3–5 days, manageable with prescribed pain relief. A soft diet is recommended for 1–2 weeks while healing progresses.

• Local anesthetic — comfortable throughout
• Sedation available for anxious patients
• Sutures removed at 1–2 weeks
• Activity can resume within 2–3 days

Timeline & Follow-Up

Soft tissue graft healing is visible within a few weeks, with full maturation over 3 months. Bone graft healing takes longer,  typically 3–6 months before regeneration can be confirmed on X-ray. Periodontal maintenance visits continue on a 3-month schedule throughout to protect the investment made in surgery.

• Soft tissue grafts: visible result in 3–6 weeks
• Bone regeneration confirmed at 3–6 months
• Maintenance every 3 months post-surgery
• Long-term monitoring included in care plan

⚑ Recession doesn't always mean surgery. Mild recession caught early may be stabilized with improved home care and maintenance alone. We'll give you an honest assessment of what your situation actually requires.