The American Academy of Periodontology treatment guidelines stress that periodontal health should be achieved in the least invasive and most effective manner. This is often accomplished through non-surgical periodontal treatment.

The first step in treating periodontal disease after it has been diagnosed is performing scaling and root planing, or deep cleaning. Scaling and root planing is a careful cleaning of the root surfaces to remove plaque and calculus [tartar] from deep periodontal pockets and to smooth the tooth root to remove bacterial toxins. Scaling and root planing is sometimes followed by adjunctive therapy such as local delivery antimicrobials, systemic antibiotics, and host modulation, as needed on a case-by-case basis.

Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment. However, patients will require ongoing maintenance therapy at 3 month intervals to sustain health. Non-surgical periodontal treatment does have its limitations. When it does not achieve periodontal health, surgery may be indicated to restore periodontal health.