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The first stage of treatment for severe gum disease or periodontal disease is a very thorough cleaning above and below the gum line and often the use of disinfecting solutions as well.

The gums at this stage are often very tender and sore so the use of local anesthetic is required. Some patients who find they are nervous at the dentist will also request sedation although it is definitely not a requirement. Most patients do quite well with the "numbing" alone.
Most of time half the mouth is done per visit. In exteme cases only the top or bottom teeth on one side will be completed in a visit.

Once local anesthetic is administered the hygienist will perform the gum cleaning. An analgesic such as Tylenol or Advil is give before hand to minimize post operative discomfort which not not usaually very severe.

Due to the nature of the bacteria that cause gum and periodontal disease the entire mouth should be completed within 1 mo or sooner. Healing is allowed to occur for the next 4-6wks and then all the gums are re-evaluated to monitor improvement or the lack there of.