Nonsurgical therapy removes plaque and calculus by controlling the growth of harmful bacteria and by treating conditions that encourage gum disease. This type of treatment may be all that's needed, especially when periodontal disease is caught early. Your periodontist may ask you to talk with your general dentist, who may provide some nonsurgical therapy. You may also need to have certain procedures, such as replacing worn fillings that can accumulate plaque, taken care of before periodontal therapy can begin. Scaling is a type of cleaning that removes plaque and calculus from the teeth at and slightly below the gumline. Root planing smooths root surfaces, so the supportive tissues can better reattach to the tooth surface. Your periodontist may use local anesthesia because this procedure goes deeper than regular cleaning. Local Antimicrobial Therapy Antimicrobial therapy is the use of antibiotics to fight periodontal (gum) disease, which is caused by certain oral bacteria. Typically, antibiotics are used in conjunction with scaling and root planing. Some periodontists use antimicrobial therapy only as a last resort, while others use it more frequently. In some cases, antimicrobial therapy can eliminate the periodontal disease. In others, periodontal surgery still is needed.