Periodontal Disease that is more advanced often results in significant amounts of residual sub-gingival (under the gum) plaque and calculus (tartar) deposits. Periodontal Disease will also cause bone resorption and deeper pockets. When non surgical treatment cannot control the disease process, Flap Surgery may be indicated. The procedure is carried out in the office with local anesthetic. The gums in the affected area are slightly folded open (like the flap of an envelope). This allows the visibility necessary to remove the visible residual plaque and calculus. As well, the uneven bone contours may be reshaped. Finally the gums are sutured and may be tightened to help reduce the pockets.