If you have advanced periodontitis, your gum tissue may not respond to nonsurgical treatments and good oral hygiene. In that case, periodontitis treatment may require dental surgery, such as: 1  Flap surgery (pocket reduction surgery).2  In this procedure, your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and root planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. 2  After you heal, it's easier to clean these areas and maintain healthy gum tissue. 3  Soft tissue grafts.