In the early stages of gum disease, most treatment involves a special cleaning called scaling and root planning, which removes plaque and tartar around the tooth and smoothing the root surfaces. Antibiotics or antimicrobials may be used to supplement the effects of scaling and root planing. In most cases of early gum disease, called gingivitis, scaling and root planing and proper daily cleaning achieve a satisfactory result. More advanced cases may require surgical treatment, which involves cutting the gums – sometimes with the assistance of a laser – and removing the hardened plaque build-up and recontouring the damaged bone. The procedure is also designed to smooth root surfaces and reposition the gum tissue so it will be easier to keep clean.