Surgery is only rarely needed to control periodontal disease, a disease that affects almost everyone. Most people can keep their teeth and gums healthy by careful daily removal of the bacterial film which causes the disease, in combination with periodic visits to a dentist or dental hygienist for the removal of bacterial deposits below the gum line. However, when there is periodontal disease, and the gum has unzipped so far down the root of the tooth that dental instruments are no longer effective (about 5-6 millimeters), periodontal surgery may be necessary. Periodontal surgery can be very beneficial, but unfortunately tends to be fairly painful post operatively. If not done, the bacterial deposits will remain on the tooth and cause further bone destruction; ultimately causing the teeth to develop painful abscesses or simply to loosen and fall out.