In the early stages, most treatment involves scaling and root planing-removing plaque and calculus around the tooth and smoothing the root surfaces. Antibiotics or antimicrobial drugs 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, and removing the hardened plaque build-up and re-contouring 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.