Osseous surgery is a procedure done when you have a pocket around a tooth (or teeth) that has not responded to other treatments. It is done in an effort to help you retain the tooth and create an environment that is easier for you to keep clean. The surgical procedure is used to smooth and reshape the affected bone and create a shallow pocket that makes it more difficult for the more aggressive bacteria to survive. The surgery includes a thorough cleaning of the root surface. These steps make it harder for the bacteria to grow and multiply and to make it easier for the body to work toward self-repair. The first step is to identify which teeth need surgery. The primary characteristic is that the pocket around the tooth, when measured by the periodontal probe, is 4mm deep or more. The gum around the tooth may also be red, inflamed, swollen and bleed easily.