Treatment will not be rendered without appropriate diagnostic documentation, including periodontal charting and radiographs when clinically indicated. Patients with uncontrolled systemic medical conditions may be deferred until medical clearance is obtained. Additionally, non-compliance with recommended periodontal maintenance therapy may result in exclusion from repeated SRP or adjunctive gingival irrigation unless new active disease is documented. These procedures are intended strictly for the management of active periodontitis and are not interchangeable with routine dental cleanings or preventive care services. Depending on the severity of the gum disease the procedure may be done under local anesthesia or using a gum numbing gel. For more information, visit the American Dental Association.