Per Arestin’s instructions: “ARESTIN® is indicated as an adjunct to scaling and root planing (SRP) procedures for reduction of pocket depth in patients with adult periodontitis. ARESTIN® may be used as part of a periodontal maintenance program, which includes good oral hygiene and SRP.” I’m not sure why a doctor would want to place Arestin without removing the irritants first (scaling), otherwise success is unlikely. Further, having a pocket heal around caclulus can cause a perio abscess, in which the doctor can be held liable (if the patient lost the tooth).