Deep Cleaning, also known as scaling and root planing, is the most common and conservative form of treatment for periodontal (gum) disease. Scaling is the removal of calculus (commonly called tartar) and plaque that attach to the tooth surfaces. The process especially targets the area below the gum line, along the root. View the video demo of the procedure
Plaque is a sticky substance, full of bacteria, that forms on teeth. When plaque hardens over time, it is called calculus. Plaque is more likely to stick to rough surfaces. For this reason, the root surface is made smooth in a process called root planing. Root planing removes any remaining calculus and smoothes irregular areas of the root surface.
Bacteria cause periodontal disease. Plaque and calculus provide an irregular surface that allows these bacteria to attach easily. Scaling and root planing are done to remove the plaque and calculus. For early stages of the disease, this treatment may be all that is needed to get the condition under control. This is especially effective with gingivitis. With more advanced gum disease, scaling and root planing may be the first step before surgery.
How It’s Done
Scaling and root planing are done with a combination of ultrasonic scalers and hand instruments. Ultrasonic instruments are used first to remove large deposits of plaque and calculus from the crowns and roots of the teeth. Hand instruments called scalers and curettes are then used to remove any remaining material and make sure that the tooth surface is clean and smooth.
Sometimes, scaling and root planing can be completed in one visit. This usually is possible if you have gingivitis, the earliest stage of gum disease. However, if you have periodontitis, multiple visits are usually needed. For some patients, scaling and root planing can cause discomfort. A local anesthetic may be used to numb the portion of your mouth that is being worked on.
For two to three days after the treatment, you may have some soreness and be sensitive to hot and cold temperatures. Over-the-counter pain relievers can help. You may be asked to use an antiseptic mouth rinse after scaling and root planing. This is especially likely if your gums are very sore. However, you should continue brushing and flossing as usual. You can expect some minor bleeding in the first days after scaling and root planing. This usually stops within a week.
Treating periodontitis decreases gum inflammation. It also eliminates periodontal pockets, which can trap plaque. Therefore, if treatment is successful, the swelling will be gone and your gums will shrink or recede.
The extent of shrinkage depends on the initial depth of the pocket and the severity of periodontitis. The more severe the disease, the more your gums will recede after successful therapy. As a result, some part of the root is exposed. This makes the tooth look longer. It also will be more sensitive to heat and cold. To prevent root cavities, your dentist may prescribe a fluoride-containing gel. It’s also important to control plaque.
Laser and localized antibiotic
If necessary, laser therapy in combination of localized antibiotic will be used to treat isolated area. Laser will remove bad infected gum tissue and sterilize the area. With antibiotic, it will stay in the pocket for few days to prevent possible infection. Antibiotic will also prevent bacteria to recolonize the pocket site. Laser therapy and localized antibiotic will increase the successful rate of treatment.