Periodontal disease is a serious gum disease that should not be left untreated. If a dentist is not seen to treat the gums, the individual may start losing teeth. Although periodontal disease is serious, there are several types of valuable treatments available.
Surgery is a common course of action, but depending on the severity of the condition, a non-surgical procedure called root planing and scaling may be appropriate.
Many patients in our practice require deep cleaning, also known as scaling and root planing. Once these words are spoken, patients tend to be alarmed. The procedure is non-surgical and requires no cutting or drilling. When a patient is diagnosed with early-stage gum disease (gingivitis), their hygienist may recommend a thorough cleaning, since regular cleaning consists only of scraping plaque from the teeth.
With gingivitis, your hygienist wants to clear out the infection, promote healthy gum regrowth, and prevent gum infection from developing into periodontitis (the second most aggressive stage of the disease). That’s why deep cleaning requires deep gum cleaning, especially to remove bacterial infections that toothbrushes and floss can’t reach.
Scaling and root planing procedure
During the exam process, your dentist and hygienist will work together to provide a thorough evaluation which will include x-rays (which will notify the dentist of any bone loss or infection). Your hygienist will also examine your gum tissue to check the depth of periodontal pockets around your teeth.
Next comes the scaling part of the procedure. This will involve removing tartar and plaque from all of your teeth and around the gum lining.
The next step is root planing. During the planning process, your hygienist will smooth out any rough areas of enamel damaged by infection.
Your hygienist will most likely recommend a follow-up to reassess your gum tissue to verify that your infection has healed.
Overview of the process
Scaling and root planing is actually an ideal deep dental cleaning procedure in the early stages of periodontal disease. During this time, the individual’s teeth may develop pockets of abnormal spaces between the teeth. If these pockets get bigger, the teeth will start to pull away from the gums and eventually fall out.
Excess bacteria that exist on the teeth can also be accidentally swallowed and make the person sick. This situation is very serious for people with heart disease because bacteria can enter the blood and cause inflammation of the heart chambers.
Scaling and root planing are usually given as a single treatment under local anesthesia unless there is a significant amount of damage to the teeth. During the “scaling” part of the procedure, the dentist uses power tools to remove excess bacteria from the teeth. The bacteria can show up as plaque, tartar, or decay.
The “brushing” part of the procedure involves cleaning below the gum level. Since bacteria may not be visible, the dentist looks for rough surfaces and uses a hand instrument to remove any debris or bacteria. There are two common types of hand instruments: an ultrasonic tool or a scaler. Dental patients tend to prefer the ultrasonic tool as it causes less discomfort.
Suitable candidates
To determine if an individual’s periodontal disease is amenable to root planing and scaling, dentists use a guide provided by the American Dental Association (ADA). According to the ADA, gum disease that extends 3 to 6 millimeters below the gum line is suitable for root planing and scaling. Gum disease deeper than this amount will likely require surgery.
After the procedure
Since scaling and root planning involve the dentist working on sensitive areas of the teeth and gums, people may experience minor aches, pains, and bleeding after the procedure. The individual may also notice temporary sensitivity to hot or cold drinks.
In most cases, over-the-counter medications are enough to relieve symptoms. The dentist should be contacted if they last for an extended period.
References:
1- Treatments for Gum Disease
Medically Reviewed by Evan Frisbee, DMD on October 31, 2021
https://www.webmd.com/oral-health/guide/gum-disease-treatments
2-Periodontal Disease
https://www.cdc.gov/oralhealth/conditions/periodontal-disease.html
3- Microbial colonization of the periodontal pocket and its significance for periodontal therapy
Andrea Mombelli, First published: 30 November 2017
https://onlinelibrary.wiley.com/doi/10.1111/prd.12147
4-The periodontal pocket: pathogenesis, histopathology, and consequences
Dieter D. Bosshardt First published: 30 November 2017
https://doi.org/10.1111/prd.12153
