Scaling and root planing is also referred to as conventional periodontal therapy, non-surgical periodontal therapy or deep cleaning. It is the process of removing dental bacteria as well as plaque and its hard by-product, tartar. Like bacteria and plaque, tartar (also called calculus) is typically found below the gum line. Scaling and root planing will only be performed after a thorough visual examination of the mouth, which may include taking X-rays. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, Dr. Madison may recommend scaling and root planing. In most cases, a local anesthesia may be used during the procedure.
When scaling is performed, calculus (tartar) and plaque that attaches to the tooth surfaces are removed. The process especially targets the area below the gum line, along the root. Scaling is performed with special instruments called scalers as well as ultrasonic instruments. The scaling instrument usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria.
Root planing is performed in order to remove the infected tooth surfaces (cementum and surface dentin) that are embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed, or planed, which promotes healing and also helps prevent bacteria from easily colonizing in the future.
Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Madison may place locally administered antibiotics (Arestin) in the periodontal pockets after scaling and root planing. This may be done to control infection and to encourage normal healing. When deep pockets between teeth and gums are present, it is difficult to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, if after scaling and root planing, there still remain residual pockets, surgery may be necessary to restore periodontal health.
Benefits of Treatment
Scaling and root planing has many benefits. Besides restoring the health of the teeth, research has shown that bacteria from periodontal infections can enter the body through the infected gum lining and then travel through the bloodstream and affect other areas of the body, sometimes causing heart and respiratory diseases. Scaling and root planing removes bacteria that may cause or contribute to these conditions.
Another benefit of treatment is protecting teeth against bone loss. When gum pockets exceed 3mm in depth, the risk for periodontal disease increases. As pockets deepen, more bacteria are able to colonize, eventually causing a chronic inflammatory response by the body to destroy gingiva and bone tissue. This leads to tooth loss.
Finally, scaling and root planing may make the mouth more aesthetically pleasing by removing dark stains and buildup around the teeth. It will also help in the elimination and reduction of chronic bad breath. Chronic bad breath, or halitosis, is usually caused by the same bacteria that causes gum disease.