Scaling and root planning is often referred as a ‘Deep Cleaning’. Scaling and root planning is treatment of choice in patients with an infectious disease of the gum tissue and underlying bone termed periodontal disease. This process is also standard treatment for a patient who has healthy bone level, though has not had a regular dental cleaning over a period of time and simply has presence of moderate amounts of calculus (tartar) present below the gum line.
Periodontal disease typically starts with plaque left on the teeth and around gum line. When plaque mixes with saliva is creates calculus over time. Eventually, calculus containing bacteria will irritate gum tissues by attaching to teeth and root surfaces and releasing toxins resulting in inflammation and infection of gums. If untreated, this can ultimately lead to distraction of the bone (bone loss) that surrounds teeth further possible mobility or loss of teeth.
Scaling and root planning is the only non surgical treatment to help treat periodontal disease by mechanically removing all calculus and paired bacteria from teeth and root surfaces. To properly diagnose the presence of periodontal disease in a patient, it is important to get necessary radiographs (X-rays) and detailed measurements of all gum tissues that surround teeth. When bacteria resides in the mouth, it compromises the ligaments that attach gum tissue to root surfaces, therefore creating deeper pockets. Areas that measure greater than 3mm in depth are indicative of periodontal disease. Overall these measurement are imperative to understand severity of this bacterial infection throughout mouth.
In office treatment for deep cleaning can be done in one or two visits. These cleanings are completed by the dentist or dental hygienist by mode of ultra sonic scaler and/or hand instruments. In addition to the deep cleaning, antibacterial agents such as Arestin placement under gum tissue to help further reduce pocketing or Chlorhexidine rinse to reduce bacteria can be used. It is common to administer local anesthetic or other anesthetics for optimal patient comfort during and following procedures.
Maintenance program. It is standard protocol to keep periodontally involved patients on 3 or 4 month recall intervals. This means more frequent cleanings in a year’s time to properly combat periodontal disease and ensure stability of gum tissues and underlying bone. Every case varies, though periodic scaling and root planning may be needed after initial deep cleaning due to more compromised bone level. It is essential that all patients practice proper daily dental hygiene at home for best overall outcome and health of teeth and surrounding structures.