Scaling & Root Planing

The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling or root planning. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque (tartar) and calculus, which cause gingival inflammation and disease. Scaling and root planning can be used as a stand-alone treatment, or a preventative measure. They are commonly performed on cases of gingivitis and moderate to severe periodontal disease.

What do the procedures entail?

Scaling and root planning is performed after a thorough oral examination, which includes visual inspection, periodontal probing, possibly additional x-rays. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, we may recommend scaling and root planning. In most cases,  local anesthesia may be used during the procedure.

• Scaling:
  When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process especially targets the area below the gum line, along the root. Scaling is performed with a special dental tool called an ultrasonic scaling instrument. The scaling tool usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria.
• Root Planing:
  Root planning is performed in order to remove cementum and surface dentin that is embedded with microorganisms, toxins and calculus (tartar). The root of the tooth is literally smoothed, 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. This is done to control infection and to encourage normal healing.

When deep pockets are present between the teeth and gums, it is difficult to thoroughly and efficiently remove plaque and tartar.  Consequently, surgery may be considered to restore periodontal health.

Benefits of Treatment

If successful, scaling and planning offer many periodontal benefits, including disease prevention by removing bacteria that cause these conditions.  

Another benefit of treatment is protecting teeth against tooth 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 gingival and bone tissue. This leads to tooth loss.

Finally, scaling and root planning may make the mouth more aesthetically pleasing, and should reduce bad breath caused from food particles and bacteria in the oral cavity. Superficial stains on the teeth will be removed during scaling and planning, adding an extra bonus to the procedures.