Has your dentist recommended scaling and root planing? This two-part procedure, often referred to as deep cleaning, is often necessary for patients who have chronic periodontitis, an advanced form of gum disease. According to the American Dental Association, roughly 47% of adults over the age of 30 in the U.S suffer from chronic periodontitis.
What is scaling and root planing?
Scaling is the actual process of removing plaque and tartar from above and below the gumline. While plaque can often be removed by a dental cleaning, tartar removal requires special tools that can scrape this hard substance off teeth. Some dentists use hand-held tools like curettes or dental scalers to remove plaque and tartar. Other dentists use a vibrating, ultrasonic instrument when manual dental tools may not be as effective against stubborn plaque.
Once scaling is completed, the next step is root planing, or smoothing out the teeth roots. Root planing encourages the gums to reattach to tooth roots by smoothing the dental enamel that was roughened by the scaling procedure. Planing also removes bacteria lodged under the gums at the gumline to prevent the chance of bacterial regrowth.
Dentists sometimes insert an antimicrobial medication directly into periodontal pockets after root planing. This medication is in the form of a tiny, systemic antibiotic chip that dissolves over time.
Why do I need scaling and root planing?
Gum disease (gingivitis) occurs when plaque accumulates at the gumline and severely inflames the gum tissue. Dentists can reverse gingivitis in its early stages by thoroughly cleaning and fluoridating the teeth and gums. Individuals with mild gingivitis should brush and floss twice a day to prevent gingivitis from returning after getting their teeth professionally cleaned.
If gingivitis is not promptly treated, plaque turns into a harder substance called tartar. The combination of plaque and tartar not only causes gingivitis to worsen, but also promotes tooth decay. Advanced gingivitis causes gums to bleed, swell, and recede from the tops of the teeth.
Gum recession encourages the development of pockets of infection above and underneath the gumline. When gingivitis reaches this stage, dentists will need to perform a scaling and root planing procedure to remove plaque and tartar.
Untreated advanced gingivitis will lead to an advanced form of gum disease called periodontitis. A serious oral disease affecting both gums and teeth, periodontitis can lead to rapid tooth decay, loss of teeth, and extensive dental treatment.
The consequences of not undergoing scaling and root planing when necessary include tooth decay, tooth loss, painfully infected gums, and possible erosion of the jaw bone.
How long does scaling and root planing take?
Two visits to the dentist is usually needed to complete scaling and root planing treatment. During the first visit, half of the mouth is treated. About a week later, the patient returns to have the other half of the mouth treated. Each visit should take no more than 90 minutes to two hours. Since only a local anesthetic is needed, you are allowed to drive yourself home after the procedure.
For cases of severe gum disease, the dentist may recommend completing scaling and root planing over four dental visits, treating one quadrant of the mouth at a time.
How painful is scaling and root planing?
During scaling and root planing, dentists apply a local anesthetic to the tooth roots and gums so that patients feel little to no discomfort throughout each process. The numbness lasts throughout the procedure and several hours afterward.
If you have concerns about discomfort during a scaling and root planing, let your dentist know. Your dentist will be happy to discuss those concerns with you and may be able to offer other options for alleviating dental anxiety, such as mild sedation.
Does scaling and root planing cure bad breath?
Yes, scaling and root planing can eliminate bad breath if gingivitis is the primary cause of bad breath. If you have a scaling and root planing procedure but continue to have bad breath, visit your primary care doctor for an exam. Halitosis may be due to a medical condition, such as peptic ulcers, gastroesophageal reflux disease (GERD), or a salivary gland disorder that reduces saliva flow.
How much does scaling and root planing cost?
Since scaling and root planing is not considered a cosmetic dental procedure, employee or personal health insurance will likely cover the full or partial cost of treatment. The cost of a scaling and root planing treatment typically ranges from $400 to $600.
For individuals without dental insurance, many dentists offer discounts and payment plans so that patients can afford to have this necessary type of dental procedure.
Scaling and root planing risks
Complications following a scaling and root planing are rare and should never be considered reasons for not having the treatment. For example, some people experience gum shrinkage after scaling and root planing. They may notice their teeth appear “bigger” as gums recede from the upper part of teeth. A noninvasive gum restoration procedure can lengthen gums and restore an attractive gumline if gum recession occurs after scaling and root planing.
Individuals with severe gingivitis and/or periodontitis could develop an infection following scaling and root planing that causes lymph glands to swell. This can happen when bacteria gets into the bloodstream via badly infected gums. A regimen of antibiotics is usually prescribed to treat such an infection.
Your dentist will want to know your medical history before performing scaling and root planing. Certain factors can increase a person’s risk for infection, such as smoking, or having an autoimmune disease or heart condition. When a gum infection is severe, dentists may prescribe antibiotics before they begin a scaling and root planing procedure to reduce the risk of bacteria entering the bloodstream.
Aftercare tips for scaling and root planing
Gums may feel sore and sensitive for a few days after scaling and root planing. It is also not unusual for gums to bleed occasionally. Your dentist may prescribe a therapeutic mouth rinse to help prevent infection, reduce discomfort, and promote healing. Instructions on when and how to brush your teeth following scaling and root planing will also be provided by your dentist at the end of your visit.
A follow-up exam is necessary to ensure your gums are healing properly and to let the dentist measure the depth of the periodontal pockets.
To avoid having another scaling and root planing treatment, always brush and floss your teeth daily, rinse with a fluoridated mouthwash, and visit a dentist every six months for a check-up and cleaning.
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