Scaling & Root Planing

The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling or root planing. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause gingival inflammation and disease. Scaling and root planing 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 does scaling and root planing entail?

Drs. Herrera or Tsang will only perform scaling and root planing after a thorough examination of the mouth, which may include taking x-rays and visually examining the mouth. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, Drs. Herrera or Tsang may recommend scaling and root planing. In some cases, a 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 tool. 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 planing is performed in order to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and 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. In some cases, Drs. Herrera or Tsang may place an antibiotic called Arestin in the periodontal pockets after scaling and 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 for Drs. Herrera or Tsang to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.

What to Expect After the Scaling and Root Planing

You may have some soreness in your gums after the treatments.  This varies from patient to patient and is normal. We see this lasting from one day to two weeks.  You can take Advil or Tylenol unless your Doctor has advised against it.   Rinsing with warm salt water is helpful also.   During this time it is very important for you to brush, floss, use the interdental brushes we demonstrated and use the Perio Science Gel on your gums.  The gel we give you is a completely natural product that will help your gums heal.  It will kill the bacteria and also increase salivary antioxidants that aid in healing.  We ask you to work diligently on your oral hygiene for the 6 weeks after your scaling root planing before you see Dr. Herrera for your reevaluation. This appointment is very important because she will evaluate healing and determine what next steps in treatment are.  Many times this initial conservative therapy is all you will need.  After this, most patients start on periodontal maintenance therapy.  We find that the pockets and periodontal condition can improve up to a year at which time we assess your case for surgery.  Done in this matter we minimize surgical care needed.

Benefits of Scaling & Root Planing Treatment

If treatment is successful, scaling and planing may have many periodontal benefits. One is that it can help prevent disease. Research has proven that bacteria from periodontal infections can travel through the blood stream and affect other areas of the body, sometimes causing heart and respiratory diseases. Scaling and root planing remove 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 planing 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 planing, adding an extra bonus to the procedures.