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Deep Cleaning: What is scaling and root planing and why do dentists recommend this treatment?

Why do I need scaling and root planing?

Gum disease affects almost half of the U.S. population over the age of 30.  It occurs when plaque is not properly cleaned from teeth and causes gums to become inflamed.  Over time, this inflammation causes the gums to pull away from teeth resulting in the development of pockets.   Once this occurs, the plaque that created the pockets becomes trapped beneath where it is too deep to be removed with regular brushing.  This leads to the loss of the supporting connective tissue and alveolar bone.  Signs of gum disease include bad breath, inflamed and tender gums, bleeding gums, shifting teeth and a change in bite. Untreated gum disease (periodontitis) is a major cause of tooth loss in adults.  

It is important to note that not all cases of gum disease result from poor oral hygiene habits. Unfortunately, a significant percentage of periodontitis can simply be attributed to genetics.

What is scaling and root planing?

Graphic explaining scaling and root planing dental procedureSimply put, scaling and root planing (SRP) is a deep below-the-gumline cleaning that is used to treat gum disease. This deep cleaning is broken down into two parts: (1) Scaling to remove the plaque and calculus that is causing the inflammation, and (2) Planing to smooth out the root below the gum.  Planing allows for the gums to reattach to the tooth and makes it harder for plaque to adhere to the tooth. Thesepl deep cleanings may take more than one visit and often require local anesthesia to provide a comfortable environment for the patient. Your dentist may also prescribe an antibiotic pill or rinse, or deliver an antibiotic patch in deeper pocket areas to aid in healing.

Scaling and root planing is considered the golden standard for initial treatment for gum disease. While there are newer adjunct technologies present to use along with scaling and root planing, the review from the July 2015 issue of the Journal of the American Dental Association does not recommend these additional treatments due to insufficient evidence regarding their benefit. Here at Better Dental, we constantly monitor advances and breakthroughs in order to provide the best available treatment.

What is scaling and root planing?

After a deep cleaning, patients may experience some pain and/or sensitivity for up to a week.  Swollen and tender gums for the first few days are not uncommon. Good homecare is essential after a deep cleaning to prevent the gum disease from recurring and becoming more serious. It is important to brush twice a day, floss daily, avoid tobacco products, and attend regular dental appointments. Depending on the severity of the initial gum disease, your dentist may have to recommend additional treatment such as surgical procedures.  For at least the first year after SRP, the regular interval between cleanings is every 3 months. In advanced cases, quarterly cleanings may become the norm. In other less severe cases, cleanings may return to just twice per year as the doctor deems appropriate.  Once again, the best hope for improvement is a combination of focused homecare and focused cleanings.

For patients who have been diagnosed with gum disease, your regular visits to the dentist are no longer considered preventative. Rather, you are now in a process whereby your disease is being treated and managed. 

Nobody wants to hear that they have gum disease. But, the good news is that with today’s science and treatment options, gum disease can be effectively treated – alleviating pain, minimizing sensitivity, and hopefully avoiding the loss of teeth.

Note: There may be irreversible damage due to periodontitis. SRP is meant to meet the disease where it is and to buttress against further deterioration of the gums.

ACTUAL BETTER DENTAL PATIENT:
Before
image of a patient after undergoing scaling and root planning
Immediately After
image showcasing a patient before undergoing scaling and root planning
Sources:
  1. Evidence-based clinical practice guideline on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. Smiley, Christopher J. et al. The Journal of the American Dental Association, Volume 146, Issue 7, 525 – 535
  2. Scaling and Root Planing. (n.d.). Retrieved February 12, 2020, from https://www.mouthhealthy.org/en/az-topics/s/scaling-and-root-planing
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