This is a therapeutic procedure that is used for the treatment of periodontal disease. It is also called a deep cleaning or non-surgical periodontal therapy. Scaling and root planing is done because you have an infection which will not be resolved by a regular dental prophylaxis.
A good comparison would be going to your regular doctor for you yearly physical. At this appointment they gather information. If you are healthy it may be all you need (like in the dental prophylaxis) but if you find out there is a more serious issue you will need treatment for the disease, the physical will not resolve any infection or disease. If you are told you need scaling and root planing you need this treatment to resolve your infection or it will not go away and will most likely progress.
- Continued infection
- Loose Teeth
- Bad Breath
- Bone Loss
There is also an association between periodontal disease and diabetes, stroke, cardiovascular disease, Alzheimer’s disease and preterm low birth weight babies born to mothers with periodontal disease.
The infection is caused by bacteria that live in the mouth and invade the tooth when:
- tooth decay occurs
- fillings leak, or;
- teeth are damaged by trauma, such as a fall
When bacteria (germs) enter your tooth through deep cavities, cracks or flawed fillings, your tooth can become abscessed. An abscessed tooth is a tooth with an infection in the pulp. If pulp becomes infected, it needs to be removed. An abscessed tooth may cause pain and/or swelling. Your dentist may notice the infection from a dental x-ray or from other changes with the tooth. If left untreated, an abscessed tooth can cause serious oral health problems
There is some confusion about the difference between scaling and root planing. Scaling is basically the process of removing dental tartar from the surfaces of the teeth (see dental cleanings). Root planing is the process of smoothening the root surfaces and removing any infected tooth structure. If you have gum disease or gum pocketing, the gum pockets around the teeth will have deepened, thereby allowing tartar deposits to form under the gumline.
The two processes tend to blur together since during the cleaning process, the dental worker scales away tartar and performs any necessary root planing at the same time. Any roughness can be planed away to result in a silky smooth surface.
- Discomfort can vary after root planing, but one can expect it to be more sore afterwards since it’s usually in a deeper region under the gums.
- The teeth themselves can become a bit more sensitive to temperature, and bleeding might occur for a little while.
- Over-the-counter painkillers such as ibuprofen work very well to alleviate discomfort, but stronger painkillers can be given should you need them.
- Brushing and flossing can be delayed or done more gently to avoid aggravating any bruised or tender gum areas.
A local anesthetic may be given. Not every patient will need anesthesia. If an anesthetic is given it is generally an injection like you would get for a filling. Most people call this Novocaine, but Novocaine has not been used in years. The most common anesthetic given today is lidocaine. A topical gel is placed on the gums before the injection is given to pre-numb the area to make the injection more comfortable. The topical gels or the non injectable option Oraquix numb only the soft tissues (the gums) but not the tooth itself. You may be more comfortable with one of these gel options if only the gums are tender, but if you experience a lot of sensitivity an injection may be necessary as this is the only way to numb the actual tooth.
The next step is a complete periodontal charting. This involves measuring the space between the tooth and the gum with an instrument called a probe. If you are told “I am going to probe you now” this is the procedure. It sounds scary but it a very simple information gathering technique. The probe is like a little ruler. It is gently placed into the space between the tooth and the gum and a millimeter measurement is taken on six places on each tooth. Another measurement taken during this process is the amount of root showing above the gum line. These two measurements together are used to calculate the amount of bone loss. Any bleeding during this process is an indicator of disease.