Regular Cleaning Vs. Scaling & Root Planing or Deep Cleaning for Periodontal Disease

You know the feeling of anxiety before going to the dentist’s office. Your gums may be a little sensitive or bleed when you brush and floss and you fear the worst: gum disease. So what now? Does that mean dental surgery? Don’t stress too much because there are a lot of ways to treat gum disease or keep it from progressing. Even if you have signs of gum disease like swollen gums, bleeding or sensitivity, there is a good chance the dentist will not send you straight to the surgeon.

There are many nonsurgical procedures that can treat signs of gum disease. One common procedure done by a dental hygienist in conjunction with a periodontist is scaling and root planing. To understand what scaling and root planing is, it’s important to understand what happens during gum disease.

When the teeth aren’t brushed and cleaned adequately for a long time period, bacteria accumulates at the gumline and forms a layer. The body’s natural response to bacteria is to send inflammatory cells to the site where bacteria are harboring and try to eliminate them. These cells will cause inflammation to protect the body from the bacteria. This is similar to a paper cut in the finger; when bacteria invade the cut, the body’s own inflammatory process kicks in and you see signs of swelling, redness and maybe a little pain. In essence, the same process is happening in your mouth.

If bacteria sits at the gumline and is not cleaned, it will get under the gingiva (gums) and a pocket will start to form around the tooth. The gums are supposed to form a tight seal around each tooth to keep bacteria from getting into the bloodstream, but as bacteria accumulates, the gums will become loose around the teeth and eventually lead to bone loss.

This is when scaling and root planing comes into play. Some dentists will refer to the procedure as a deep cleaning instead, but they are the same thing. Scaling and root planing removes bacteria and deposits from deep under the gumline. The goal is to make the root of the tooth smooth and free of any tartar or plaque so that the tissue around the tooth can heal and adhere to the tooth once more.

This differs from a normal cleaning or scaling because scaling only removes deposits from above the gumline or only a few millimeters under the gumline. But after the pockets deepen and roots are covered with tartar and plaque, scaling and root planing is necessary.

Does it hurt?

Depending on how deep the pockets are around the teeth, the sensitivity and the condition of the root surface, it may be necessary to administer some local anesthesia to numb the area for comfort while cleaning. Another option is Oraqix, a gel that is put under the gumline to make the gums tingly and numb.

What to expect afterwards

• Since the cleaning was done under the gums, you should expect to feel a little sore afterwards
• The teeth may be a little sensitive to hot and cold for a few weeks
• You should stay away from spicy foods or foods with little seeds because this could irritate the gums
• Rinsing with salt water is always a good idea to help the tissues heal

Address any concerns with your dentist and become an active member in the care and health of your mouth.