TL;DR
Scaling and root planing is the standard first treatment for periodontitis. With the area numbed, tartar and bacterial film are removed from the roots inside the gum pockets, and the root surfaces are smoothed so the gum can tighten back against them. It is usually done one or two sections of the mouth at a time. Tenderness and cold sensitivity for a few days to weeks are common. Several weeks later the pockets are measured again. At Stone Falls Dental Care in O’Fallon, the plan and its cost are set out before the first appointment.
What is scaling and root planing?
Scaling and root planing is a nonsurgical deep cleaning that treats periodontitis at its source, on the root surfaces inside the gum pockets. Scaling removes plaque and hardened tartar from the tooth, both above the gumline and down into the pocket. Root planing then smooths the root so bacteria have fewer rough places to cling to.
A smooth, clean root gives the gum tissue the chance to shrink back and reattach more closely. Pockets often become shallower as a result, which makes them easier to keep clean at home and at each visit afterward.
It is called nonsurgical because no incisions are made and no gum is cut away. The instruments work inside the natural space between the gum and the tooth, which is why the recovery is usually short and most people return to their day straight afterward.
Who needs a deep cleaning instead of a regular cleaning?
A deep cleaning is needed when periodontitis has created pockets that a regular cleaning cannot reach. That usually means readings of 4 or 5 millimeters or more that bleed when probed, tartar visible below the gumline on X-rays, or bone loss around the roots.
A routine cleaning is designed for healthy gums and works mostly at and above the gumline. Using it on active periodontitis would leave the infection in place under a clean-looking surface. The measurements from your periodontal exam are what decide which cleaning is right, and we will show you those numbers so the recommendation is clear.
What happens during scaling and root planing?
The area being treated is numbed first, so the cleaning below the gumline is done in comfort. Treatment is usually split into sections, often one quarter or one half of the mouth per visit, which keeps each appointment manageable and lets you eat normally on the other side.
- Local anesthetic to numb the teeth and gums in the section being treated
- An ultrasonic scaler that breaks up tartar with vibration and a cooling water spray
- Fine hand instruments to clean and smooth each root surface
- Rinsing the pockets to flush out loosened debris
- In some pockets, an antimicrobial medication placed directly after cleaning
- Home care instructions for the days that follow
How will my mouth feel after a deep cleaning?
Most people feel some tenderness in the treated area for one to three days, and the teeth may be sensitive to cold for a few weeks. The gums can look a little smaller as the swelling goes down, which can make teeth appear slightly longer. That is the tissue tightening, a sign of healing.
Wait until the numbness has worn off before eating, so you do not bite your cheek or tongue. Soft foods for the rest of the day, warm salt-water rinses and an over-the-counter pain reliever you can safely take usually handle the soreness. Keep brushing gently and cleaning between your teeth, even if the gums bleed a little at first. Call us if pain or swelling increases after the second day.
What comes after scaling and root planing?
A re-evaluation follows several weeks after treatment, once the gums have had time to settle. The pockets are measured again and compared with the chart from before, which shows which areas have healed and which, if any, need more attention.
From there, most patients move into periodontal maintenance, a cleaning below the gumline about every three months. Some also use Perio Protect trays at home. Our treatment coordinators check your insurance before treatment begins, and CareCredit and other options on the financial options page can spread the cost.