Scaling and root planing otherwise known as conventional periodontal therapy or deep cleaning, is a procedure in which plaque and calculus are removed. It also involves smoothening (planing) of the exposed tooth surfaces above and below the gum line. A smooth surface is less receptive to the accumulation of food particles. Removal of these potential irritants resolves the inflammation and favors reattachment of the gingiva to the tooth. Additionally, extrinsic stains caused by long-term use of tobacco, coffee, tea and colored beverages, are also effectively removed with the help of this procedure.
In this article, we’ll go over everything you need to know about periodontal scaling and root planing.
The presence of either plaque or calculus is detrimental to the health of oral tissues. It causes inflammation and swelling of free gums, ultimately spreading to involve the part of gums attached to the teeth. Once this happens, the gum connection with the tooth and the sulcus deepens and forms a pocket. This further predisposes to more and more food accumulation, which if left untreated, can cause tooth and bone destruction.
Calculus is hard and cannot be removed with the help of a toothbrush. This is when scaling and root planing becomes important. It is done professionally by a dentist at the clinic, generally completed in one appointment. However, in extreme cases, you might even require two or more appointments to completely get rid of the calculus through scaling.
Scaling and root planing is performed either manually with the help of instruments such as periodontal scalers and curettes or by ultrasonic scalers. Good adaptation to different tooth morphologies and greater access to deeper sulcus are some of the advantages of manual scaling procedure, which ultrasonic procedures lack.
However, manual scaling is time-consuming and can even get tiresome for the dentist. Ultrasonic instruments offer some good advantages of their own. First and foremost, it is pretty quick and thus has wider patient acceptance. Moreover, it is less traumatic to the soft tissues as well. One of the drawbacks of ultrasonic instruments for scaling is that they generate aerosol and are thus contraindicated in patients with infectious diseases such as tuberculosis due to risk of contamination. Also, ultrasonic scaling must be applied with caution in patients with pacemakers.
Signs that indicate that you need scaling include: swollen and tender gums, bleeding gums, bad breath, and staining of teeth. It is a painless procedure although slight discomfort can be felt by the patients especially if calculus is being removed from deeper parts of the tooth. In such a case, local anesthetic may be required. Scaling and root planing is considered to be a gold standard for treating long-standing periodontal disease.
After scaling and root planing, patients tend to experience generalized sensitivity to hot, cold and sweet sensations in mouth. Fluoride toothpastes and mouthwashes are prescribed to counteract the sensitivity issue. In case of severely infected tissues, antibiotics in the form of paste are placed in periodontal pockets. This method destroys any remaining bacteria and assists in the healing process. Systemic antibiotics are generally not needed. Benefits of scaling include prevention of further destruction of supporting tissues of teeth, elimination of bad breath, and better-looking, hygienic teeth and mouth.
During scaling and root planing, a little natural tooth substance is also removed along with the calculus. The amount is so tiny that it is not of any significance. After the procedure, patients should be given adequate oral hygiene instructions so that this procedure is not required in near future. Proper brushing and flossing techniques should be taught to the patient as soon as the procedure is completed and before he leaves the clinic.
It is also important to instruct patients to brush twice daily, especially at night after having dinner. Dentists usually recommend soft toothbrushes because they are less traumatizing to the soft tissues. Flossing should be done at least once daily and patients should take balanced diet that includes all essential nutrients. Avoid excessive use of substances that tend to discolor tooth. Patients should be motivated to keep their teeth clean because the mouth is the gateway to your whole body. Clean teeth and a good breath gives a more confident and attractive look, and it is obviously much more hygienic to sport a plaque-free mouth!