Your dentist may recommend that you get your teeth scaled. This procedure is generally conducted along with root planning. In more common terms, these procedures are known as a “deep cleaning.” Teeth scaling and root planning helps to treat chronic periodontal disease (otherwise known as gum disease). They are more in-depth than a typical teeth cleaning.
Teeth scaling and root planning often take more than one dental visit and could require a local anesthetic based on the severity of your chronic periodontal disease and if you have receding gums. Recovery from this outpatient procedure usually only takes a few days but may take longer.
WHAT IS THE DIFFERENCE BETWEEN SCALING AND ROOT PLANING?
Root planning is the process in which any area of the tooth root that is infected by bacteria is cleaned. The treatment involves removing plaque and tartar and smoothing the root of the tooth where it sits beneath the gum line. Scaling is clearing away the tartar and plaque on surface of the teeth that is above the gum line. Both procedures are vital parts of maintaining good oral and dental health.
When do you need teeth scaling?
Your dentist will recommend teeth scaling and root planning if your mouth has signs of chronic periodontal disease. These procedures can help stop the harmful effects of this condition and keep your mouth healthy.
Chronic periodontal disease occurs when the bacteria in plaque cause your gums to pull away from your teeth. This causes large pockets to grow between your teeth and gums, and more bacteria can grow there that you cannot reach with teeth brushing at home. That’s why it’s key to floss regularly to reach spots that toothbrushes can’t.
Several conditions will require this scaling, root planning, or both:
- For whole body health: It has been established through research that gum disease is linked to other health problems, including the risk of heart disease and stroke. This procedure keeps the area cleaner, and helps to keep bacteria from growing and travelling into the bloodstream.
- For healthier teeth: When the gums have receded, the risk of periodontal disease is increased. The pockets (areas around the tooth) get deeper, creating the perfect environment for bacteria to lodge and grow. The body responds with inflammation, and the gums become red and can appear puffy or swollen. This inflammation begins to destroy the gum tissue.
- Aesthetics: This procedure can be helpful in removing stains on the teeth and creating a more pleasing smile.
- Bad breath: Ongoing bad breath is caused by bacteria, much of which is living below the gum line. Scaling and root planning clears away the bacteria and plaque so you can have fresher, cleaner breath.
If left untreated, chronic periodontal disease can lead to:
- bone and tissue loss
- tooth loss
- loose teeth
- moving teeth
Some of the reasons you may develop this condition include:
- poor dental hygiene
- changes in hormones
- poor nutrition
- family history
- other medical conditions
HOW DOES SCALING AND ROOT PLANING WORK?
Depending on how many of your teeth require scaling and root planning, the procedure may take several appointments to complete. During each appointment, your dentist performs the following steps:
- Your doctor starts by using a local anesthetic to numb the area of the mouth he is working on. If he is treating more than one area, your doctor will probably only numb one area at a time to make sure the anesthetic doesn’t wear off too soon.
- After he confirms that the anesthetic is working, your hygienist or dentist begins scaling the teeth and planning the roots of all calculus and debris in the periodontal pockets. Your dentist accomplishes this using curved instruments called scalers and curettes. These tools fit into the space between the teeth and gums, allowing your dentist to reach the periodontal pockets. He may also use an electric ultrasonic scaler to remove calculus a bit more quickly and efficiently.
Root planning actually involves removing small amounts of the tooth’s cementum and dentin. In addition to removing debris, the curettes also smooth out uneven surfaces on a tooth’s root to prevent bacteria, biofilm, and calculus from re-accumulating in the future. Root planning is required for the gumline to effectively re-attach to your teeth.
- Your dentist generally divides scaling and root planning into four sections, or quadrants, of the mouth: upper right, upper left, lower right, and lower left. Scaling and root planning an entire mouth usually requires multiple appointments. After completing one section of the mouth, he may move on to another or stop until the next appointment.
- After the procedure is complete, your dentist will want you to come back in a number of weeks later for a follow-up appointment. During this appointment, he will re-probe your gums and assess how effective the scaling and root planning was in treating your gum disease. He will also give you tips on how to maintain your improved gum health. Sometimes it can take multiple rounds of scaling and root planning to arrest the periodontal disease and see improved tissue health.
What are the benefits of teeth scaling?
Teeth scaling and root planning are considered to be the “gold standard” treatment for chronic periodontal disease. A 2015 review of 72 journal articles on these procedures found that they improved the pocket gap between teeth and gums by .5 millimeters on average.
By reducing the pockets that develop between your teeth and gums through teeth scaling and root planning, you will reduce your risk of experiencing tooth, bone, and tissue loss associated with chronic periodontal disease.
What are the risks?
The risks of teeth scaling are minimal. You may be at risk for infection following the procedure, so your dentist may prescribe an antibiotic or a special mouthwash to use for a few days or weeks.
WHEN TO CALL THE DENTIST
Following dental scaling and root planning, contact your dentist immediately if you experience any of the following:
- worsening pain
- the area doesn’t heal as expected
- you have a fever
You may also experience pain and sensitivity for a few days following the procedure as well as tenderness in your gums.
Any side effects of the procedure should clear up within a few weeks. If they don’t, contact your dentist.
What to expect after a teeth scaling
Following Scaling and Root Planning, you can expect to notice less redness, and less bleeding, and less swelling of your gum tissue. Your gum health can be maintained with proper home care and regular professional care.
Discomfort or pain should be acute and should subside in a few days. Discomfort immediately after treatment is usually associated with slight throbbing or aching and occasionally may be uncomfortable. This discomfort usually subsides in about four hours. Any discomfort due to brushing should get better in one to three days.
Teeth may be sensitive to temperature changes and/or sweets. The sensitivity to temperature may be intense the first two or three days.
Some slight bleeding may occur during the next several brushings but the bleeding should steadily decrease after two or three days.
Root surfaces may be more exposed as the inflammation subsides. This may result in more spaces between teeth.
Instructions to Minimize Symptoms
Diet/Eating—If extensive root planning was performed, chewing hard foods, such as meat or raw vegetables may be uncomfortable; this should last no longer than a few days. A diet of softer consistency would be advised until chewing becomes more comfortable.
If a local anesthetic was used, avoid chewing foods until feeling returns to avoid injury to the tongue or cheeks. Acetaminophen or a non-aspirin analgesic should be taken as needed to reduce discomfort. If tooth sensitivity persists, use a desensitizing dentifrice (toothpaste) containing potassium nitrite. If the sensitivity is severe and prolonged, professional application of a desensitizing agent may be required.
If gum tissues are tender, brush your teeth gently but thoroughly; this may take a little more time than normal. By the third to fourth day, normal oral hygiene techniques can be resumes. Mouth rinsing is recommended with either of the following solutions: (1) an antimicrobial rinse, or (2) a warm saline rinse. Use of these rinsed should be limited to one to two weeks.
Other Points to note after root planning:
- In the first few days after root planning, it is common to have mild discomfort and mild bleeding from the gum. Keep on good oral hygiene, and the discomfort and bleeding will subside eventually. The gum will become healthy again.
- Good oral hygiene is essential for gum healing after root planning. Proper daily oral care should be performed which includes brushing the teeth thoroughly twice daily, and using floss or interdental brush to clean adjacent tooth surfaces. Smoking will adversely affect the recovery from gum disease, so it must be quitted.
- The entire course of treatment on gum disease usually involves multiple appointments, remember to follow the schedule of appointments and to keep regular dental check-up.
Teeth scaling and root planning are common procedures to treat chronic periodontal disease. Your dentist can perform this outpatient procedure at the dentist’s office with or without local anesthesia.
You may need more than one appointment to complete the procedure. You may experience mild side effects following the procedure for a few days or a week.