Scaling & Root Planing

The heart of all periodontal therapy is removal of calculus and plaque from the tooth . Removing debris from the crown of the tooth is often referred to as scaling , while root planing (debridement) referred to cleaning the tooth below the gum. This procedure is also referred to as a deep cleaning . To successfully treat periodontal disease it is necessary to adequately debride the periodontal pocket. This is generally accomplished using curettes and/or ultrasonic scalers, although rotary instruments may be useful. Adequately cleaning a periodontal pocket takes time and skill and many feel it is most the technically demanding procedure performed by dentists and hygienists. Often a local anesthetic is used to assure patient comfort.

With early and moderate pockets, up to 5mm in depth, adequate pocket debridement is generally possible. However, with pockets over 5mm, mush of the root calculus is missed. Many studies have shown that deeper pockets cannot be adequately cleaned with any technique other than laser therapy or traditional gum surgery . Please see Laser Gum Therapy for more information on how the laser treats gum disease.

What do the procedures entail?

Dr. McCawley and Dr. DeTure will only perform scaling and root planing after a thorough examination of the mouth, which may include taking x-rays and visually examining the mouth. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, Drs. McCawley and DeTure may recommend scaling and root planing. In some cases, a local anesthesia may be used during the procedure.

• Scaling:
  When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process especially targets the area below the gum line, along the root. Scaling is performed with a special dental tool called an ultrasonic scaling tool. The scaling tool usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria.
• Root Planing:
  Root planing is performed in order to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future.

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. McCawley and Dr. DeTure may place antibiotic fibers in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.