Root Planing and Scaling Explained

Root planing and scaling are treatments for gum disease.
Root planing and scaling are treatments for gum disease.
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You know the feeling. Maybe you have some teeth that are a little bit sensitive or your gums bleedwhen you floss or brush. You're dreading your next dental visit, fearing what your dentist is going to say. What if it's gum disease? Will that mean dental surgery?

Don't stress too much. Even if do you have the signs of gum disease, like swelling or bleeding gums, sensitive or loose teeth, and bad breath that just won't go away, there's a good chance your dentist won't go straight to surgery to treat it [source: National Institute of Dental and Crainial Research]. One common non-surgical treatment for gum disease is actually a pair of procedures that your dentist, hygienist or periodontist will do together: root planing and scaling.

These procedures are basically a deep dental cleaning. Scaling involves removing built-up plaque below the gum line using either manual scraping instruments or an ultrasonic tool. When your dentist does your root planing, he'll essentially be gently sanding your teeth, removing rough spots on the tooth surfaces and roots, which tend to harbor bacteria [source: University of Maryland Medical Center].

There are two different methods that your dentist can use: mechanical, involving dental tools to manually scrape away debris, or ultrasonic, where a tiny vibrating wand breaks up plaque and cleans your teeth [source: Healthwise]. The ultrasonic method is less uncomfortable, because instead of digging and scraping, the wand moves side to side at a high speed to break up and remove plaque and bacteria. Sometimes dentists will combine ultrasonic with mechanical methods, like dental chisels, to remove plaque below the gumline [source: Turchetta].

While root planing and scaling are not high-risk procedures, there is a risk of infection in the gums. To prevent infection after the procedure, your dentist might insert antibiotic fibers into your gums which come out about a week after the procedure. If you're at high risks for infection, you may have to take antibiotics before and after the procedure, to prevent bacteria from entering your bloodstream [source: Healthwise].

When is root planing and scaling appropriate, and how do you care for your mouth after the procedures are complete?

The Importance of Root Planing and Scaling

Your dentist might use a couple of different terms to describe your gum disease: gingivitis or periodontitis. Basically, gingivitis is mild gum disease where your gums become inflamed and prone to bleeding. Periodontitis is more severe, and it means that there's damage to the bones around your teeth [source: Healthwise]. If you have gingivitis, your dentist may recommend upping your brushing and flossing game at home, but if you're suffering from periodontitis, root planing and scaling can help heal your gums and teeth without resorting to surgery [source: Healthwise].

Gum disease can be painful and cause you to lose teeth. It's also linked to a higher risk for other health problems, because it causes bacteria to enter your body, leading to inflammation. This triggers production of a protein that's linked to heart disease and stroke [source: Rohm]. Your body is using its resources to fight that inflammation, and stressing out your immune system, which should be keeping you safe from disease.

If your dentist determines that you do have periodontitis, root planing and scaling are usually the first treatments that she will try to non-surgically treat you [source: American Academy of Periodontology]. Some people find it painful, while others just think it's uncomfortable. Your dentist will use a local anesthetic to numb your mouth before starting the procedure [source: Healthwise] Local anesthetic should prevent you from feeling pain during the procedures. Instead, you'll just feel the pressure of the instruments in your mouth.

Root planing and scaling fight gum disease in two ways: by removing the plaque that's on your teeth deep down in your gums and smoothing out areas of your teeth where bacteria like to live [source: NIDCR]. The earlier you start treating gum disease, the better your chances of being able to take care of the problem without surgery and the lower your risk of losing any teeth.

Once the procedure is complete, your dentist will give you some aftercare instructions. What can you expect?

Root Planing and Scaling Aftercare

Root planing and scaling is an outpatient procedure, so once the cleaning is complete, you get to go home and rest. While this isn't surgery, you do need to give your teeth and gums a little bit of extra attention after the procedures to help your body heal.

If your dentist used anesthetic it's important not to chew, because when your mouth is numb, you can injure yourself by biting down on your lips or tongue. Your dentist may also recommend that you take an over-the-counter anti-inflammatory, like ibuprofen, as needed to help with pain and swelling [source: Snydman]. You may need to visit your doctor again to have the antibiotic fibers removed from your gums, if he used them in the procedures [source: Healthwise].

Good oral hygiene helps you heal, so brush, floss, and use a mouthwash to keep bacteria and plaque at bay. While your gums heal, your teeth or gums may be more sensitive. If it's painful to brush your teeth after the procedures, you can switch to a toothpaste that's specifically made for sensitive teeth [source: Snydman].

It usually takes more than one treatment to complete root planing and scaling on your mouth. Since all of that deep cleaning can leave your teeth pretty sensitive, the dentist will only do one part your mouth at a time. The number of treatments can depend on the severity of your gum disease and your oral hygiene habits, and usually takes three to four visits to complete the process. Your dentist will schedule your follow-up appointments, usually leaving you a week to recover before the next one. She'll probably also recommend more frequent cleanings after scaling and root planing to help prevent the return of gum disease [source: UMMC].

Related Articles

Sources

  • American Academy of Periodontology. "Periodontal Procedures." AAP. (January 23, 2012) http://www.perio.org/consumer/procedures.htm
  • Healthwise. "Root planing and scaling for gum disease." WebMD. August 21, 2009. (January 23, 2012) http://www.webmd.com/oral-health/root-planing-and-scaling-for-gum-disease
  • NIDCR. "Periodontal (Gum) Disease: Causes, Symptoms, and Treatments." July 2011. (January 23, 2012) http://www.nidcr.nih.gov/nidcr2.nih.gov/Templates/CommonPage.aspx?NRMODE=Published&NRNODEGUID={CE246689-D899-4CC7-B68A-805AD910F4E7}&NRORIGINALURL=%2fOralHealth%2fTopics%2fGumDiseases%2fPeriodontalGumDisease.htm&NRCACHEHINT=Guest#deep
  • Rohm, Dr. John G. "Surprising Dangers of Gum Disease." JGR Cosmetic & Family Dentistry. (January 23, 2012) http://www.drjohnrohm.com/articles/gumdisease.htm
  • Romito, Kathleen. "Gum Disease." WebMD. August 21, 2009. (January 31, 2012) http://www.webmd.com/hw-popup/gum-disease
  • Shaju, Jacob P. "Factors Influencing Pain Experienced During Scaling and Root Planing: A Correlative Pilot Trial." Journal of Periodontology and Implant Dentistry. Vol 3, no. 1, Page 8-12. June 11, 2011. (January 23, 2012) https://docs.google.com/viewer?a=v&q=cache:Ci52ZHjRch4J:dentistry.tbzmed.ac.ir/jpid/index.php/jpid/article/view/2011e5/30+&hl=en&gl=us&pid=bl&srcid=ADGEESilLMm2NRPXfUrbpph7zuWuVNB1UzzRuD6Q84m4UQJHK5VKOFfNIL8TFuGrwYvYsPlctm088bBzMRv9aqUUSZ3mSOie_wF8qVOQtNc0W-Az6zxy46CX5jOWGu1_CsFXoa6wh1eN&sig=AHIEtbTBivCTZP-69OaixzwDyizZ1wENvw
  • Snydman, Dr. Harry D. "Post-Op Instructions After Scaling and Root Planing." (January 23, 2012) http://www.newtowndental.com/POScalingRootPlaning.html
  • Turchetta, Anastasia L. "Simplifying Scaling and Root Planing with Ultrasonics." Academy of Dental Therapeutics and Stomatology. 2008. (January 25, 2012)
  • University of Maryland Medical Center. "Periodontal Disease – Treatment." January 22, 2009. (January 23, 2012) http://www.umm.edu/patiented/articles/what_procedures_treatment_of_periodontal_disease_000024_8.htm
  • WebMD. "Gingivitis and Periodontal Disease (Gum Disease)." (January 24, 2012) http://www.webmd.com/oral-health/guide/gingivitis-periodontal-disease