Scaling & Root Planing

The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling or root planing. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause gingival inflammation and disease. Scaling and root planing can be used as a stand-alone treatment or as part of a sequence of treatment for more advanced disease. It is a conservative initial procedure which is commonly performed on cases of  periodontal disease.

What does scaling and root planing entail?

Drs. Morse or Cwiklinski 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. Morse or Cwiklinski 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, Drs. Morse or Cwiklinski may place localized antibiotic materials directly in the periodontal pockets after scaling and planing. This is done to eliminate more of the damaging bacteria.  This is not required with every patient.

When deep pockets between teeth and gums are present, it is difficult for Drs. Morse or Cwiklinski to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque.  Studies have shown that oral home care methods, such as brushing, flossing, or waterflossing can effectively reach only about 3mm below the gum line,  Therefore, any pockets deeper than 3mm will have bacteria still in them even after thoroughly cleaning your teeth.  Scaling and root planing reaches deeper into these pockets to more effectively clean the roots of the teeth.

Benefits of Scaling & Root Planing Treatment

If treatment is successful, scaling and planing has many periodontal and general health benefits. The main one is keeping your teeth.  When gum pockets exceed 3mm in depth, the risk for periodontal disease increases. As pockets deepen, they become more difficult if not impossible to fully clean.  More bacteria are able to colonize in them and grow, eventually causing a chronic inflammatory response by the body to destroy gingival (gum) tissue and bone. This is how periodontal disease causes tooth loss.

Another benefit is that it can help prevent other systemic diseases. Research has proven that bacteria from periodontal infections can travel through the blood stream and affect other areas of the body, sometimes causing heart and respiratory diseases. Scaling and root planing remove bacteria that cause these conditions.

Finally, scaling and root planing may make the mouth more aesthetically pleasing, and should reduce bad breath caused from food particles and bacteria in the oral cavity. Superficial stains on the teeth will be removed during scaling and planing, adding an extra bonus to the procedures.