Scaling and Root Planing (Deep Cleaning)
Scaling and root planing is a procedure that removes all plaque, calculus and stains for the crown and root surfaces of the teeth. During the process, cementum or surface dentine that is contaminated with toxins or microorganisms is removed.
The term “deep cleaning” originates from the fact that pockets in patients with periodontal disease are literally deeper than those found in individuals with healthy pockets. Such scaling and root planing may be performed using a number of dental tools, including ultrasonic instruments and hand instruments, such as periodontal scalers and curettes.
Prior to beginning these procedures, the patient is generally numbed in the area intended for cleaning.. Because of the deeper nature of periodontal scaling and root planing, either one half or one quarter of the mouth is generally cleaned during one appointment. This allows the patient to be entirely numbed in the necessary area during treatment. It is typically not recommended to have the entire mouth scaled at one appointment because of the potential inconveniences and complications of numbing the entire mouth- i.e., inability to eat or drink, likelihood of self injury by biting, etc.
In cases of severe periodontitis, scaling and root planing may be considered the initial therapy prior to future surgical needs. Additional procedures such as bone grafting, tissue grafting, and/or gingival flap surgery done by a Periodontist (a dentist who specializes in periodontal treatment) may be necessary for severe cases. Patients who present with severe or necrotizing periodontal disease may have further steps to address during their treatment. These patients often have genetic or systemic factors that contribute to the development and severity of their periodontitis. Common examples include diabetes type I and type II, a family history of periodontal disease, and immunocompromised individuals.