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Scaling

Scaling and root planing, also known as deep cleaning, is a dental procedure that removes or eliminates dental plaque and calculus, which cause inflammation and can lead to periodontal disease.

Plaque is a soft yellow-grayish substance that adheres to the tooth surfaces including removable and fixed restorations. It is an organised bio-film that is primarily composed of bacteria. Regular brishing and flossing disturbs and removes these bacterial colonies. If plaque is left undisturbed for 24 hours, it absorbs mineral in saliva and becomes calculus. Calculus is harder than bone and cannot be removed by brushing or flossing.

Plaque accumulates more on the area of tooth most adjacent to the gums. This plaque can cause as inflammation known as gingivitis. If untreated, the gingivitis can proceed to periodontal disease and eventual bone loss in the jaw.

Procedure

Patient are generally numbed in the area intended for instrumentation. Several appointments are often necessary, in order to keep from numbing the entire mouth.

  • Scaling involves the the removal of dental plaque from the tooth.
  • Root planing involves scaling the tooth’s root.

Scaling and root planing is also referred to as "deep cleaning", as it involves more deep cleaning methods than for people with healthy periodontal tissues. The procedure can use a variety of dental tools:

  • Periodontal scalers
  • Curettes
  • Ultrasonic instruments (sonic scalers, power scalers)
    This device uses ultrasonic frequencies to help remove plaque. In addition, they create tiny air bubbles that create oxygenation, helping to destroy aneorbic bacteria.
  • Dental laser
    Lasers may be used following scaling and root planing in order to promote healing of the tissues.

Typically ultrasonic instiruments are used to start the cleaning, and hand tools are used afterwards to to complete the fine hand scaling that removes any remaining deposits.

The dentist may place site-specific anitbiotics following the procedure, or may prescibe a medicated mouthwash to help kill remaining bacteria. 

In cases of severe periodontitis, scaling and root planing may be considered the initial therapy prior to future surgical needs performed by a Periodontist.

Prognosis

A scaling and root planing procedure is to be considered effective if the patient is subsequently able to maintain their periodontal health. The procedure's long-term effectiveness depends on patient compliance, how far the disease progressed before intervention, probing depth, and anatomical factors.

Successful periodontal therapy is a long term process, and takes dedication not only on the part of the patient, and not only from the practitioner. Rather, both must work to remain part of a team in order to achieve and maintain long term success after periodontal therapy.