The objective of scaling and root planing is to remove etiologic agents which cause inflammation in the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and calculus (tartar).
A local anesthetic is usually given to reduce discomfort during scaling and root planing. These non-surgical procedures, which completely cleanse the periodontium, work very effectively for individuals suffering from gingivitis (mild gum inflammation) and early stages of periodontitis.
Reasons for Scaling & Root Planing
Scaling and root planing can be used both as a preventative measure and as a stand-alone treatment. Here are some reasons why these dental procedures may be necessary:
- Disease prevention – Scaling and root planing removes bacteria and calculus (tartar) and halts periodontal disease from progressing by reducing inflammation.
- Disease treatment – As periodontitis progresses, the attachment between teeth and the gum tissue and underlying bone is lost. By removing plaque and calculus with the scaling and root planing, it can decrease pocketing by helping to reduce swelling of the gum tissue, and by facilitating re-attachment connective tissue around each tooth.
What do scaling and root planing treatments involve?
Scaling and root planing treatments are only performed after a thorough examination of the mouth. Dr. Knochel will review current X-rays, conduct visual examinations and make a diagnosis before recommending or beginning these procedures. Prior to scaling and root planing, an examination should document the current condition of the periodontal tissues, including measuring pocketing around the teeth, tooth mobility (looseness of teeth), bleeding, inflammation, the bite relationship between the upper and lower jaws, an evaluation of bone loss evident on x-rays, and a thorough review of health information which may relate to the health of the mouth.
Depending on the current condition of the gums, the amount of calculus (tartar) present, the depth of the pockets and the progression of the periodontitis, local anesthetic may be used during scaling and root planing.
Scaling – This procedure is usually performed with special dental instruments and may include an ultrasonic scaling tool. The scaler removes calculus and plaque from the surface of the crown and root surfaces, resulting in a smooth root surface. In many cases, the ultrasonic scaler includes an irrigation process that may be used to deliver sterile water or an antimicrobial agent below the gums that can help reduce oral bacteria. The ultrasonic scaler also disrupts the cell wall of bacteria, thus reducing the bacterial load.
Root Planing – This procedure is a specific treatment which serves to remove infected cementum and root surface dentin that is embedded with unwanted microorganisms, toxins, and tartar. The root of the tooth is literally smoothed in order to promote good healing. Having clean, smooth root surfaces helps bacteria from easily colonizing in future, and may allow the soft tissue to re-attach to the tooth.
To evaluate the results of treatment, and prior to planning surgical treatment, Dr. Knochel and his registered hygienists will thoroughly examine the gums again to see how well the pockets have healed. If the gum pockets still measure more than 3mm in depth, additional and more intensive treatments may be recommended. Depending on the extent of problems in different areas of the mouth, a combination of treatments, or scaling and root planing in some areas and periodontal surgery in others, may be recommended based on your specific treatment needs.
Limits of Scaling & Root Planing
As periodontitis progresses, pocket depths increase. When pocket depths exceed 5mm, operator effectiveness in removing tartar under the gum line drops with each millimeter of pocket depth increase.
Contact us if you would like to set up a full mouth evaluation with Dr. James R. Knochel at 520-747-7944.