Scaling and Root Planing
What is scaling and root planing?
Scaling and root planing is one of the most popular ways of treating periodontal disease or gum disease. Scaling is the process of removing calculus or what is also known as tartar and plaque that is attached to the tooth's surfaces. This process focuses on the area below the gum line right along the root. Plaque attaches itself more commonly to rougher surfaces. Since you want to prevent plaque from developing on your teeth, there is a process called planing. The root surface is smoothed down in a process called root planing. Root planing will remove any remaining calculus and will smoothen the irregular areas of the root surface.
What is calculus made of?
Plaque is a sticky substance that is full of bacteria. This forms on teeth and attaches itself more commonly on rough surfaces. When plaque hardens over time, it turns into calculus.
What is scaling and root planing used for anyway?
Bacteria cause periodontal disease and by all means, it is better to prevent it than to cure it. With irregularly surfaced teeth, plaque and calculus can easily attach themselves. Scaling and root planing is used to remove these unwanted elements. During the early stages of the disease, you can completely eliminate the periodontal disease using these methods. Keeping it under control is much better than curing it at its worst. Scaling and root planing is especially effective in treating gingivitis. With more advanced gum disease, scaling and root planing is the first step before surgery.
How do you prepare for the scaling and root planing treatment?
Some patients find it uncomfortable going through the scaling and root planing treatment. Normally, a local anaesthetic is used to numb the portion of the mouth that will be worked on.
How is scaling and root planing done?
Scaling and root planing is performed using a combination of ultrasonic scalers and hand instruments. Ultrasonic instruments are powered by electricity or by air. There are two components
- a relatively dull metal tip that vibrates at a very high frequency. This knocks out the plaque and the calculus from the tooth
- a water irrigation system that cools the tip. This also helps flush out the debris around the teeth
The hand instruments used are not powered. They simply have cutting edges that your dentist or your hygienist will use to remove the plaque and calculus. These instruments come in a variety of shapes and sizes. There are specific instruments designed for specific teeth. Some instruments are specialized that there are different tools for different surfaces of the same tooth.
Normally, the ultrasonic instruments are used to remove large deposits of plaque and calculus specifically from the crowns and roots of the teeth. The hand instruments called scalers and curettes are then used to remove and remaining elements. This will make sure that the tooth surfaces are clean and smooth. When the dentists work under the gum line, they can not see the plaque or the calculus. The dentist will merely rely on their touch and feeling for the roughness on the root surface.
There are times where scaling and root planing can be completed in one visit. This is possible if you have gingivitis. Gingivitis is the earliest stage of gum disease. However, if you have periodontitis, you may need to visit the dentist several times. The periodontist will usually work on a quarter of your mouth on every visit.
Follow-up regimen
For the first two to three days after the treatment, you will have some soreness in your mouth. Your teeth will also be sensitive to the hot and cold temperatures. Over the counter pain relievers can help you address intolerable pain and discomfort.
You will be asked to use an antiseptic in your mouth after scaling and root planing. This is very common especially if the soreness of the gums prevents effective oral hygiene. You must continue to brush and floss as usual. You can expect some minor bleeding for the first few days after scaling and root planing. This will usually stop within a week's time.
What are the risks associated with scaling and root planing?
When you treat periodontitis, you will decrease gum inflammation. This will eliminate periodontal pockets, which can trap plaque. If the treatment is successful, swelling will go away and your gums should shrink or recede. The extent of the shrinkage will depend on the initial depth of the pocket and the severity of the periodontitis. More severe periodontitis will have more receding of the gums. As a result, some part of the root will be exposed. This will make the tooth look longer and it will make it more sensitive to changes in temperature. In order to prevent root cavities, your dentist will prescribe a fluoride-containing gel. This is also important to control plaque. On a last note, if your doctor tells you that you need to take antibiotics before certain dental procedures then you must notify your dentist or hygienist about it before going through scaling and root planing.
When should you call for professional help?
You should call for professional help if you have excessive bleeding, are in pain, have swelling after the scaling and root planing. Contact your dental professional right away.