Scaling and Root Planing

Nonsurgical Treatments: Scaling and root planing are terms often used interchangeably with the terms “nonsurgical treatment” or “soft tissue management.” The goal of this type of treatment is to create a healing environment in the mouth by disrupting the bacterial plaque and calculus (tartar) that harbor harmful bacteria. These treatments are sometimes offered as the initial therapy to prepare the mouth for periodontal surgery. In other cases, the nonsurgical therapy is recommended as an alternative to surgical treatment, if it is expected that adequate healing will eliminate the need for surgery. After evaluating your overall health and the health of your mouth, you and your periodontist will decide which treatment options are right for you.

Scaling: Scaling is the removal of plaque and tartar from above and below the gumline. An ultrasonic device may be used to remove heavy deposits and flush bacterial toxins from around the teeth and beneath the gums.

Root Planing: Root planing smooths roughnesses on root surfaces below the gumline. Just as someone would “plane” a piece of wood to remove roughnesses and irregularities, root planing removes irregularities and toxins that have irritated and infected the root surface. The gum tissue is then much more likely to reattach to a clean, smooth root surface and prevent bacteria from colonizing under the gumline.

Antibiotics: Specialized time-released antibiotics such as Arestin® or Atridox® can be used as part of the scaling and root planing therapy. This delivers a potent, time-released dose of antibiotics to the specific area of gum infection. Research indicates that when used in conjunctions with scaling a root planing, these antibiotics can reduce periodontal pockets by and additional 1-2 millimeters. While suitable for certain areas, these antibiotics are appropriate for all situations. If you are allergic to tetracycline, pregnant or nursing or under the age of 12, these products will not be suitable for you. You and your periodontist can discuss this treatment option.

Comfort: Several choices are available to maintain your comfort during scaling and root planing appointments. An anesthetic gel can be placed in the space between your tooth and gum, which will offer mild to moderate pain control for 15-20 minutes. If this is not sufficient, your mouth can be numbed with a local anesthetic (“novocaine”) for profound numbness that will last for 1-2 hours. As a general rule, it is preferable to numb the mouth with “novocaine” as this greatly increases your comfort and it also diminishes bleeding, which increases visibility and allows the hygienist to better remove deposits from above and below the gumline. With advanced arrangements, nitrous oxide (“laughing gas”) can be provided during your root planing to aid in your comfort and relaxation during this appointment.

Home care: Your commitment to excellent home care is a critical part of the success of the scaling and root planing procedure. Because plaque begins to re-form immediately after removal, you are considered the “co-therapist” as you set time aside daily to thoroughly clean your teeth and gums at home. We will be giving you extensive home care instruction and several oral hygiene aids to assist you with your personal oral hygiene. Again, it is important to remember that periodontal disease is a maintenance disease, much like diabetes or high blood pressure. While it can never be cured, with good professional care and good home care, it can be controlled.