Scaling and Root Planing

After X-Rays, a clinical examination including periodontal charting and patient education, scaling and root planing is often the initial treatment for periodontal disease. Bacterial plaque biofilms and calcified plaque under the gums are removed in order to resolve infection and reduce inflammation.

One-fourth or half of the mouth is anesthetized so that the dental hygienist can comfortably scrape below the gums. Scaling involves careful instrumentation of the crowns of the teeth where root planing is focused on the removal of deposits and smoothing of the tooth root. The procedure may be performed by a dentist, hygienist or periodontist (gum specialist), using hand instruments or ultrasonic vibrating instruments to remove deposits from the teeth. Smooth root surfaces are easier for patients to keep clean. Swelling of infected or inflamed gum tissue is reduced following root planing.

Consequently, after several days or weeks, depending on the severity of the condition, there is a dramatic reduction in bleeding of the gums. After scaling and root planing is completed and the soft tissues have healed, the status of the periodontal tissues is re-evaluated in order to issue the tissue response to treatment. The ultimate goal is to reduce the pockets around the teeth to a more manageable depth. Desirable responses to root planing are typically 1-2 mm reductions of the periodontal pocket depths.

One common side effect of periodontal scaling and root planing is temperature sensitivity. Conscientious oral hygiene, use of desensitizing toothpaste, and “tincture of time” usually minimizes the sensitivity.

For many patients, scaling and root planing is the only treatment needed. It can often eliminate the inflammation and infection that promotes the tissue destruction around teeth from periodontal disease. Most effective in treating early periodontal disease, this non-surgical approach is well-received among dental patients. Unfortunately, scaling alone is not a cure for periodontal disease. It must be followed by an ongoing process of good dental hygiene and regular oral care.