Dental scaling and root planing are crucial procedures for maintaining optimum oral health, especially in the treatment and prevention of gingivitis and periodontitis (gum disease). The goal of this procedure is to remove tartar and plaque, which cause inflammation to the gum tissues and surrounding bone. For this procedure to be successful, it should be performed by a qualified dental professional.
At The Encino Dentist, we are devoted to providing personalized, honest dental services that meet the special needs of every patient. Our professional team of dentists is committed to delivering scaling and root planing with the highest level of precision and care to help patients achieve a beautiful, healthy smile and optimal oral health. Do not hesitate to call us for a dental appointment.
Root Planing and Scaling Overview
Root planing and scaling can also be called deep cleaning. They are non-surgical dental procedures performed to treat periodontitis and enhance gum health. They involve thorough cleaning of the tooth root surface to remove calculus (tartar) and dental plaque from periodontal pockets and around teeth, and to smooth the tooth roots to eliminate bacterial toxins.
Root planing and tooth scaling are two-step dental procedures. First, the dental professional performs scaling, followed by root planing. Scaling entails removing tartar and plaque from the teeth’s surfaces, as well as from underneath and above the gum line. It is crucial because tartar and plaque keep bacteria that can cause gum infection and inflammation. Scaling helps lower the amount of bacteria in the oral cavity.
On the other hand, root planing centers on tooth roots. It involves the dental professional smoothing the tooth root surfaces to eliminate any remaining tartar and uneven spots where bacteria can stay. This procedure prevents the growth of more bacteria and allows the gums to reattach more securely to the teeth, promoting better stability.
These two procedures, alongside appropriate dental flossing and brushing, are effective for treating and preventing gingivitis and periodontitis. Gingivitis refers to the early-stage gum disease that can be easily treated. On the other hand, periodontitis, also called periodontal disease, refers to the more advanced stage of gum disease that progresses over a long period. For periodontal disease, treatment and consequences might be more complex. Root planing and scaling procedures are minimally invasive, non-surgical, and cost-effective ways to restore gum health.
Periodontitis involves infection and swelling of your gums and the adjacent oral tissues. It is primarily caused by bacterial plaque. This is a colorless, sticky film that develops on teeth. The bacterial plaque hardens, forming a porous, coarse substance that produces toxins. The released toxins then loosen and break down the gum tissues that anchor the teeth, creating periodontal, or gum, pockets. More toxins or bacteria can fill these periodontal pockets, and if they are not removed, the pockets deepen further, and the jawbone anchoring the teeth is destroyed, ultimately resulting in edentulism (tooth loss).
Who Performs Root Planing and Scaling?
The extent to which periodontitis or gingivitis has progressed, its severity, and a patient’s response to therapy determine the kind of treatment they receive and who administers it. A family dentist, general dentist, or dental hygienist can perform preventive dental scaling and planing or treat gum disease when it is still in its early stages. Further training and education are required to handle complex conditions. In these situations, your general dental professional can refer you to a qualified periodontist.
A periodontist refers to a specialist who diagnoses, prevents, and treats periodontal diseases. They receive an additional 3 years of advanced dental education after graduating from dental school. This advanced dental education entails specialized treatment methods and gum training. If the condition is more serious, a periodontist can carry out surgical treatments, including incising the gums, removing calculus buildup, and refining bony defects.
Common Causes and Risk Factors Leading to Root Planing and Scaling
The causes of gum disease are contributing factors in root planing and scaling procedures. When excessive bacteria accumulate in your oral cavity, they form plaque on teeth, which is the onset of gingivitis. If you do not address this plaque early, more issues can emerge. These are the prevalent reasons why gum disease can occur:
- Long-term tobacco chewing and smoking
- Consuming excessive sugary drinks and foods
- Irregular flossing and brushing, which causes calculus to build up
- Crooked teeth create space for plaque and tartar to build up
- Family genetics of gum disease
- Existing diseases, including high blood pressure, heart disease, cardiovascular disease, bacterial pneumonia, and seizures
Ideal Candidate for the Procedures
The ideal candidate for dental root planing or dental scaling is someone showing symptoms of existing periodontitis. These symptoms include the following:
- Red, swollen gums
- Significant tartar and plaque beneath the gum line
- Persistent bad breath
- Periodontal pockets bigger than 4mm
- Bone loss that is detectable on a dental X-ray
- Bleeding when flossing and brushing
- Gum recession
- Visible tooth mobility or movement
Generally, individuals faced with a greater risk of periodontitis, including smokers, pregnant women, individuals with diabetes, or individuals with a history of dental disease, can benefit from root planing and dental scaling. During your regular dental examination, your dentist can assess whether deep cleaning is appropriate for your dental health situation.
The Scaling and Root Planing Procedure
Here is what to expect during your root planing and scaling procedure:
Initial Consultation
During your initial consultation, your dental hygienist or general dentist will thoroughly examine your dental health, including evaluating the extent of plaque accumulation, reviewing your medical history, and comprehensively assessing your gums to check for any periodontal issues. Using a periodontal probe, they will determine the depth of your periodontal pockets. The dentist might conduct an X-ray to assess the severity of your gum disease.
At the margin of the gum line, healthy gums have a sulcus, which is a V-shaped, shallow furrow between the gum tissue and a tooth. Usually, normal sulci are 3 millimeters deep or less. When you have advanced gum disease, the sulci will widen, leading to a pocket deeper than 3 millimeters. This leads to the accumulation of harmful plaque that is difficult to remove without professional treatment. Root planing and scaling are conducted when the periodontal pockets are deeper than 3 millimeters. Tooth scaling removes dental plaque and calculus below and above the gum line.
Preparation for the Procedure
Based on the quantity of plaque and calculus accumulation and the extent of tooth sensitivity, dental scaling might be painful. Before the treatment, your dentist will administer local anesthesia. Alternatively, they may administer numbing gel. The gel numbs the treatment site and ensures you are comfortable.
Dental Scaling Procedure
After anesthesia or numbing is achieved, the dental professional will utilize an ultrasonic cleaner, a small scaler, or both instruments to carefully remove tartar and plaque from the bottom of every periodontal pocket. With a scaler, the dentist manually removes tartar and plaque. The scaler requires more force, meaning it will not be as gentle on guns and teeth.
On the other hand, an ultrasonic dental cleaner is an electronic device that vibrates to chip off the tartar or plaque. The dentist will then use a water spray to wash residual tartar and plaque, keeping the tips fresh. Dentists sometimes use a dental scaler to supplement an ultrasonic cleaner to eliminate more stubborn deposits.
The Root Planing Process
The dentist will then smooth the surfaces of your teeth’s roots to remove rough areas in which bacteria can build up. This enables the gums to reattach to teeth and encourages healing. It also prevents plaque and tartar from collecting along the tooth root surfaces and enables gum tissue healing.
These procedures take 1 to 2 hours to complete. Your hygienist or general dentist may do everything in a single appointment, or they may clean half of the teeth in a single visit and the remaining half during the second visit. It is all based on your preferences, situation, and insurance plan. Your general dentist or hygienist will provide you with a proper timeframe contingent on your unique needs and dental exam.
Based on a patient’s condition, these procedures may be conducted in parts to minimize discomfort. Generally, the dentist treats the bottom and top sections of one half of your face during one dental session, while the bottom and top sections of the remaining side are treated during the following visit.
During treatment, your hygienist or general dentist can also administer drugs such as antimicrobials and antibiotics directly into the gum pockets to manage any resulting pain and infections and encourage a swift recovery.
Treating gum disease at its early stage may involve dental cleaning and scaling every 3 months, as well as daily flossing, brushing, and using mouthwash. Treating advanced gum disease may include root planing and scaling, laser surgery, and periodontal surgery.
Dental Lasers for Scaling and Root Planing
Instead of the usual scalers and ultrasonic cleaners, your dental professional can also use a dental laser to carry out tooth root planing and scaling. Dental professionals have studied the use of these high-intensity, low-energy devices in periodontal treatments and found that they provide several benefits over the handheld scalers and ultrasonic cleaners.
For example, using dental lasers generally causes less bleeding, discomfort, and swelling during the procedure. The laser is designed for soft tissues only. Dental lasers also promote faster wound healing and tissue repair.
A dental laser exerts an anti-inflammatory effect by irradiating periodontal disease to relieve cellular stress, lowering the production of pro-inflammatory agents after therapy. In addition to decreasing bacteria, it helps decrease gingival overgrowth. Dental lasers also enhance tissue regeneration and wound healing, which is particularly beneficial in recovery by causing little apical migration and a shorter junctional epithelium.
When dental lasers are used for these procedures at the required wavelength, the treatment area is irradiated, generating heat that is absorbed. On the contrary, damage to periodontal tissue may happen if the dentist uses improper wavelengths during the procedure. Thus, only experienced dentists who have been properly trained to safely and properly use dental lasers must perform the laser procedure.
Aftercare Following the Procedure
For the initial few days following scaling, you might experience minimal bleeding. This should slowly subside. Your gums may also feel tender for one or two days after treatment. However, your dentist will advise you on how you can manage the tenderness. They may suggest having painkillers or anti-inflammatories such as acetaminophen or ibuprofen on hand for when the anesthesia wears off.
During your follow-up visits, your dental professional will assess the progress of gum healing to verify whether the depth of the periodontal pockets has decreased. If pockets bigger than 3 millimeters remain after your initial treatment, they may recommend additional treatment.
Otherwise, proper maintenance and care are crucial to the success of your root planing and scaling treatment. After the procedure, when the periodontal pockets have been reduced to the desired size, your dentist will provide comprehensive aftercare instructions to support your healing and maintain gum health. They may also schedule follow-up visits to monitor your progress and ensure optimal results. Here are tips that can help you take care of your gums post-procedure:
- Healthy diet. For a few days after your procedure, eat a diet gentle on your gums. These include mashed potatoes, yogurt, soups, and scrambled eggs. These will not make you exert pressure on the gums when chewing. Avoid spicy, crunchy, and hard foods, as they can delay healing and cause discomfort. A balanced diet rich in minerals and vitamins supports gum health, so consider it. This includes calcium and vitamin C.
- Avoid using tobacco products. Smoking or using other tobacco products can stall the healing process and aggravate gum disease. Avoiding them is essential for maintaining gum health.
- Proper oral hygiene habits. Brush teeth at least twice daily using fluoride toothpaste and a soft-bristle toothbrush. Be gentle when brushing around or near the treated sites to avoid inflicting further gum damage or irritation. Floss at least once daily to clear food debris and plaque from below or along the gum line and in between teeth.
- Avoid irritants. Do not drink alcohol, as it can delay healing and cause gum irritation. Also, avoid acidic drinks such as citrus sodas and juices, as they can cause discomfort.
- Use of antibacterial mouthwash. Rinse your mouth using alcohol-free, mild antibacterial mouthwash to help promote healing and reduce bacteria. Mouthwashes containing alcohol can irritate sensitive gum tissues and cause them to dry.
- Stay hydrated. Drink lots of water throughout the day. Water washes away bacteria and food particles, keeping your mouth hydrated.
- Manage discomfort and sensitivity. Use a desensitizing toothpaste to manage tooth sensitivity to cold and hot drinks and foods. Also, avoid consuming extremely cold or hot drinks and foods. Lastly, take any prescribed medication regularly.
- Avoid doing intense physical work. Do not do any strenuous physical work for at least a day following the procedure. Let your body focus on recovery and prevent discomfort or bleeding by increasing blood flow.
- Soothe your gums using warm, salty water. After treatment, your gums may become irritated. Dentists recommend soothing them using a mild saltwater solution. Rinse using this solution after meals. Salt water removes dirt without brushing. Also, it alleviates gum inflammation and redness.
- Routine check-ups. Ensure the root planing and scaling procedure was effective. See your dentist for professional cleaning and routine check-ups to monitor your gum health and prevent gum disease from recurring. Allow the dentist to detect and address any complications before they become severe.
Ideally, you will need root planing and scaling only once. After your hygienist or general dentist removes the bacteria and tartar, proper oral hygiene and routine dental cleaning should help keep you on track. The objective is to enhance your gums’ health so you will not require another deep dental cleaning.
Benefits of Root Planing and Scaling
Undergoing tooth scaling and dental root planing provides several advantages for your dental health. These include the following:
- Prevention of periodontitis. These procedures help eliminate harmful bacteria that cause gum disease, preventing the disease from progressing.
- Enhanced gum health. By removing tartar and plaque buildup, root planing and scaling lowers inflammation and permits the gums to heal and reattach to the teeth.
- Tooth loss prevention. Early treatment of gingivitis helps prevent tooth loss caused by weakening of the tooth-supporting structures.
- Reduction of halitosis. Removing plaque and bacteria beneath the gum line can greatly reduce bad breath resulting from gum disease.
- General health benefits. Having healthy gums is associated with improved general health, as periodontitis has been linked to various medical conditions, including diabetes, respiratory problems, and heart disease.
- Aesthetic effects. Root planing and scaling remove plaque and tartar from beneath the gum line and teeth. Also, if tough stains are present, the dentist removes them in the process, restoring your teeth’s original color and improving their aesthetics.
Risks and Complications of the Procedure
Like many dental procedures, root planing and scaling carry risks and complications. However, they are rare. They include the following:
- Loose teeth. Right after the treatment, your teeth may feel quite loose. This should disappear once the gums recover and tighten.
- Bleeding. Little bleeding after the process is normal. Let your dental hygienist or general dentist know if you experience excessive bleeding that does not stop.
- Tenderness. Your gums may feel quite sore for some days. Taking over-the-counter painkillers can manage the discomfort.
- Tooth sensitivity. Removing tartar and plaque can make your teeth more sensitive to cold and hot drinks and foods. The sensitivity should disappear in one or two months.
- Infection. Root planing and scaling can introduce harmful bacteria into your bloodstream. This could result in a blood infection (bacteremia). Mouth rinse or prescribed antibiotics can lower this risk.
- Gum recession. If you had swollen gums before treatment, they will shrink back after the infection clears up. As a result, you may see a little more of your teeth’s roots.
Inform your dental professional if, in the course of your recovery, you develop severe swelling, pain that does not improve with medication, or bleeding that does not stop.
Root Planing and Dental Scaling Cost
The cost of a routine professional dental cleaning, also known as dental prophylaxis, can range from $70 – $150. This range depends on various factors. On the other hand, the price of periodontal root planing and scaling per quadrant averages from $250-$400. The entire procedure can cost more than $800. Active periodontal treatment, which generally involves administering a local antimicrobial agent to gum pockets, costs around $75 per tooth. The cost of gum maintenance after having active treatment averages $120.
Some of the factors impacting the gum disease treatment cost include the following:
- The technology the dentist uses in the treatment
- The dentist’s location
- Number and specialty of dental professionals involved in the treatment plan
- Frequency and kind of treatment procedure, and the necessary follow-up dental care
- Type of dental insurance
On average, you may need up to two dental appointments based on the severity of your condition. Dental visits for gum check-ups then follow. You must stick to your dental appointments until your gums become healthy and firm. Any additional procedures result in extra charges.
If the charges are not mentioned under the general cost, the dental professional will charge them separately. This includes additional charges for services such as consultations and X-rays. Since the treatment can cause a little pain, you may need prescribed medication and pain relievers.
Consult your dental professional and dental insurer before being treated for periodontal disease or gingivitis. Understand whether your dental insurance plan covers this kind of treatment and to what extent, to know how much you will be required to pay. Also, ask your dentist whether there are any extra charges for the treatment.
Find an Experienced Dentist Near Me
The root planing and dental scaling are delicate procedures. If you wish to undergo them, you should look for a dental professional who is experienced and certified to provide the treatment. At The Encino Dentist, we provide transparent, honest dental care. We will take the time to explain the root planing and dental scaling procedures, address any questions, and tailor a treatment plan that satisfies your individual needs.
Our objective is to ensure you are informed, confident, and comfortable throughout your root planing and scaling experience. If you are not a suitable candidate for scaling and root planing, we will recommend another procedure that can yield the results you desire. Call us at 818-650-0429 for expert dental care.