What is Scaling and Root Planing?

Because you’re taking the time to read this blog post on the NK Family Dental blog, we assume you care about your oral health. If we’re right (as we hope we are), you schedule a dental check-up and cleaning at regular six-month intervals.

Under typical circumstances, the professional cleaning procedure you’re accustomed to will go a long way to keeping your gums healthy. But if you’re experiencing symptoms of periodontal disease, your dentist will likely recommend a procedure called gum scaling and root planing (SRP). While this might seem intimidating and a little scary, it’s also known more commonly (and less alarmingly) as deep cleaning.

Why You May Need a Deep Cleaning

As covered in our blog post - “What Is Periodontal Gum Disease?” - even if you brush your teeth every day, you could still be at risk for developing gum disease, which is an infection of the tissues that hold your teeth in place.

Periodontal disease begins when bacterial plaque and tartar (calculus) - which plaque eventually hardens into - accumulate around and under the gums. Healthy gum tissue fits tightly around each tooth. Plaque and tartar build-up eventually causes inflammation. When this happens, gums pull away from the teeth, forming spaces called pockets. Plaque then gets trapped in these pockets and cannot be removed with regular brushing or a professional teeth cleaning alone. Without a deep cleaning, periodontal disease will advance. Left untreated, it leads to tooth loss and erosion of supporting bone structures. Gum disease has also been linked to other health conditions, including heart disease, stroke, diabetes and some cancers.

Being aware of the symptoms of periodontal disease - especially in the initial stages - can alert you to schedule an appointment for a diagnosis and appropriate treatment.

While a regular cleaning removes plaque and tartar from above and around the gumline, a deep cleaning - as the name implies - goes under the gumline. Although the American Dental Association (ADA) advises that dentists use SRP as initial treatment for chronic periodontitis, your dentist may recommend a deep cleaning as a preventive measure if you haven’t had a regular cleaning in the past 12 months.

Moreover, your dentist may prescribe antibiotics as a precaution prior to scheduling a deep cleaning, based upon your medical history. Tell your dentist if you take prescription medications (including blood thinners), have a weakened immune system, HIV/AIDS, liver disease or other medical condition that the procedure could affect. Never discontinue any prescription medication for any length of time without consulting your doctor.

What Scaling and Root Planing Involves

SRP is a two-step procedure, which Colgate describes as follows.

Step One: Scaling —Dental scaling dives deep into the gumline with manual hand instruments, ultrasonic instruments, or both. If your hygienist or dentist uses an ultrasonic scaling device, sonic vibrations will remove the plaque bacteria and tartar from the tooth surface and underneath the gumline. A manual dental scaler can do the same thing. Or it can supplement the ultrasonic device by removing particles the device can't break loose.

Step Two: Root Planing — Root planing involves an even deeper dive with detailed scaling of the root surface to smooth out rough areas. Smooth root surfaces keep bacteria, plaque and tartar from re-adhering underneath the gumline. Root planing decreases gum tissue inflammation, allowing your gums to heal and reattach themselves more firmly to your teeth.

If needed to prevent infection, your dentist might administer medicine directly into the area undergoing the procedure. After your deep cleaning, you'll need to schedule a follow-up visit with your dentist.

Depending on the severity of your individual case, scaling and root planing could require more than one visit to complete and may require a local anesthetic. However, the procedure generally causes very little discomfort.

What to Expect After a Deep Cleaning

After a deep cleaning, expect some soreness for a day or two, and teeth sensitivity for up to a week. Your gums also may be swollen, feel tender and bleed. Your dentist may prescribe a mouth rinse, and schedule a follow-up visit to see how your gums have healed and measure the depth of your pockets.

Signs that a deep cleaning has successfully treated early-stage or chronic periodontitis are that the bleeding has stopped, and the pockets surrounding your gum tissue are smaller. Further treatment may not be necessary, although your dentist will probably recommend scheduling a standard cleaning every three months, instead of six.

However, if the pockets have become deeper, additional treatment —including periodontal surgery - might be necessary. A scaling and root planing treatment, however, often lessens the degree of surgery required.

Let a deep cleaning be a wake-up call that you need to pay greater attention to your oral hygiene routine - as well as quite possibly your diet and lifestyle habits. Brush your teeth twice a day with a soft brush, floss daily, eat a balanced diet, avoid using tobacco and see your dentist on a regular basis.

The Take-Home Message

Whether you call it scaling and root planing, or deep cleaning, this procedure is an essential treatment for periodontal disease. Getting to the root of periodontal disease - so to speak - can stop it from advancing, and allow your gums to keep your teeth in place for a lifetime of healthy smiles!

At NK Family Dental, it is our mission to provide the highest quality and most compassionate oral care to our Chicago patients, including both dental and periodontal services. Our practice is trusted for advanced oral surgery procedures and comfortable root canal treatment.

Our team of experienced, dedicated dental professionals will help address your oral health concerns, and determine the best solution for you based on your individual situation. We strive to identify treatment options that fit your needs.

Our dental specialists include our general dentist, Dr. Nilofer Khan, our endodontist, Dr. Sabek, and our periodontist, Dr. Amir Danesh. Dr. Danesh is a board-certified periodontist and Diplomat of the American Board of Periodontology. He has contributed to the publication of two books, as well as published over 20 papers in prestigious dental research journals.

We serve the neighborhoods of Logan Square, Bucktown, Humboldt Park, and Wicker Park with the dedication that’s earned us the reputation as the Best Dentist in Chicago!

We understand that the main concern you may have is cost, which is why we accept all major PPO plans for dental insurance and also offer our in-house dental plan. Please see our financing page for more information.

Schedule your visit through ZocDoc, or contact us directly. We look forward to treating you soon!

What Happens During a Deep Dental Cleaning

Brushing your teeth twice a day, flossing at least once, and using a mouthwash twice daily after brushing is the best day-to-day method to maintain oral hygiene between semi-annual dental checkups and cleaning. However, under certain circumstances, you may need a deep cleaning to stop the progression of early-stage periodontal disease. Let’s take a look at what a deep dental cleaning is, how to determine if a deep cleaning is needed, and how to prepare for one.

What Is a Deep Dental Cleaning?

A deep dental cleaning starts out similar to a regular cleaning. But first things first, starting with dental plaque. As Dentalcare.com explains, “Dental plaque is a sticky, colorless or pale yellow film that is constantly forming on your teeth. When saliva, food and fluids combine, plaque - which contains bacteria - forms between your teeth and along the gum line. Dental plaque begins forming on teeth 4-12 hours after brushing, which is why it is so important to brush thoroughly at least twice a day and floss daily.”

This is also why semi-annual professional cleanings are important. Even excellent oral hygiene practices at home can’t eliminate all of the plaque that turns into tartar. Unless tartar is regularly removed by a dental hygienist, it builds up, putting you at risk for - or in the initial stages of - periodontal disease. Deep cleaning is necessary when tartar buildup has caused your gums to become infected, which results in pockets - a widening of the gumline that has pulled away from the tooth (or teeth). This represents loss of connective tissue that can lead to bone loss and, eventually, tooth loss.

As the American Dental Association (ADA) describes, this deep cleaning consists of two parts: scaling and root planing. Scaling is when your dentist, dental hygienist or periodontist removes all the plaque and tartar above and below the gumline, cleaning all the way down to the bottom of the pocket. Your dental provider will then begin root planing, smoothing out your teeth roots to help your gums reattach to your teeth. 

The deep cleaning process involves different tools than those used in a regular cleaning. The dental professional providing your treatment will use either manual scaling tools or electric/ultrasonic instruments to remove plaque and tartar from gum pockets and near tooth roots. Deep cleaning teeth typically requires one or two visits. The process should take around one to two hours each time, and a local anesthetic may be used to minimize potential discomfort. Scaling and root planing should not be a painful experience, however.

How to Determine If a Deep Cleaning Is Needed

So, how will you know if you need a deep cleaning? During the examination, your dental provider will use a tool called a probe, placing it beside your tooth beneath your gumline. In a healthy mouth, the pocket depth is usually between 1 and 3 millimeters (mm). Pockets deeper than 4 mm may indicate periodontitis. Your dentist may also take x-rays to see if bone loss has occurred.

Some signs you can look for in your gums and teeth that might indicate the need for a deep dental cleaning include:

Scaling and root planing will be the first treatment step if your dental provider determines you have gum disease, or periodontitis. Other treatments will fall under the category of periodontics, which is the area of dentistry focusing on the supporting structures of the teeth, most notably the gums and mouth bones. 

How to Prepare for a Deep Cleaning

Once you find out you need to have a deep dental cleaning, you’ll need to prepare. Write down your medical history before the appointment so you can communicate it with your dental provider. You’ll want to have all significant conditions or medical events ready to discuss so that your dentist can take the necessary precautions to ensure your safety.

It’s possible for the procedure to release bacteria into your bloodstream. Those who have a weakened immune system due to a heart condition, HIV/AIDS, liver disease, joint replacement or any similar medical issue will need special attention. Your dentist may prescribe an antibiotic before your appointment to reduce the risk of infection. If you take blood thinner medication, consult with your doctor to see if you can pause your dose prior to the appointment. NEVER discontinue any prescription medication for any length of time without consulting your doctor.

After the procedure, you should expect a follow-up appointment in about four to six weeks. To ensure your gum health is maintained, your dentist may also ask you to make an appointment for regular cleanings and checkups every three months instead of semi-annually - at least for a while. You may also receive further treatment from a periodontist.

Deep Dental Cleaning in Chicago

Are you looking for a dentist in the Chicago area who can perform deep dental cleanings? NK Family Dental is again open for patients. We offer both dental and periodontics services, provided by dentist Dr. Nilofer Khan and periodontist Dr. Waeil Elmisalati. Learn more about our leading dental and periodontal services in Bucktown and Logan Square, and schedule an appointment with us today! We look forward to getting your oral health back on track.