Scaling & Root Planing 

The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling or root planing. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause gingival inflammation and disease. Scaling and root planing can be used as a stand-alone treatment or a preventative measure. They are commonly performed on cases of gingivitis and moderate to severe periodontal disease.

What do the procedures entail?

After a thorough examination of the mouth, which may include taking X-rays, and depending on the condition of the gums, the amount of tartar present, the depth of the pockets and the progression of periodontitis, Dr. Yamaoka may recommend scaling and root planing. In some cases, a local anesthetic may be used during the procedure.

Scaling

When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process especially targets the area above the gum line, along the root. Scaling is performed with a special dental tool called an ultrasonic scaling tool in addition to hand instruments for the gentle removal of these deposits.

Root Planing

Root planing is performed in order to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is smoothed, which promotes healing and also helps prevent bacteria from easily colonizing in the future.

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Yamaoka may place apply an antibiotic locally into the periodontal pockets after scaling and root planing. This may be done to control infection and encourage normal healing.

When deep pockets between teeth and gums are present, it is difficult for Dr. Yamaoka to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health.


An animated illustrion showing the process of scaling
An animated depiction of a root planning procedure

Benefits of Treatment

If treatment is successful, scaling and root planing have many periodontal benefits. One is that it can help prevent disease. Research has proven that bacteria from periodontal infections can travel through the blood stream and affect other areas of the body, sometimes causing heart and respiratory diseases. Scaling and root planing removes bacteria that causes these conditions.

Another benefit of treatment is protecting against tooth loss. When gum pockets exceed 3mm. in depth, the risk for periodontal disease increases. As pockets deepen, more bacteria is able to colonize, eventually causing a chronic inflammatory response by the body to destroy the bone. This leads to tooth loss.

Finally, scaling and root planing may make the mouth more aesthetically pleasing. It will reduce bad breath caused from food particles and bacteria in the oral cavity and superficial stains on the teeth can also be removed.