Root Planning and Scaling
Root scaling and planning is a non-surgical procedure for removing plaque and dental calculus from the mouth. These substances adhere to the teeth as sticky or hardened residues and are the result of bacterial colonies under the gums. If these plaques and bacteria are not removed frequently they can produce acids which promote tooth decay and gingivitis. Root scaling and planing is a most effective way to treat gum disease before it becomes severe and chronic. It is also a usual first step in treating more advanced periodontal disease.
Root scaling and planing provides a much deeper effort than a standard teeth cleaning and is very often performed by a dental hygienist.
The Procedure
Root scaling and root planning employ slightly different techniques and are usually used in combination. Both are of great value in combating periodontal disease from gingivitis to advanced periodontal disease.
Root scaling is generally performed with local anesthesia and involves cleaning the teeth below the gum line. The dental plaque (tartar) is carefully and firmly scraped away. In root planing the dentist or hygienist uses instruments to smooth the tooth's root surface which has become roughened from the disease process. This can help promote reattachment of the gum tissue and lead to a healthier mouth. In most cases the treatment will consist of four separate appointments to treat each quadrant of the mouth.
After scaling and root planing are completed the periodontist will re-evaluate the patient's gingival condition and together they will discuss and decide on any further treatment.
How Its Done
Scaling and root planing are done with a combination of ultrasonic scalers and hand instruments. Ultrasonic instruments are electric or air-powered. They have two components:
*A relatively dull metal tip that vibrates at a very high frequency and "knocks" plaque and calculus off the tooth
*A water irrigation system that cools the tip and helps to flush out debris from around the teeth
Hand instruments are not powered. They have cutting edges that your dentist or hygienist uses to chip away plaque and calculus.
These instruments come in various shapes and sizes. Different instruments are used for different teeth, and even for different surfaces of the same tooth.
Typically, ultrasonic instruments are used first to remove large deposits of plaque and calculus from the crowns and roots of the teeth. Hand instruments called scalers and curettes are then used to remove any remaining material and make sure that the tooth surface is clean and smooth. When working under the gum line, your dentist or hygienist cannot see the plaque or calculus. He or she will rely on the sense of touch to feel for roughness on the root surface.
Sometimes, scaling and root planing can be completed in one visit. This usually is possible if you have gingivitis, the earliest stage of gum disease. However, if you have periodontitis, multiple visits are usually needed. The periodontist typically will do a quarter of your mouth (a quadrant) at each visit.
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