Scaling and root planing, also known as conventional periodontal therapy, non-surgical periodontal therapy, or deep cleaning, is a procedure involving removal of dental plaque and calculus (scaling or debridement) and then smoothing, or planing, of the (exposed) surfaces of the roots, removing cementum or dentine that is impregnated with calculus, toxins, or microorganisms.
Often, an electric device, known as an ultrasonic scaler, sonic scaler, or power scaler may be used during scaling and root planing. Ultrasonic scalers vibrate at a high frequency to help with removing stain, plaque and calculus. In addition, ultrasonic scalers create tiny air bubbles through a process known as cavitation. These bubbles serve an important function for periodontal cleanings. Since the bacteria living in periodontically involved pockets are anaerobic, meaning unable to survive in the presence of oxygen, these bubbles help to destroy them. The oxygen helps to break down bacterial cell membranes and causes them to lyse, or burst.
In cases of severe periodontitis, scaling and root planning may be considered the initial therapy prior to future surgical needs. Additional procedures such as bone grafting, tissue grafting, and/or gingival flap surgery done by a periodontist (a dentist who specializes in periodontal treatment) may be necessary for severe cases or for patients with refractory (recurrent) periodontitis.
Therefore, patient compliance is, by far, the most important factor, having the greatest influence on the success or failure of periodontal intervention. Immediately following treatment, the patient will need to maintain excellent oral care at home. With proper homecare, which includes but is by no means limited to brushing twice daily for 2–3 minutes, flossing daily and use of mouthrinse, the potential for effective healing following scaling and root planing increases.
The process which allows for the formation of deep periodontal pockets does not occur overnight. Therefore, it is unrealistic to expect the tissue to heal completely in a similarly short time period. Gains in gingival attachment may occur slowly over time, and ongoing periodontal maintenance visits are usually recommended every three to four months to sustain health. The frequency of these later appointments is key to maintaining the results of the initial scaling and root planing, especially in the first year immediately following treatment.
Periodontal surgery may be needed to treat certain gum diseases and conditions, such as gingivitis or periodontitis. This type of surgery is commonly known as gum surgery.
The procedure aims to treat the gum disease and any damage it may have caused by:
Regrowing damaged bones and tissues
Preventing tooth loss
Reducing gum gaps between teeth, known as black triangles
Reshaping the jaw bone to lower the risk for bacterial growth in bone crevices
Eliminating bacteria and infection
A gum liftis a cosmetic dental procedure that raises and sculpts the gum line. The procedure involves reshaping the tissue and/or underlying bones to create the appearance of longer or more symmetrical teeth.