A beautiful smile depends on healthy teeth and gums. If you have gum disease, the gums could start bleeding and receding, and if periodontal disease is severe, our experienced dentists at Northridge Dentist will recommend scaling and root planing. The procedure will smoothen out the tooth surface so that your gums can adhere to the tooth roots again. Having your teeth cleaned also prevents cavities from forming, brightens your smile, and improves your overall health.
What is Scaling and Root Planing?
Also known as deep cleaning, scaling and root planing is a dental procedure for patients with periodontal disease. The dental process reaches below the gum to remove plaque build-up. It goes beyond the standard cleaning that you receive after an annual visit and regular checkup.
Scaling is the cleaning of your teeth' root surfaces and crowns and getting rid of strains, calculus, and plaque of the surfaces. On the other hand, root planing involves removing surface dentin or cementum, which is rough and contaminated with microorganisms or toxins or has calculus.
The dental procedure was designed by Albucasis approximately one thousand years ago. The scientist believed that removing calculus helped keep patients' mouth healthy. Pierre Fauchard also recommended the treatment procedure in 1882.
Why is Scaling Essential?
Calculus on the enamel in the supragingival area is less hard than calculus in the interproximal and subgingival spaces. That means it is easy to remove.
Also, at the time of calculus deposition, the apatite could be deposited on the surfaces and calculus matrix. It brings the two surfaces into contact, making the removal of calculus from the surface harder.
Why is Root Planing Essential?
Cementum surface exposed to the pocket is rougher than non-exposed sites. The rough areas trap microorganisms causing periodontal disease progression. Resorption defects formed on the cementum at the time of pocket formation act as plaque reservoir. Therefore, removing the defects and having a smooth and clean root surface is essential as far as gum disease treatment is concerned. The roughness and resorption defects are linked to gum disease treatment failure, and fiber optic illumination and magnifying glasses are essential to check your root surfaces after the instrumentation.
The second importance of root planing is cementum removal. Periodontal pathogens secrete endotoxins that invade the surface. The toxins interfere with cell migration during periodontal recovery. As a result, a healthy surface is needed for adequate recovery. Only a thin layer of cementum is removed to get the root surface.
When Do You Require Deep Cleaning?
The dental expert will commend deep cleaning if you have signs and symptoms of periodontal disease. The procedure helps stop the damaging effects of gum disease as well as keeps the mouth healthy.
Periodontal disease happens when bacteria in plaque make the gums pull away from your teeth. It causes large pockets to grow between the teeth and gums, causing more bacteria to enter there since your toothbrush can't reach. That is why it is essential to floss often.
Other signs and symptoms of chronic periodontal disease include:
Changes in the bite
Shifting permanent teeth
Tender, red or inflamed gums
If left unaddressed, the condition can result in moving teeth, loose tissue, tooth loss, or tissue and bone loss.
According to the American Dental Association (ADA), approximately half of the United States population above thirty years of age suffer from gum disease. It is believed that this is because of the following factors:
Poor oral hygiene
Other health conditions
What are the Advantages of Deep Cleaning Treatment?
For those with periodontal disease, deep cleaning offers several advantages to boost your dental health. The procedure prevents both gum disease from causing significant dental challenges and the need for costly dental work.
Other benefits include:
Stops gum disease — The procedure can assist get the health of your gums back on track.
Prevents tooth loss — Huge pockets between gums and teeth and infection and delay around your tooth root can cause tooth loss. The process stops these challenges before they cause tooth loss.
Protects the roots of your tooth — The procedure protects your teeth's roots when bacteria and plaque start to build up below your gum line.
Prevents tooth decay — The dental treatment removes tartar and plaque build-up, preventing periodontitis pockets and tooth decay.
Eliminates bad breath — Periodontal disease causes bad breath, something that can be treated with deep cleaning.
Prevent the formation of cavities.
What are the Common Tools Used?
Discussed below are tools used in the dental procedure:
Sickles or scalers— Scalers are used for supra-gingival scaling. When well used, the cutting edges of scalers make a ninety-degree angle with your tooth surface. While some have a shank and blade with a handle, others come with an angulated shank that allows access to different tooth surfaces.
Hoe —A hoe removes calculus from your deep pockets and root surfaces. The angle between the hoe's face and the cutting surface is approximately seventy degrees. However, the hoe's face makes a ninety-degree with your tooth surface. The shark of the hoe is bowed. More than four hoes are used to access every circumferential tooth surface.
Files — Files are used to get rid of gross roughness. However, they can cause streaking. They should be used after the application of sickles and curettes. The end of a file can be used to reach calculus in narrow and deep pockets where a hoe or curette can't be brought into a proper working position.
Curette — A curette is an essential tool used in the dental procedure in question. Its working part is a spoon-shaped blade with two curved cutting edges. It removes plaque and tartar on surfaces in various regions of your dentition. During root planing, an angle between sixty and eighty degrees is achieved by the curette's face with your root surface. Then a stroke is used using little pressure.
How to Prepare for the Dental Procedure
There is not much to do as far as preparation of a scaling and root planing procedure is concerned. Sometimes your dentists may recommend rinsing your mouth with a strong antiseptic mouthwash. It prevents:
Development of cold sores and chapping after the procedure,
Transmissions of contagious virus and bacteria to the dentist, and
Development of soft tissue infections following the scaling and root planing.
However, other dentists suggest oral health habits like eating low sugar or low-carbohydrate diet, oral probiotics, or oral pulling. It does not disrupt the oral microbiome as well as reduces inflammation. As a result, it helps you make the initial steps to prevent periodontal diseases and boost your immune system.
If you are worried about pain or sensitivity, you can use an over-the-counter painkiller before the scaling and root planing. You can also use a natural option like CBD oil.
Before the dental procedure, it is essential to establish a periodontal disease diagnosis.
Both your dental and overall health history should be analyzed. You might also require premedication with systemic antibiotics if you have prosthetic heart valves or prosthetic joints. The doctor could also suggest pre-medication if you need a transplant.
If you take blood-thinning medication, the dentist might recommend the suspension of your medication before the dental procedure. However, this must be in coordination with your doctor.
A Comprehensive Guide on How Deep Cleaning is Done
Deep cleaning comprises getting rid of hardened calculus (tartar), strains, and plaque from your tooth roots and tooth. Root planing and scaling aren't separate dental procedures but a part of the initial therapy of a comprehensive periodontal disease treatment plan.
Normally, the process is executed in a single, one to a two-hour dental visit. However, if you have several trouble spots or the infection is widespread, the dentist will divide the process into two (2) appointments. During the initial dental visit, your dentist will clean the lower and upper quadrants of a side of the mouth. The rest quadrants will then be cleaned in another appointment.
Deeping cleaning is essential when pockets are more than 3 mm. The procedure removes tartar and plaque above and below your gum line. Depending on the degree of your tooth sensitivity or the amount of plaque and tartar build-up, the dental procedure might be painful.
Identification of Calculus
The initial step in performing the dental procedure in question is detecting where calculus is deposited. These sites could be identified using visual examinations under a light. Calculus below your gingival margin and the supragingival calculus could be identified under a clean field and good lighting. On the other hand, a jet of air detects tartar on your root surface with periodontal pockets. The air moves the tissue from the surface of your tooth, making the calculus deposits visible in the root site.
Another method of site detection is the use of explorers. The technique needs a pointed and sharp explorer that is moved in your subgingival sites on your root surface.
Fingers' pads perceive vibrations performed through the explorer shank. The explorer's tip is moved vertically on your surface, making exploratory strokes. After a calculus deposit is identified, the explorer's tip is moved slowly until the surface of your tooth root is felt. Typically, the distance between the bottom of your pocket and calculus apical end is between 0.2 and 1 millimeter. In your contact sites, the explorer is stretched halfway on the surface above the contact site to notice all deposits.
The explorer's handle must be moved between the fingers and thumb. That way, your dentist can detect surface changes like concavities or convexities at the line angles.
Local Anesthesia Administration
Commonly known as a membrane-stabilizing drug, local anesthesia assists in regulating bleeding and pain during the dental process.
First, the dentist will inject the medication into the mouth, numbing the treated region. After five minutes, you will experience loss of sensation for a while (you will be conscious and awake during the procedure but will not feel pain). However, you could feel tenderness in the injection area after and during the deep cleaning.
The next step is carrying out subgingival scaling where your dentist removes calculus and plaque on the teeth crowns base and beneath your gums.
It can be done either using a piece of ultrasonic equipment or manually. Both methods get rid of hardened tartar and loosen plaque.
When removing bacteria and plaque, the scaler is put in a pocket with the bevel at an angle between forty-five and ninety degrees of your tooth. Then the root surfaces and teeth are scraped and cleaned in a horizontal, circular, or vertical motion.
The scaler's sharp tip can scratch your exposed root surface or injure your gingiva's soft tissues. Therefore, your dentist should cautiously adapt the scaler to the tooth's surface and activate the stroke.
After all visible calculus is removed and your tooth surface free from deposits, the sites below your gingival margins must be inspected.
When your dentist is sure your teeth surfaces are calculus free, polishing is performed to smoothen all surface irregularities that might be a result of instrumentation.
Enamel, dental pulp, dentin, and cementum are components of your teeth. Typically, as periodontitis progresses, the condition damages dentin, cementum, or both. Planing smoothens rough areas and gets rid of all subgingival bacteria.
Throughout the dental procedure, your dentist will clean deep below your gums to get rid of tartar build-up and plaque on the teeth's root. It also involves complete cementum removal, a calcified film that covers your tooth's root.
Additionally, the procedure involves getting rid of a tiny dentin layer, the layer below your enamel.
During initial deep cleaning in inflamed sites, local anesthesia must be avoided. It is because the odds are the instrument might extend to junctional epithelium because of the lack of pain response.
Excessive pressure during root planing and scaling might lead to the formation of gouges and nicks and loss of your tooth structure. Occasionally, ditches develop on your root surface due to excessive cementum removal from one site. To prevent these challenges, powerful and short scaling strokes should be used to get rid of calculus. Also, immediately the roughness on your root surface and calculus has been removed, longer root planing strokes together with pressure should be applied.
Following the deep cleaning process, the dentist will flush the treated site to remove the remaining bacteria. The dental expert will then apply pressure to make sure the proper growth of the gum tissue.
The dentist can also perform host modulation. It is an additional medication that is directly administered into the gums. It helps lower the risks of infection after the dental procedure or corrects the negative consequences of long-term periodontal disease.
Healing After the Dental Procedure
After the dental procedure, the epithelial attachment is cut off, while junctional and Sulcular epithelium is partly removed.
After twenty-four hours, mitotic activity in the epithelium is seen, and within two days, the whole gingival crevice will have epithelium. In about four to five days, you will observe new epithelium formation. Complete epithelium healing will occur within a week or two. However, it depends mainly on the seriousness and degree of inflammation.
Changes Observed Following the Dental Procedure
One of the expected changes following the procedure is the gingival inflammation resolution. As a result, the following is observed:
The gingiva tissue is reduced
The density of the tissue increases
Reduction of bleeding
Crevicular depth reduction
Another significant observation is reduced probing depth. According to research conducted by Lux L., Lohr KN, and Bonito AJ, pockets four to six mm deep are reduced by 1 mm while the anticipated reduction for pockets seven mm is two mm. The reduction is experienced due to the gingival margin recession and gain in your attachment level.
How Often Should You Undergo Deep Cleaning?
You only have to undergo a deep cleaning once in your lifetime. After all food debris and plaque have been removed from the gums and teeth, you start on a clean slate. The key to a successful procedure is practicing proper dental hygiene.
Re-evaluation is a vital element of periodontal disease treatment. It accesses the efficacy of the treatment option as well as offers future treatment guidance. Moreover, it identifies both what has worked and what hasn't.
A re-evaluation must be carried out four to eight weeks following the dental procedure. That is enough time for the inflammation to lessen and the formation of a new gingival unit to happen. Also, it is enough time for you to have a practical dental hygiene routine.
In this appointment, your dentist will:
Examine you to check if plaque scores and gingival inflammation have reduced. Documentation of probing depth should also be conducted to check if probing depths have reduced.
Develop a treatment plan about the future management of your periodontal disease. If the probing depth is below three mm, all you need is maintenance. However, if the probing depths are above four, you might benefit from another nonsurgical periodontal therapy that might include local antimicrobial/antibiotic therapy or systemic antibiotics.
A deep probation depth related to the radiographic indication of angular bone loss could result in a surgical procedure to access the root surface. The surgery could offer pocket reduction through regeneration therapy.
Moreover, during the re-evaluation appointment, the dentist will include a self-care review, including:
Diet especially if you are diabetic
Vaping and smoking
Other factors related to potential future cavities and periodontal attachment loss
What to Expect After Deep Cleaning?
After deep cleaning, you will notice that the gums are less red, swollen, and vulnerable to bleeding. However, you might also experience the following side effects during the recovery process:
Discomfort and pain: It is a common phenomenon to feel throbbing or mild aching after the dental procedure. Typically, the throbbing and discomfort should stop within hours and three days following scaling and root planing, respectively.
Sensitivity to cold or hot beverages and foods
Bleeding while brushing
Discomfort in the jaws
One of the things you could do to minimize the above-discussed side effects is minding what you eat. Avoid foods like popcorn, hard and crunchy foods, nuts, chips, granola, and seeds during the recovery process.
To reduce pain, discomfort, or sensitivity, consider using over-the-counter painkillers. If the sensitivity persists, use a desensitizing toothpaste.
Remember to brush your teeth gently and avoid flossing. You should be able to resume regular brushing habits within three days.
After one day following the deep cleaning, rinse your mouth about four to six times with salty water. It helps keep the area free from infection and clean.
Additionally, after the dental procedure, your teeth could be more sensitive than before. It can last for a few weeks. You can also experience some bruising and swelling. Icing the areas can help. However, consult your dentist should the swelling persist.
Avoid smoking. Tobacco slows down the recovery process.
What Is the Average Cost of a Deep Cleaning Procedure?
There is no exact answer to this question. It is because the following factors affect the overall cost:
Whether you're having active periodontal therapy
Maintenance costs after the procedure
The geographical location
The number of medical experts involved in the treatment plan
The seriousness of the periodontal disease
Other associated costs include cost for:
Dental x-rays used to diagnose gum disease.
Full mouth debridement carried out during your routine cleaning before carrying out the deep cleaning.
How to Cut Costs
While deep cleaning can be expensive, there are methods to cut costs. They include:
Dental insurance: Dental insurance is an excellent place to start cutting dental procedure costs. The insurance might cover more than fifty percent of the total cost.
Dental payment plans: Most dental experts offer a dental payment plan. Remember to confirm with your dentist if this is an option.
Find a Scaling and Root Planing Dentist Near Me
Periodontal disease is a condition that can cause tooth loss. Luckily, scaling and root planing is an effective treatment procedure. Some of the symptoms of the condition include bleeding gums, swollen gums, and gum tenderness. If you are experiencing these symptoms, you need to speak with dental experts at Northridge Dentist at 818-875-0216. We can help you determine if deep cleaning is an ideal procedure and answer your questions.