Scaling and Root Planing
Scaling This is the removal of calcified bacterial products (tartar or calculus) from the crowns and roots of the teeth. Sometimes, an ultrasonic scaler will be used to dislodge the larger deposits and debris above and below the gum line while rinsing everything out with a stream of water. Then fine hand instruments called scalers are used to “feel” the tooth surface and remove all calcified deposits from the pocket area to complete the scaling process.
Root Planing After all calculus (or as much as can be reached in the gum pocket) has been removed, scaling instruments are used to remove a thin layer of diseased root surface. This creates a hard, smooth root surface for the gum tissue to heal against.
Note: Both scaling and root planing are done at each “scaling” appointment.
Polish After all scaling and root planing has been completed, the teeth are polished to remove stain and bacteria (dental plaque). This is done to maximize the healing response to treatment.
Fluoride A topical fluoride is applied to teeth after polishing. This strengthens any weakness in the teeth and helps reduce any sensitivity after scaling.
WHAT TO EXPECT
Does it hurt?
During Most patients do not find these procedures too uncomfortable. However, if necessary, the gum tissues can be numbed by a “spray” anesthetic, which lasts for about 30 to 60 minutes. If the gum pockets are deep, the dentist or hygienist may recommend that both the teeth and gums be numbed with a local anesthetic injection.
After On the day of the scaling, the tissue will be slightly tender. If home care suggestions are followed, any tenderness will resolve within 48 hours. Rarely if needed, medication for discomfort will be prescribed.
Sensitive Teeth Some patients experience sensitivity to cold following scaling. Avoid drinking cold liquids and brush your teeth with toothpaste for sensitive teeth (Sensodyne-F or Colgate /Crest for Sensitive Teeth). The sensitivity should gradually decrease.
Recession The goal of scaling and root planing is to improve the health of the gum tissue. Gums that are swollen, inflamed and infected are diseased. Hopefully, with this treatment and with good home care, the gums will shrink and tighten around the teeth. You may notice that the roots of your teeth will be more exposed, and that there may be increased spacing between your teeth with healing.
Mobility (movement) It is not uncommon to experience slight to moderate increases in mobility of the teeth following treatment. This is due to stretching of the gum tissue during removal of the debris and infection within the pockets. Your teeth should return to normal within a short time. If abundant tartar was holding loose teeth from moving, then the removal of that tartar will show the true mobility of those teeth and this is a problem which will have to be addressed.
Home Care After treatment, please resume brushing after meals and before bed and floss daily.
HOW MUCH OF YOUR MOUTH IS SCALED AT ONE APPOINTMENT? This will vary with each patient depending on depth of the gum pockets and the amount of tartar present above and below the gum line. Treatment can involve scaling the whole mouth in one appointment, half of the mouth in each of two appointments or one quarter of the mouth in each of four appointments.
HOW OFTEN IS THIS PROCESS REPEATED? Once the disease process has been controlled, usually the whole mouth can be cleaned and polished in one appointment. To maintain periodontal health, many patients require scaling every three months.
WHY DO I HAVE TO GO THROUGH THESE SCALING APPOINTMENTS? The scaling appointments are critical to the healing process of your gums. Tartar and plaque irritate the gums and keep the gum disease active. Healing can only start in a clean mouth. If bone and gum disease (periodontal disease) is slight to moderate, then scaling and root planing may be all that is needed to control the disease process. If periodontal disease is more advanced, then scaling and root planing will start the healing process, but may not in itself be enough to control the disease. After a healing period, gums and pockets are generally reassessed to determine if other treatments are required to control the disease process.
WILL THIS TREATMENT BE COVERED BY MY INSURANCE PLAN? Regular cleanings are considered basic or preventive care paid by your insurance carrier at 6 or 9 or 12 month intervals. Scaling and root planing are treated differently. Every 15 minutes of scaling is considered 1 unit of scaling; so a 45 or 60 minute scaling appointment is considered 3 or 4 units of scaling. Some insurance plans pay for unlimited units of scaling, while others pay for maximum of 16 or 12 or 8 units of scaling per calendar year. Unfortunately, some employers in order to save on costs, have purchased an insurance plan for their employees that does not include scaling units. Exclusion of scaling from a dental plan in no way infers that patients do not require this routine treatment approach. Our office will gladly help you find out what insurance coverage you have for this and other treatments. Please ask for this help before any treatments are started.