Scaling & Root Planing

The early stages of periodontal disease are best treated with non-surgical therapy. Even in severe cases of periodontal disease, non-surgical therapy often precedes surgical treatment.

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.

There are limitations to what scaling and root planing can accomplish. Research has shown that the deeper the pocket the less effective we are at removing the plaque and calculus. Also back teeth are more difficult to reach and are therefore more difficult to effectively clean and detoxify.

Approximately 4 – 6 weeks after the initial therapy, Dr. Alvord, Dr. Rawlings and Dr. Young will schedule another examination to evaluate the results of the non-surgical therapy.

What do the procedures entail?

Drs. Alvord, Rawlings and Young will only perform scaling and root planing after a thorough examination of the mouth, which may include taking x-rays and visually examining the mouth. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, Drs. Alvord, Rawlings and Young may recommend scaling and root planing. In some cases, a local anesthesia 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 below the gum line, along the root. Scaling is performed with a special dental tool called an ultrasonic scaling tool. The scaling tool usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria.
  • 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 literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future.

An animated illustration showing the process of scaling An animated depiction of a root planing procedure

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, Drs. Alvord, Rawlings and Young may place antibiotic fibers in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.

When deep pockets between teeth and gums are present, it is difficult for Drs. Alvord, Rawlings and Young 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. Please call our office if you have any questions at .

Benefits of Treatment

If treatment is successful, scaling and planing may 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 remove bacteria that cause these conditions.

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

Finally, scaling and root planing may make the mouth more aesthetically pleasing, and should reduce bad breath caused from food particles and bacteria in the oral cavity. Superficial stains on the teeth will be removed during scaling and planing, adding an extra bonus to the procedures.