Deep Cleaning

Scaling and Root Planing (Also Kwow as Deep Cleaning)

The objective of scaling and root planing, also known as conventional periodontal therapy or non-surgical periodontal therapy, is to remove or eliminate the agents which cause inflammation: dental plaque, its products and calculus, thus helping to establish a periodontium (peri meaning around and odons meaning tooth) that is free of disease.

 Periodontal scaling procedures "include the removal of plaque, calculus and stain from the crown and root surfaces of teeth, whereas root planing is a specific treatment that removes the roughened cementum and surface dentin that is impregnated with calculus, microorganisms and their toxins.

Scaling and root planing are often referred to as deep cleaning, and may be performed using a number of dental tools, including ultrasonic instruments and hand instruments, such as periodontal scalers and curettes.

Removal of adherent plaque and calculus with hand instruments can also be performed on patients without periodontal disease. This treatment would then be referred to as a prophylaxis (a cleaning, although literally, it means "prevention"), or a prophy for short. Sometimes this device may be electric, known as an ultrasonic.

¿What is the difference between an ordinary cleaning and deep cleaning?

There is some confusion about the difference between scaling and root planing. Scaling is basically the process of removing dental tartar from the surfaces of the teeth.  Root planing is the process of smoothing the root surfaces and removing any infected tooth structure. If you have gum disease or gum pocketing, the gum pockets around the teeth will have deepened, thereby allowing tartar deposits to form under the gumline. scaling-root-planing

The two processes tend to blur together since during the cleaning process, the dental worker scales away tartar and performs any necessary root planning at the same time. Any roughness can be planed away to result in a silky smooth surface.

 ¿Do I need a deep cleaning?

Once the dentist does a clinical exam using a dental probe (hand instrument) combined with X-ray information, he will determine if the patient does have periodontal diseases to some degree.   At this point he will discuss a treatment plan which may or may not require deep cleanings.

Removal of bacterial plaque and calculus is necessary to establish periodontal health. The first step in the treatment of periodontitis (gum disease) involves non-surgical cleaning below the gumline with Scaling and Root planing. This procedure involves use of specialized curettes to mechanically remove plaque and calculus from below the gum line, and may require multiple visits and local anesthesia to adequately complete. In addition to initial scaling and root planing, it may also be necessary to adjust the occlusion (bite) to prevent excessive force on teeth with reduced bone support. Also it may be necessary to complete any other dental needs such as replacement of rough, plaque retentive restorations, closure of open contacts between teeth, and any other requirements diagnosed during the initial evaluation.

¿Does it hurt?

 Depending on the depth of the pocket and severity of the root surface irregularity, the dentist may wish to make the area numb so that the process is comfortable for you.

Sometimes if the pockets are not too deep, there may be little or no discomfort during the procedure - even without numbing. The only sensation may be the physical scraping feeling along the teeth as the area is cleaned and smoothened. A root planed root surface free of tartar has a better chance of allowing the gum tissues to heal and reattach to it. As a result, some deep gum pockets can be reduced after a deep cleaning.

¿How long does it take?

 Typically with deeper pockets and extensive rough root surfaces, the deep scaling and root planing procedure might be broken down into quadrants of work per appointment. For example, the upper right side of the mouth might be worked on one day, and the three other parts worked on at separate appointments. Or alternatively, one half of the mouth (right or left, upper or lower) might be cleaned per appointment. This also allows for only a part of the mouth being numbed at a time and makes for more manageable, shorter appointments.

 ¿How much does Deep cleaning costs?

 Many patients tend to believe “the deeper the better” so, they think they need a “deep cleaning” even if they do not have periodontal disease at all.

In a lot of cases a general detailed ultrasonic cleaning and a prophy will do it perfectly.

It is also very common that a patient comes for a regular cleaning and after the clinical exam and X-rays is found an undiagnosed periodontal disease (gum disease).

Regular visits to a qualified dentist office can help prevent large deterioration and can reduce substantially the need of complex dental treatment.

Quite often, patients tent to look for the “cheapest dental cleaning” they can get and fall into the wrong hands.  An improper clinical exam and the lack of X-rays may seem very cheap at the beginning just to find out later that some teeth will be loose. For patients needing deep scaling and root planning (deep cleaning), the cost per quadrant is between $100 to 150 dollars.


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