If you have been diagnosed with some form of periodontitis (see section on Periodontal Disease), the first step in trying to eliminate the infection and get the disease under control is done through a non-surgical approach called scaling and root planing. Scaling and root planing (sometimes called a deep cleaning) is a very thorough cleaning done under anesthetic (you are numb), so we can aggressively get under the gum line and into the deep pockets in an attempt to clean out as much of the plaque, calculus (tarter), toxins, and bacteria as possible that have caused the pockets. The deeper the pockets, the harder it is to completely eliminate the factors (i.e., plaque, calculus, toxins, and bacteria) leading to the disease. Studies have shown that you can effectively clean 4mm deep pockets, but as the pocket depths increases the ability to clean and smooth the roots of your teeth significantly decreases.

What can I expect?

Normally with this procedure either your whole mouth is cleaned by the hygienist in one three-hour appointment or half your mouth is cleaned in two 2-hour appointments. On occasions however, depending on your time schedule and the difficulty of your case this may be broken up into two to four shorter appointments. After your cleaning you may have some mild discomfort or soreness which can normally be relieved with something like Tylenol®, Advil® (Motrin or Ibuprofen), or Aleve®. As the inflammation goes down some of your roots may become exposed causing possible thermal sensitivity to hot or cold. This sensitivity will get better, but it may take time for it to diminish.

Four to six weeks following this deep cleaning you return to our office for a re-evaluation. At this appointment, which has no charge, you receive another exam similar to your first visit to the office in order to determine how you have responded to your initial therapy. Sometimes scaling and root planing is enough to completely correct mild to moderate periodontal problems, greatly reducing both the inflammation, bleeding, and pocket depths in your mouth. If residual disease and deep pockets remain however, you most likely will need some form of surgical treatment and intervention such as flap and osseous (pocket reduction) surgery, guided tissue regeneration (re-growing some lost bone), or in a worst case scenario tooth extraction(s) in order to adequately treat and control the disease process. Our goal is to help you keep and maintain as many of your natural teeth for as long as possible without compromising adjacent teeth.

Am I finished?

It is very important that you realize that periodontitis is not a curable disease, but it is treatable and something that can be controlled. Once we have gotten the disease under control and you have what we call a reduced but stable periodontium, relapse can and will recur if you are not maintained on a regular follow-up program called periodontal maintenance. This is usually done every 3 months and sometimes it is alternated between our office and your general dentist’s office. In other words, if you have ever been diagnosed with periodontitis and have been treated for it, you are a periodontal patient for life. Just getting the disease treated and into a stable condition through scaling and root planing and surgery (if necessary) is only the first part of keeping compromised teeth. If you perform good home care and stay on your regular periodontal maintenance program with us and your general dentist, you can remain in this stable state of health for many years to come. If, however, you do not perform good home care and don’t follow a regular maintenance program you will once again begin breaking down and the disease will recur and become more severe.