You know the feeling. Maybe you have a few teeth that are a little sensitive, or your gums bleed when you floss or brush. Deep scaling and root planning can help.
You fear your next visit to the dentist for fear of what your dentist will say. What if it’s gum disease? Will this mean dental surgery? Don’t stress too much. Even if you have signs of gum disease, such as swelling or bleeding, sensitive or loose teeth, and bad breath that just won’t go away, there’s a good chance that your dentist won’t go to surgery immediately to treat it. A typical non-surgical treatment for gum disease is actually a couple of procedures that your dentist, hygienist or periodontist do together: Root smoothing and scaling.
What is scaling?
These procedures are basically a thorough cleaning of the teeth. Scaling involves removing plaque under the gumline using manual scraping instruments or an ultrasound tool. When your dentist smoothes your roots, he gently grinds your teeth and removes rough stains on tooth surfaces and roots that tend to harbour bacteria.
There are two different methods your dentist can use:
- Mechanical, with dental instruments for manually scraping off deposits, or
- Ultrasound, where a small vibrating rod breaks off plaque and cleans your teeth. The ultrasound method is less unpleasant because instead of digging and scraping, the rod moves at high speed from one side to the other to remove plaque and bacteria.
Sometimes dentists combine ultrasound with mechanical methods such as tooth chisels to remove plaque below the gumline.
While root smoothing and scaling are not risky procedures, there is a risk of infection in the gums. To prevent infection after the procedure, your dentist can insert antibiotic fibres into your gums that come out about a week after the procedure. If you have a high risk of infection, you may need to take antibiotics before and after the procedure to prevent bacteria from entering your bloodstream.
The importance of root planing and scaling
Your dentist might use a few different terms to describe your gum disease: gingivitis or periodontitis.
What is gingivitis?
Basically, gingivitis is mild gum disease where your gums become inflamed and prone to bleeding.
What is Periodontitis?
Periodontitis is more severe, and it means that the bones around your teeth will be damaged. If you have gingivitis, your dentist may recommend improving your brushing and flossing at home. But if you suffer from periodontitis, planing and scaling can help heal your gums and teeth without requiring surgery.
Gum disease can be painful and cause you to lose teeth. It is also associated with a higher risk of other health problems because it allows bacteria to enter the body and cause inflammation. This triggers the production of a protein associated with heart disease and stroke. Your body uses its resources to fight this inflammation and strengthen your immune system, which should protect you from disease.
If your dentist determines that you have periodontitis, root smoothing and scaling are usually the first treatments where you will try to treat you non-surgically. Some people find it painful, while others simply find it unpleasant. Your dentist will use a local anaesthetic to numb your mouth before starting the procedure. Healthwise local anaesthesia should prevent you from feeling pain during treatment. Instead, you simply feel the pressure of the instruments in your mouth.
Root smoothing and root scaling combat gum disease in two ways:
- First by removing the plaque that is on your teeth, deep inside your gums
- Second, by smoothing out areas of your teeth where bacteria like to live. The earlier you start treating gum disease, the better your chances of coping with the problem without surgery, and the lower the risk of losing teeth.
Once the procedure is complete, your dentist will give you some follow-up instructions. What can you expect?
Root planning and scaling aftercare
Root smoothing and scaling is an outpatient procedure. Once the cleaning is complete, you can go home and rest. While this is not an operation, you need to give your teeth and gums a little extra attention after the procedures help your body heal.
If your dentist uses anaesthesia, it is important not to chew, because if your mouth is numb, you can hurt yourself by biting your lips or tongue. Your dentist may also recommend that you take an over-the-counter anti-inflammatory such as ibuprofen to relieve pain and swelling. You may need to see your doctor again to have the antibiotic fibres removed from your gums if you use them during surgery.
Good oral hygiene helps you heal, brush, floss and use mouthwash to keep bacteria and plaque at bay. As your gums heal, your teeth or gums may be more sensitive. If it’s painful to brush your teeth after the procedure, you can switch to a toothpaste designed specifically for sensitive teeth.
It usually requires more than one treatment to complete the root smoothing and scaling on your mouth. Because all this deep cleaning can make your teeth very sensitive, the dentist will only do part of your mouth at a time. The number of treatments may vary depending on the severity of your gum disease and your oral hygiene habits and usually takes three to four visits to complete the process. Your dentist will plan your follow-up appointments so that you typically have one week to recover before the next. She may also recommend more frequent cleaning after scaling and root smoothing to prevent the return of gum disease.