Sometimes, brushing and flossing the teeth is not enough to clean them, and there’s no other home remedy. In that case, you need deep cleaning – scaling and root planing – in an in-office professional setting.
Root planing is a non-surgical treatment that you need to undergo if you want to prevent further deterioration of your teeth and the underlying bone. However, the procedure is not that simple, which is why you should know about it. That way, you’ll be prepared and know what to expect.
What Is Root Planing?
Root planing is a specialised procedure to smooth out tooth roots by removing tartar, bacteria deposits, and parts of cementum (bony tissue covering tooth roots) from below the gum line. The smooth and clean tooth roots allow the gum tissue to reattach to the teeth.
Today, root planing is more conservative than it once was. Previously, dentists used to remove the entire cementum believing that the bacteria was bound to it. However, research has shown that that’s not true, and certain instruments can help in the easy removal of bacteria from below the gum line. The dentist aims to remove only the softened cementum so that the health of the tooth is restored.
What Are The Benefits Of Root Planing?
Together with scaling, root planing is considered the “gold standard treatment” for chronic gum disease (periodontitis). Chronic periodontitis is a serious oral health problem that, if left untreated, can lead to tooth and bone loss.
It happens due to the accumulation of plaque around the gum line, which causes inflammation and results in the formation of pockets. These pockets can become deeper and deeper as the problem worsens. It can also cause the following symptoms:
- Bad breath
- Red, swollen and bleeding gums
- Gum recession
- Teeth shifting
- Gum pain
- Exposure of tooth roots
- Loose teeth (even tooth loss)
Once this has happened, it’s not possible to clean the teeth with a simple floss and toothbrush. That’s because it cannot reach the deeper areas of the periodontal pockets. And it’s because of the depth of the gum pockets that the recommended treatment is called “deep” cleaning.
Other than halting the progression of the chronic periodontitis, root planing (together with scaling) will also help you improve the overall aesthetics of your smile (tartar has an unsightly green, brown or black colour). It will also reduce the risk of tooth loss, get rid of bad breath, and, of course, improve your overall oral health.
What’s The Difference Between Regular Cleaning & Deep Cleaning?
Usually, it’s recommended that people get a dental cleaning after every 6 months (twice a year). However, this dental cleaning is different from a deep cleaning. During this regular cleaning session:
- The dentist first performs an oral exam using a small mirror to check the health of the gums and the teeth.
- If there are any plaque deposits, they’ll remove them using a periodontal scaler.
- Following that, the teeth are polished with an electric toothbrush and a gritty prophy paste.
- Teeth are professionally flossed and rinsed with fluoride.
- You might be given a fluoride treatment after that.
This is how regular dental cleaning sessions go. However, when the plaque and tartar have seeped into the area below the gums to the roots of the teeth, regular dental cleaning will not be enough. In that case, you will undergo deep cleaning, which includes scaling and root planing (instead of polish).
Unlike a regular cleaning, you may need to make multiple appointments for deep cleaning, depending on the severity of the problem. It is necessary to stop the deterioration of the jawbone.
What Is Root Planing Procedure?
For a scaling and root planing procedure, the dentist will begin by administering local anaesthesia so that you don’t feel pain and discomfort during the treatment. Additionally, it will make the procedure easier for the practitioner.
After a few minutes, the local anaesthesia will take effect, and the dentist will begin by scraping plaque and tartar from above and below the gum line. This is done using either a handheld scaler or an ultrasonic scaler (another dental tool – curette – is used to clean the area below the gumline as its blunt ends won’t damage the gum tissue).
The latter produces vibrations that separate the tartar from the tooth, making it easier to remove. Once the dentist has cleaned the bottom of the periodontal pocket, they’ll proceed with root planing.
In root planing, a curette is used to remove the bacterial deposits, plaque and some softened cementum. The curette may also use vibrational forces to dislodge the plaque. The rough tooth roots are smoothed out so that they can easily attach themselves back to the surface of the teeth. Also, this prevents bacteria and plaque from getting stuck on the roots again.
Following scaling and root planing, the dentist may perform what’s known as host modulation therapy. In this, certain drugs are injected locally into the gums. And according to the authors of Oral Diseases, host modulation can help:
- Promote wound healing
- Enhance bone formation
- Create new gum tissue
Other than that, it can also help decrease the risk of oral infection. Here, it should be noted that if the gum pockets are too deep, then scaling and root planing might also not be able to clean the plaque properly. In that case, the dentist may recommend gum flap surgery.
As the name indicates, in this procedure, a flap of the gum tissue is pulled back by making incisions. This exposes the tooth roots and the underlying bone, allowing the dentist to thoroughly clean the teeth. Also, if the bacteria have eaten away at your supporting bone tissue, the dentist may perform a bone graft procedure. This is done under local anaesthesia.
How Long Does Scaling And Root Planing Take?
Scaling and root planing procedures can take anywhere between 1-3 hours. The duration of the treatment will depend on the severity of the problem (amount of plaque, depth of the gum pockets, and bone loss). Also, it will depend on the number of additional procedures that you need to undergo.
Here, keep in mind that sometimes dentists recommend performing the treatment in stages, so you will have to come to the clinic multiple times. It will also help ensure that you’re more comfortable during the procedures. You may have to take a few days off work, so you should discuss the recovery timeline with the dentist according to the number of procedures you require.
How Often Do You Need Scaling and Root Planing?
Scale and polish are recommended every 6 months. However, how often you’re recommended scaling and root planing will depend on how advanced your gum disease is.
How frequently you need this treatment can also depend on your age, health status and lifestyle. It’s important that you get yourself evaluated by a dentist, and they’ll recommend a visiting frequency accordingly.
Scaling And Root Planing: What To Expect?
You may temporarily experience the following side effects for a few days following a scaling and root planing procedure:
- Teeth sensitivity (about 1 week)
- Slight bleeding
Your dentist may prescribe you painkillers and antibiotics for the management of pain and to prevent infection, respectively. You may also be advised to use chlorhexidine mouthwash. According to a study published in the Journal of Clinical Dentistry, patients are able to heal better following scaling and root planing if they use a chlorhexidine rinse.
During recovery, you have to make sure that you’re brushing your teeth gently to avoid further damage to the gum tissue. You may also need to avoid extremely hot or cold foods for some time and stick to a soft diet that doesn’t require a lot of chewing. Do not try poking the gums or teeth with your tongue or fingers.
And make sure to not smoke or consume any other tobacco products as it can slow down the healing process. You will have to visit your dentist again so they can examine your teeth and check if you’re recovering normally.
How Much Does Scaling And Root Planing Cost?
In the UK, scale and polish are available on the NHS on Band 1 and Band 2 (includes root planing) for £23.80 and £65.20, respectively. But this is only available if the treatment is medically necessary. So, you can’t get these treatments for preventative purposes.
And if you’re getting the treatment privately, scale and polish would cost you about £110, and root planing can cost you as much as £600 for the whole mouth. In private practice, you’d have to pay separately for the examination, consultation and follow-up, which can cost you £200 or more. Also, keep in mind that you may end up needing additional procedures like bone grafting, which can cost you anywhere between £500 to £2,500 in the UK.
There can be further variations in the price depending on the location of the clinic and the expertise of the surgeon. The cost of scale and polish and root planing (separately) in Turkey starts at £50 and dental bone grafting at £300.
Root planing and scaling are very effective treatments for inhibiting the progress of chronic gum disease. However, once you’ve had the treatment, you must maintain good oral hygiene. That means brushing, flossing and using a mouth wash. Additionally, you should eat a healthy diet and quit smoking for good. You should see a dentist as soon as you notice any symptoms of gum disease to prevent further damage.