Scaling & Root Planing

In most cases, the initial stage of treatment for periodontal disease is Initial Non-Surgical Therapy, or scaling and root planing. This procedure is performed by one of our dental hygienists, all of which have extensive experience in treating patients with periodontal disease.

Almost always, a local anesthetic is given by the doctor using a gentle technique to anesthetize, or numb, the gum tissues during the procedure. One of our hygienists then uses special instruments to remove the calculus (tartar) and plaque that have attached to the root surface, especially targeting the areas below the gum line that cannot be reached via normal means. The tooth roots are smoothed in order to remove any embedded unwanted bacteria and toxins, which promotes healing, gum re-attachment, and also helps prevent bacteria from easily colonizing in the future.

Occasionally an irrigation process is used to deliver an antimicrobial agent below the gums to help reduce oral bacteria. Antibiotics or home 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, your hygienist may place an antibiotic in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.

An animated illustrion showing the process of scaling
An animated depiction of a root planning procedure

Even in the most severe cases of periodontal disease, non-surgical periodontal therapy often precedes surgical therapy. This is done so that the overall tissue health is improved prior to surgery and to limit the areas requiring surgery.

When deep pockets between teeth and gums persist, it is difficult for our doctors, your restorative dentist, your hygienist, or you 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 if non-surgical treatments are not entirely effective.

Periodontal Maintenance (also called Supportive Periodontal Therapy, Periodontal Recalls or Periodontal Cleanings) is a procedure that is performed to remove bacterial plaque and calculus (tartar) from above and below the gumline in patients who have been previously treated for periodontal disease. Anyone with a history of periodontal disease is susceptible to disease recurrence and progression, so periodontal maintenance is the most important factor in keeping the gums healthy and preventing tooth loss. Diligent oral hygiene is also extremely important, however even patients with excellent oral hygiene still cannot effectively remove plaque in areas where pockets may persist.

Periodontal maintenance is performed by one of our hygienists, and typically takes one hour or less. Dr. Suttle or Dr. Pierce also performs an examination during this appointment, and a report is sent to your general dentist detailing our findings.

The frequency of Periodontal Maintenance is dependent on each patient. Some patients build up plaque and calculus more frequently than others, and the greater the number of other risk factors present (such as smoking, diabetes, etc.) the more frequently they need to be seen. Typically patients are seen every 3-4 months, and usually alternate their Periodontal Maintenance between our office and their general dentist’s office.