Scaling and root planing is a nonsurgical procedure that helps remove from the gums and root surfaces many of the irritants responsible for gum inflammation.  It is typically performed with local anesthesia on patients suffering from gingivitis and moderate/severe periodontal disease.  

Reasons for scaling and root planing

Depending on the amount of periodontal destruction from which a patient is suffering, scaling and root planing may be used during the initial stages of therapy or as a stand-alone treatment. 

Here are some reasons why this procedures may be necessary:

• Disease prevention – The bacteria that cause periodontal infections can travel to other parts of the body via the bloodstream.  Lung infections and heart disease have been linked to periodontal bacteria.  Scaling and root planing help remove these bacteria and slow the rate at which periodontal disease progresses, thereby limiting the risk of systemic spread.  
  
  
• Tooth protection – As the space between the roots and the gums ("pocket") increases, the risk of periodontal disease increases.  Periodontal disease, the number one cause of tooth loss in the developed world, is a chronic inflammatory response to the bacteria, calculus and other foreign bodies that occupy deeper pockets.  By cleansing the pocketed areas of the teeth, root planing improves their health and stability. 
  
  
• Aesthetic effects – By removing the irritants from the gum and root surfaces, inflammation is decreased.  This makes the gums appear healthier in color and shape. Superficial stains are also eliminated with this procedure, giving the teeth a cleaner, brighter appearance.  
  
  
• Better breath – One of the most common signs of periodontal disease is halitosis (bad breath).  Root planing eliminates many of the food particles and bacteria that can cause persistent mouth odor.  It also enables better access for cleansing procedures by the patient. 

What do scaling and root planing treatments involve?

Scaling and root planing is performed only after thorough oral, dental and radiographic examinations.  Local anesthesia is used to keep patients comfortable. 

Scaling – Scaling refers to the process of removing plaque, calculus and other deposits from the crown and exposed root surfaces.  Often, ultrasonic cleaners are used, in addition to special hand instruments.

Root Planing – This procedure involves removing the layers of cementum and dentin that are contaminated with bacteria, toxins and tartar.  Clean, smooth root surfaces are a deterrent to reinfection. 

Following these procedures, the gum pockets are often treated with antibiotics.  This will soothe irritation and help the gum tissues to heal quickly.

Following healing, your periodontist will thoroughly examine the gums again to see how well the pockets have healed.  Areas that have responded inadequately may require additional forms of treatment. 

If you have any concerns or questions about scaling and root planing or periodontal disease, please ask your periodontist.