The objective of scaling and root planing, otherwise known as conventional periodontal therapy or non-surgical periodontal therapy, is to remove or eliminate the etiologic agents which cause inflammation: dental plaque, its products and calculus, thus helping to establish a Periodontium that is free of disease.

Periodontal scaling procedures “include the removal of plaque, calculus and stain from the crown and root surfaces of teeth, whereas root planing is a specific treatment that removes the roughened cementum and surface dentin that is impregnated with calculus, microorganisms and their toxins.

Scaling and root planing are often referred to as deep cleaning, and may be performed using a number of dental tools, including ultrasonic instruments and hand instruments, such as periodontal scalers and curettes.

Removal of adherent plaque and calculus with hand instruments can also be performed on patients without periodontal disease. This treatment would then be referred to as a prophylaxis (a cleaning, although literally it means “prevention”) or a prophy for short. Sometimes this device may be electric, known as an ultrasonic or sonic scaler. At present, there is inadequate research evidence to claim that periodic pre-emptive scaling reduces the incidence of periodontal disease.

Sonic and ultrasonic scalers are powered by a system that causes the tip to vibrate. Sonic scalers are typically powered by an air-driven turbine. Ultrasonic scalers typically use either Magnetostrictive or piezoelectric systems to create vibration. Magnetostrictive scalers use a stack of metal plates bonded to the tool tip. The stack is induced to vibrate by an external coil connected to an AC source. Many ultrasonic scalers also include a liquid output or lavage, which aids in cooling the tool during use. The lavage can also be used to deliver antimicrobial agents.

When periodontal pockets do not heal after scaling and root planning, surgery may be needed to better remove inflamed tissues and reduce the damage to the bone that has formed around the teeth. As the pockets enlarge, they provide a greater place for bacteria to live and attack the bone and tissue.

Surgery allows the dentist to access hard-to-reach areas under the gum and along the roots where tartar and plaques have accumulated. Eliminating the bacterial stronghold and regenerating bone and tissue help to reduce pockets and repair damage caused by the progressing disease.

During the procedure, the dentist turns back the gum tissue and removes tartar and smoothes the roots so that gum tissue can reattach. The gums are sutured back into place or into a new position to make gum tissue snug around the tooth.

Your dentist may recommend additional procedures to regenerate lost bone and tissue. Bone surgery, including bone grafts, is used to rebuild or reshape bone destroyed by periodontal disease. Membranes (filters), bone grafts or tissue-stimulating proteins may be used to encourage your body’s natural ability to regenerate bone and tissue.

Splints bite guards or other appliances may be used to stabilize loose teeth and to aid the regeneration of tissue during healing. If excessive gum tissue has been lost, a soft tissue graft (gum graft) may be performed. A soft tissue graft can reduce further gum recession and bone loss.

Soft tissue grafts can be used to cover roots or develop gum tissue where excessive gingival recession has occurred. During this procedure, gum tissue is taken from your palate or another donor source to cover the exposed root. This procedure can be used to even your gum line and reduce sensitivity. This can be done for one tooth or for several teeth.

After surgery, the dentist may apply a protective dressing over teeth and gums and a special mouth rinse may be recommended or prescribed. An antibiotic and mild pain reliever also may be prescribed. Your dentist may also recommend applying cold packs to the outside of our cheeks to reduce any swelling.