Scaling and Root Planing
Scaling and root planing (also referred to as a deep cleaning) is a careful cleaning of the root surfaces to remove plaque and calculus (tartar) from deep periodontal pockets and to smooth the tooth roots to remove bacterial toxins and make it more difficult for plaque to accumulate along the root surfaces. When performed properly, scaling and root planing can reduce gingival inflammation and probing depths, and can shift the bacterial composition living in the pockets from one associated with disease towards one associated with health. It is considered an active treatment for periodontitis and the results of the therapy should be assessed for success at some point after adequate time for healing has been allowed. For those patients who achieve periodontal health following scaling and root planing, ongoing maintenance therapy is necessary to sustain health.
After scaling and root planing, many patients do not require any further treatment, however; nonsurgical therapy does have its limitations. Areas that have not responded favorably to scaling and root planing (continued to show signs of periodontal disease) may require further treatment. Multiple studies in the periodontal literature have shown the limitations of effectively scaling and root planing in a pocket greater than 4 millimeters in depth. Because of the complex anatomy of the root surfaces below the gum line, scaling and root planing is a much more demanding procedure than a prophylaxis. It is often necessary to perform the scaling and root planing treatment over the course of more than one appointment and with the adjunctive usage of local anesthesia so that a thorough job to be performed in a comfortable manner for the patient.
A reevaluation should be performed following adequate time to respond to your active treatment of periodontal disease. For areas that continue to exhibit signs of periodontal disease, further active therapy may be indicated. Treatment options available included continued nonsurgical therapy, laser periodontal therapy, periodontal surgical therapy, dental implant therapy, or a combination of each. If any of these treatments are indicated a Peridontist may be enlisted to anticipate your expected response to various treatments available for management of your periodontal condition. We are proud of our abilities to be a patient advocate and provide guidance for what we feel is most appropriate treatment while respecting your right to know about alternative treatments their risks and their benefits.
Periodontal maintenance is a specialized program developed for each patient once periodontal health has been improved. These appointments tend to be more thorough than traditional six-month cleanings. They are designed to prevent periodontal disease from occurring in patients who have undergone treatment for periodontitis or dental implant therapy. This ongoing phase of treatment will allow Dr. Belton and his hygienists to assess your periodontal health and make sure infection stays under control. Periodontal diseases are chronic diseases, just like diabetes. Without careful, ongoing treatment, periodontal diseases can and often do recur.