Deep Teeth Cleaning

The initial stage of treatment for periodontal disease is usually a thorough cleaning called scaling and root planing. The objective of this non-surgical procedures is to remove agents such as dental plaque, tartar, and calculus above and below the gumline which cause gingival inflammation and disease. Scaling and root planing can be used as a stand-alone treatment, or a preventative measure. They are commonly performed on cases of gingivitis and moderate to severe periodontal disease.

What is Scaling and Root Planing?

Dr. DarDr. HeffelfingerDr. AbbassDr. PatelDr. ChaudhryDr. CastilloDr. PanDr. Murad, and Dr. Stimpson will only perform scaling and root planing after a thorough examination of the mouth, which includes taking x-rays and and a visual exam. Depending on the condition of the gums, amount of tartar present, depth of the gum pockets, level of bone loss, and the progression of periodontitis, the doctors may recommend scaling and root planing. In some cases, a local anesthesia may be used during the procedure.

An animated illustration showing the process of scaling


When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process especially targets the area below the gum line, along the root. Scaling is performed with a special dental tool called an ultrasonic scaling tool. The scaling tool usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria.

An animated depiction of a root planing procedure

Root Planing:

Root planing is performed in order to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future.

Antibiotics or 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, the doctor may place antibiotic fibers in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.

When deep pockets between teeth and gums are present, it is difficult 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.

Benefits of Treatment

If treatment is successful, scaling and planing may have many periodontal benefits.  Research has proven that bacteria from periodontal infections can travel through the blood stream and affect other areas of the body, sometimes causing conditions such as heart and respiratory diseases. Scaling and root planing remove bacteria that cause these conditions.

Another benefit of treatment is protecting teeth against tooth loss. When gum pockets exceed 3mm in depth, the risk for periodontal disease increases. As pockets deepen, more bacteria are able to colonize, eventually causing a chronic inflammatory response by the body to destroy gingival and bone tissue. This leads to tooth loss.

Finally, scaling and root planing may make the mouth more aesthetically pleasing and should reduce bad breath caused from food particles and bacteria in the oral cavity. Superficial stains on the teeth will be removed during scaling and planing, adding an extra bonus to the procedures.

Periodontal Maintenance

Similar to a regular teeth cleaning, periodontal maintenance removes tartar buildup from the teeth. Unlike a normal preventative cleaning, periodontal maintenance is a treatment prescribed to combat periodontal disease after scaling and root planing has been completed, as tartar should continuously be removed from deep between the teeth and gums.

During a periodontal maintenance appointment, tartar and build up are removed from in-between your teeth and gums down the entire length of each tooth, stopping where the gum, root and bone meet. Your hygienist will carefully monitor the depth of each pocket in your gums and irrigate these pockets with antiseptic medications, if inflammation or infection are present.

Periodontal maintenance appointments only occur after a patient has been diagnosed with periodontal disease and treated with periodontal root planing & scaling. These types of cleanings are usually recommended every three months in order to maintain gum health and eradicate the dangerous bacterial growth that occurs with periodontal disease.