Gum Therapy (Scaling and Root Planning)
Periodontal scaling procedures include the removal of plaque, calculus and stain from the crown and root surfaces of teeth. Root planing is a specialized skill involving scaling of the root of the tooth. Scaling and root planing is an important part of stopping progression of periodontal disease, especially once deeper pockets have formed in the gums, which is really in the bone. Thus root planning is a specific treatment that removes plaque, calculus and stain of the surface dentin that is impregnated with calculus, microorganisms and their toxins.
Because in periodontal disease pockets form that are deeper than the usual gingival depth, such scaling and root planing are often referred to as Gum Therapy (deep cleaning), and may be performed using a number of dental tools, including ultasonic instruments and hand instruments, such as periodontal scalers and curettes.
Scaling and root planning is considered the basic treatment of periodontal diseases and may be the only treatment required to treat mild cases of periodontitis; however, it may also be the initial therapy prior to future surgical needs. For the procedure to be considered effective, the patient must be able to be maintained at a level of periodontal health that will prevent re-infection with periodontal pathogens. This requires optimal home care and ongoing periodontal maintenance therapy with you dental hygienists, usually every three – four months to sustain health.
It is effective only when certain conditions are fulfilled. A complete removal of calculus from the periodontal pockets using hand and ultrasonic instruments is done by your dental hygienist. The depth of the pocket, when identified by the probe, exceeds more than 3mm then calculus removal becomes more insufficient. The maximum access of a probing instrument is up to 6mm, any calculus beyond that can’t be reached. If there is calculus exceeding more than 6mm, then scaling and root planing are ineffective and the best treatment option in such cases will be surgical access for complete pathogen and calculus free area.
The probing depth and methods affects the success of the procedure, and factors like root grooves, concavities, and furcation involvement may limit visibility of underlying deep calculus and debris. In severe periodontal disease where there is a systemic involvement, scaling and root planing are insufficient and surgery is required. Scaling and root planing are ineffective in cases where tooth mobility is severe; such conditions require periodontal surgery and placement of bone grafts.