Scaling and root planing is the procedure done for the treatment of the periodontal (gum) diseases. This is the most common and conservative treatment in the dentistry. On the teeth plaque, which is the sticky layer made up of bacteria and the food particles get deposited. When this calcifies it is known as calculus or tartar. This provides the rough surface on which the bacteria gets deposited and causes the gum diseases. These gum diseases if left untreated leads to periodontal disease. With scaling and root planing we remove this plaque and then smoothens the root surface so that further deposit does not take place and the gums remain healthy.

Why Scaling and Root Planing Is Done

Now we know that bacteria causes gums and periodontal diseases and the plaque and calculus deposited on the teeth makes the tooth surface rough and provides the substrate for the bacteria to deposit and cause the gum and the periodontal diseases. So scaling and root planing is done to remove the plaque and calculus. Normally it is the treatment for the gingivitis which is caused by the deposition of plaque and calculus but if one has advanced gum disease like periodontal disease and surgery is required, in that case scaling and root planing is done before the surgery.

Preparation

Some patients while getting the scaling and root planing feels slight discomfort like pain and they are anxious. To help them the area in which scaling and root planing procedure has to be carried out is numbed by giving the anesthesia.

Procedure

Scaling and root planing is done with ultrasonic scalers and the hand instruments. The ultrasonic scalers are electric or air powered. They have a scaler or tip which has ultrasonic vibrations and is used to remove the deposits. It also has an irrigation system which keeps the tip cool. The hand instruments are used by hand. They have different shapes and the cutting edges depending upon the tooth surface and the tooth.

    
 Ultrasonic Scaler                                        Hand Scalers and Curettes

When the procedure is started firstly the ultrasonic scalers are used to remove the plaque and the calculus and then the hand instruments are used depending upon the tooth surface and the tooth to smooth the tooth surface so that the further deposit does not take place. These hand instruments are called curettes and the scalers. Some times when the deposit is deep down the gum line and the operator is not able to see it then he has to rely on the sense of touch to see whether the root is clean and smooth or not.

Normally this procedure is completed I single visit but if deposits are more then some times dentist do it quadrant wise. In that case whole mouth is divided into four quadrant two upper and two lower and the periodontist do it in multiple visit.

What to expect after scaling and root planing

After the scaling and root planing one may feel soreness and the sensitivity to hot and cold sensation for one or two days. This is normal. The painkillers available over the counter can help relieving the soreness. You can use antiseptic mouth wash. One can experience mild bleeding for a day or two at the time of brushing but this is fine maximum with in a week. Normal oral hygiene measures like brushing and the flossing should be done regularly even if bleeding is there or the gums are sore or sensitive.

 Risk factors

If the person is suffering from periodontitis there is inflammation and the pockets are formed due to the deepening of the sulcus because of the bone resorption. The scaling and root planing is done to treat the inflammation and if the treatment is successful the gums which are inflamed due to periodontitis, they heal and subsequently they will shrink. The extent of shrinkage depends upon the severity of disease. If it is severe the shrinkage will be more and more tooth surface will get expose. It will expose the root surface also which will be sensitive to hot and cold sensation and for that the dentist can prescribe the fluoride gel and desensitizing tooth paste.

If one is suffering from any medical condition and if it requires antibiotic coverage then it should be told to the dentist before starting the procedure of scaling and root planing.

When to seek the professional help

if after getting the scaling and root planing one has fever or experience acute pain. Bleeding or swelling then one should seek the medical help.

How often scaling and root planing should be done

Scaling and root planing is the routine procedure. To maintain the health of the gum one should get the scaling and root planing done after every six months. If one does not get it done regularly then chances of gum disease like bleeding, pain and the swelling of the gums can be there. So to maintain good oral hygiene and to have healthy gums it is mandatory to get scaling done after every six months.  

 

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