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What is Deep Cleaning (Deep Scaling & Root Planing)?
If plaque and tartar are left on the teeth, it provides the right conditions for bacteria to thrive. The bacteria irritates the gums, which means they bleed more easily. You may notice this if you are brushing your teeth, or eating, and sometimes your gums bleed a bit. This is the early stage of gum disease called gingivitis. If you have gingivitis, your hygienist will clean your teeth by scaling and polishing them. She may also recommend an antiseptic mouthwash containing chlorhexidine and show you how to brush and floss your teeth effectively. Most adults have some degree of gum disease.
If gingivitis is not treated and nothing is done about it, the inflammation will work its way down towards the foundations of the tooth causing a "periodontal pocket". Again, within the confines of the pocket, the conditions are such that the bacteria multiply causing infection that in turn causes the bone surrounding your teeth to deteriorate.
Periodontal (Gum) disease can break down the support (bone) structures of the teeth, so that eventually, they will become loose. The problem is that until it gets quite severe, the person often has no symptoms. Sadly, the damage or bone loss to the teeth is irreversible. The good news is that if periodontal(gum) disease is caught in time, its progression can be halted and stabilized, the active infection is reduced or eliminated: this is the key.
To stop periodontal (gum) disease from progressing, your dentist may advise periodontal therapy, or deep cleaning. This gets rid of the bacteria in the pocket and provides the necessary conditions for healing to occur.
What is the difference between an ordinary cleaning and deep cleaning?
There is some confusion about the difference between scaling and root planing. Scaling is basically the process of removing dental tartar. Root planing is the process of removing tarter, smoothing the root surfaces and removing any infected tissue or tooth structure from the surfaces of the teeth. If you have gum disease or periodontal pocketing, the periodontal pockets around the teeth will have deepened, thereby allowing tartar deposits to form under the gum line.
The two processes tend to blur together since during the cleaning process, the dental hygienist scales away tartar and performs any necessary root planing at the same time. Any roughness can be planed away to result in a silky smooth surface.
Does it hurt?
Depending on the depth of the pocket and severity of the root surface irregularity, the dental hygienist may wish to make the area numb so that the process is comfortable for you. Don't hesitate to discuss with your dentist or hygienist how to best manage any discomfort.
Sometimes if the pockets are not too deep, there may be little or no discomfort during the procedure - even without numbing. The only sensation may be the physical scraping feeling along the teeth as the area is cleaned and smoothened. Our hygienists use Piezoelectric Ultrasonic Scaling, which is more effective and comfortable for the patient, in addition to hand instrumentation. A root planed root surface free of tartar has a better chance of allowing the gum tissues to heal and reattach to it. As a result, some deep gum pockets can be reduced after a deep cleaning.
How long does it take?
Typically with deeper pockets and extensive rough root surfaces, the deep scaling and root planing procedure might be broken down into quadrants of work per appointment. For example, the upper right side of the mouth might be worked on one day, and the three other quadrants worked on at separate appointments. Or alternatively, one half of the mouth (right or left, upper or lower) might be treated per appointment. Our doctor or hygienists may use antibiotic gels within the periodontal pocket to decrease bacteria and may irrigate the pocket with various medications such as chlorhexidine.
We may use laser therapy in isolated areas with deep periodontal pockets to further reduce pocket depth, sterilize the pockets and possibly stimulate some regrowth of bone.
What can I expect afterwards?
Discomfort can vary after root planing, but one can expect it to be tender afterwards since it's usually in a deeper region under the gums.
The teeth themselves can become a bit more sensitive to temperature, and bleeding might occur for a little while.
Over-the-counter painkillers such as Tylenol or Ibuprofen work very well to alleviate discomfort
Brushing and flossing can be done more gently to avoid aggravating any bruised or tender gum areas.
Your dentist or hygienist may recommend salt water or chlorhexidine rinses.
Generally though as health returns to your gums, sensitivity and soreness tend to resolve. Remember though, if diagnosed with periodontal disease, you did not get there overnight and we cannot treat it overnight. If you are faithful with your home care it usually will resolve. Successful treatment is 70% what you do at home to treat the disease and 30% what we do when you come in for treatments. Left alone it will only get worse. If you go through the non-surgical therapy and do not continue with the maintenance therapy the disease will come back again.
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