If you develop a severe gum disease called periodontitis, you may need tooth scaling and root planing to remove tartar and treat inflamed gums. These deep-cleaning procedures chip off tartar that hardens to the surfaces of your teeth and roots. The treatments help protect your smile and prevent the loss of teeth, gums and bone.
Scaling and root planing are otherwise known as deep cleaning in dentistry. The procedure gets rid of tartar (hardened minerals) that can adhere to your teeth. You may need these treatments if you have periodontitis (advanced gum disease).
Tooth scaling removes tartar from the surface of your teeth that you see when you smile. Root planing removes tartar from the roots of your teeth below your gum line.
Dentists and periodontists (gum disease specialists) offer these gum disease treatments. The procedure is usually done by a dental hygienist. Tooth scaling and root planing take place during the same dental visit. You’ll usually need more than one appointment to treat all of your teeth.
Close to half of Americans over the age of 30 have some form of periodontal disease. Your risk of developing periodontitis increases as you get older. Nearly 3 in 4 adults over 65 have it.
Risk factors for periodontitis include:
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Periodontal disease usually doesn’t cause pain. Your dentist may diagnose you with periodontitis during a dental check-up. You may also get dental X-rays to look for problems like cavities, an abscessed tooth (tooth infection) and bone loss. If you have periodontitis, your provider will discuss treatment options with you. Tooth scaling and root planing will take place during a future appointment.
This deep dental cleaning goes below your gum line to completely remove tartar from each of your teeth, including their roots. To minimize any discomfort or pain, your provider numbs your mouth with a local anesthetic. You’re awake for the procedures.
Your provider uses a vibrating tool called an ultrasonic scaler to perform the scaling process. These steps may take place during tooth scaling:
Root planing is like tooth scaling except it takes place on the roots of your teeth that sit below your gum line.
During root planing, your provider:
Bacteria and plaque are less likely to stick to the smooth surfaces of your treated teeth. Inflammation decreases as your gums heal. Your healthy gums can reattach more firmly to the smoothed tooth roots.
During follow-up appointments, your provider will measure the pockets surrounding your gum tissue. If the pockets haven’t decreased, you may need periodontal surgery. Surgical treatments for periodontitis include:
The total number of dental appointments you need for scaling and planing depends on the severity of your condition and your provider’s preference. Some providers treat one side of the mouth (both upper and lower teeth) in one visit. You’ll need a second visit to treat the other side of your mouth.
Some providers treat each mouth quadrant separately instead. For instance, they scale and plane only the lower right side of your mouth. At your next appointment, they may treat the upper right side of your mouth. With this treatment approach, you’ll need four appointments.
Studies show that tooth scaling and root planing are effective treatments for periodontitis. They can keep you from losing gum tissue, teeth and bone.
Tooth scaling and root planing can cause temporary discomfort while you heal. But the overall risks are minimal. People with certain heart conditions, like endocarditis, or who have synthetic heart valves may need to take antibiotics before getting any dental procedures. Antibiotics lower your risk of a bacterial infection. Ask your dentist and your cardiologist if you need to take this preventive step.
Your gums may be temporarily swollen and tender after the procedure. You may also have some teeth sensitivity. You should follow your healthcare provider’s instructions for recovery.
You may need to:
Regular dental cleanings help get rid of plaque before it hardens into tartar. But some people are afraid to go to the dentist. If this sounds like you, you’re not alone. Dentophobia (also called odontophobia), or fear of dentists, affects as many as 1 in 3 people. For 10% of people, dentophobia is so severe that they never see a dentist.
The American Psychiatric Association (APA) recognizes dentophobia as a specific phobic disorder, which is a type of anxiety disorder. Seeing a mental health professional can help you overcome this fear. You should also let your dentist know about your phobia. They can take steps to help you feel more comfortable so you get the dental care you need.
A note from Cleveland Clinic
As an adult, you only have one set of teeth. No one wants to risk losing them to advanced gum disease. Thankfully, tooth scaling and root planing can save your smile if you develop periodontitis.
Only a dental professional has the necessary tools and expertise to remove the tartar that causes periodontal disease. But daily brushing and flossing can keep your teeth and gums healthy. To lower your chances of another bout of gum disease, ask your provider to show you how to properly brush, floss and take care of your teeth.
Last reviewed by a Cleveland Clinic medical professional on 08/11/2022.
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