The objective of scaling & root planning is to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus).
These non-surgical procedures which completely cleanse the periodontium, work very effectively for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease.
Scaling and root planning can be used both as a preventative measure and as a stand-alone treatment. These procedures are performed as a preventative measure for a periodontitis sufferer.
Here are some reasons why these dental procedures may be necessary:
Scaling and root planing treatments are only performed after a thorough examination of the mouth. The dentist will take X-rays, conduct visual examinations and make a diagnosis before recommending or beginning these procedures.
Depending on the current condition of the gums, the amount of calculus (tartar) present, the depth of the pockets and the progression of the periodontitis, local anesthetic may be used.
Scaling: This procedure is usually performed with special dental instruments and may include an ultrasonic scaling tool. The scaling tool removes calculus and plaque from the surface of the crown and root surfaces. In many cases, the scaling tool includes an irrigation process that can also be used to deliver an antimicrobial agent below the gums that can help reduce oral bacteria.
Root Planing: This procedure is a specific treatment which serves to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed in order to promote good healing. Having clean, smooth root surfaces helps bacteria from easily colonizing in future.
Following these deep cleaning procedures, the gum pockets may be treated with antibiotics. This will soothe irritation and help the gum tissues to heal quickly.
During the next appointment, the dentist or hygienist will thoroughly examine the gums again to see how well the pockets have healed. If the gum pockets still measure more than 3mm in depth, additional and more intensive treatments may be recommended.
Periodontal disease is a progressive condition which leads to severe inflammation and tooth loss if left untreated. Antibiotic treatments can be used in combination with scaling and root planning, curettage, surgery or as a stand-alone treatment to help reduce bacteria before and/or after many common periodontal procedures.
Antibiotic treatments come in several different types, including oral forms and topical gels which are applied directly into the gum pockets. Research has shown that in the case of acute periodontal infection, refractory periodontal disease, prepubertal periodontal disease and juvenile periodontal disease, antibiotic treatments have been incredibly effective.
Antibiotics can be prescribed at a low dose for longer term use, or as a short term medication to deter bacteria from re-colonizing.
Oral antibiotics tend to affect the whole body and are less commonly prescribed than topical gel. Here are some specific details about several different types of oral antibiotics:
Noticeable periodontal improvements are usually seen after systemic or oral antibiotic treatment. Your Periodontist or dentist will incorporate and recommend the necessary antibiotic treatments as necessary for the healing of your periodontal condition.
Pocket reduction surgery (also known as gingivectomy, osseous surgery and flap surgery) is a collective term for a series of several different surgeries aimed at gaining access to the roots of the teeth in order to remove bacteria and tartar (calculus).
The human mouth contains dozens of different bacteria at any given time. The bacteria found in plaque (the sticky substance on teeth) produce acids that lead to demineralization of the tooth surface, and ultimately contribute to periodontal disease.
Periodontal infections cause a chronic inflammatory response in the body that literally destroys bone and gum tissues once they invade the subgingival area (below the gum line). Gum pockets form and deepen between the gums and teeth as the tissue continues to be destroyed.
Periodontal disease is a progressive condition which, if left untreated, causes massive bacteria colonization in gum pockets can eventually lead to teeth falling out. Pocket reduction surgery is an attempt to alleviate this destructive cycle, and reduce the depth of the bacteria-harboring pockets.
Pocket reduction surgery is a common periodontal procedure which has been proven effective at eliminating bacteria, reducing inflammation and saving teeth. The goals of pocket reduction surgery are:
Before recommending treatment or performing any procedure, the dentist will perform thorough visual and x-ray examinations in order to assess the condition of the teeth, gums and underlying bone. Pocket reduction surgery may be performed under local or general anesthetic depending on the preferences of the patient.
The gums will be gently pulled back from the teeth and bacteria and calculus (tartar) will be eliminated. Scaling and root planing will generally be required to fully remove the ossification (tartar) from the surface of the tooth root. If the root is not completely smooth, a planing procedure will be performed to ensure that when the gums do heal, they will not reattach to rough or uneven surfaces.
The final part of the surgery is usually the administration of an antimicrobial liquid to eliminate any remaining bacteria and promote healing. The gum is then sutured with tiny stitches that are left in place for 5-10 days.
Though the gums will be more sensitive immediately following the procedure, there will be a significant reduction in pocket depth and a vast improvement in the condition of the teeth and gums.
Most people don’t realize that periodontal disease is the leading cause of tooth loss among adults. According to statistics from the Centers for Disease Control and Prevention, one out of every two adults over the age of 30 in the United States has periodontal disease.
You may be surprised to learn that the human mouth is home to a wide variety of microbes. The fact is that over 700 different strains of bacteria have been detected in the oral cavity. Although some of these bacteria are beneficial, others are harmful to oral health. Without proper oral hygiene and routine dental care, these harmful bacteria can cause tooth decay and gum disease, compromising both your oral health and overall wellbeing.
In addition to inadequate oral hygiene and infrequent professional care, other factors, including smoking, genetic tendencies, and unchecked diabetes, can contribute to the escalation of periodontal disease.
Your gums and teeth have an interdependent relationship, which means healthy teeth depend on the support of healthy gums. Also, taking care of your smile does more than keep your teeth and gums in optimal condition; good oral health also supports systemic health. In addition to being the leading cause of tooth loss in adults, researchers are finding more and more links between periodontal disease and a number of medical problems, including heart disease, stroke, diabetes, respiratory problems, and adverse pregnancy outcomes such as pre-term and low birth-weight babies.
If you notice that your gums are bleeding with the slightest pressure while brushing or flossing, it’s a sign of gingivitis. Although gingivitis is the earliest stage of gum disease, it can easily be reversed with deeper cleanings as well as an improved regimen of oral hygiene at home.
In the absence of professional treatment and better home care, gingivitis progresses to the next stage, which is known as periodontitis. In this stage, the connective tissue and bone that hold the teeth in place begin to break down with an increase in pocketing between the teeth and bone, gum recession, and bone loss. Without proper treatment by your dentist, periodontitis will progress from a mild to moderate loss of supporting tissue to the destruction of the bone around the teeth.
Although gingivitis can often be reversed with improved oral hygiene and professional cleanings, as periodontal disease advances, more extensive procedures are required to halt its progression. Based on a complete assessment of your periodontal health and a review of possible contributing factors, our office will recommend the best options in care. Treatment for periodontitis may include a series of deeper cleanings known as root planing and scaling, surgical procedures to reduce pocket depth, bone or tissue grafts, laser procedures, or antimicrobial medications.
The cost of care depends on the type of procedures required to restore your periodontal health. If you have dental insurance, plans often cover treatment to prevent gum disease as well as many procedures to treat the various stages of gum disease. Our goal is to help patients restore and maintain good oral health. We do all we can to help you begin care without additional stress or delay. Our business office works with you to maximize your benefits and provide easier, more convenient payment options.
By seeing our office regularly for care and doing your best to eat a healthy diet and practice good oral hygiene, you can keep your smile in tip-top shape as well as protect your overall wellbeing.
At the office of Maryland Center for Periodontics and Dental Implants, we provide a comprehensive range of services to address all your oral healthcare needs. You can rest assured that your smile is in the best of hands at our office. Our skilled and experienced team maintains a position at the forefront of advances in care and remains dedicated to providing the highest quality of skilled and compassionate treatment.
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