Deep Teeth Cleaning

There are some differences between a routine dental cleaning and scaling and root planing. The goal of the regular dental cleaning (known as adult prophylaxis) is cleaning of teeth at and above the gum line and prevention of periodontal disease on patients with healthy gums. The goal of scaling and root planing is therapeutic and its purpose is to treat an already established condition or disease and remove plaque, tartar, and bacteria below the gum line. If it is determined that you have buildup below the gum line then you need a deep cleaning since regular dental cleaning will not help in such case.

Typically, a hygienist cleans the teeth above the gum line every 6 months by removing plaque, calculus (aka tartar), and stain. However, if the pockets between the gums and teeth are deep and infected, scaling and root planing is beneficial because the excessive plaque, calculus, and harmful bacteria are removed from above and under the gum line and deep into the infected pockets. This will stop the spread of the disease.

The procedure is performed in two separate appointments where one side of the mouth is treated at a time. The removal is performed with hand scalers including an ultrasonic scaler that uses high frequency vibrations and water to separate the calculus from the teeth to create a smooth surface to prevent bacteria from attaching. In addition, a dental laser is used as part of scaling and root planing to provide bacterial decontamination, collagen repair, and regeneration of the gums. Finally, an antibacterial irrigation of the gums is performed to flush out any remaining debris.

The clinician will also provide the patient with oral hygiene instructions and nutritional counseling and, if necessary, local, or systemic antibiotics. The patient will be sent home with prescription strength fluoride toothpaste called Prevident and a prescription antimicrobial rinse called Chlorhexidine. The patient is advised to swish the solution for 30 seconds and then spit it out and wait at least 30 minutes before eating or drinking. It is important not to use the rinse longer than 7-10 days as it may temporarily stain the teeth. Additionally, it is recommended to avoid eating seed-like foods (seeds and nuts, popcorn, chips) and dense/chewy foods (steak, bagels) for 24-48 hours. To ensure that the patient is comfortable, local anesthesia is administered in the treated quadrants at each appointment.

You may have some mild discomfort immediately after the anesthesia wears off. This should subside within a few hours. NSAIDS such as Ibuprofen can be taken if necessary. Some patients’ teeth may be sensitive to temperature changes as well because after the procedure the gums tighten as they heal and expose the root surface in areas where bone loss has already occurred. Fluoride application is a great way to reduce tooth sensitivity and prevent root surface decay in areas of recession, which is why it is important to use Prevident toothpaste regularly and do not rinse, eat, or drink for 30 minutes after. Some of the many benefits you should expect after scaling and root planing are less bleeding and less swelling of the gums when brushing and flossing. Additionally, the mouth will taste and feel better.