For patients with periodontal disease, a dentist or hygienist may recommend more advanced types of dental cleanings often referred to as “deep teeth cleaning”. There are actually several procedures that fall into this category. Debridement is a procedure to remove excessive calculus and bacterial deposits beneath the gum line. This is normally used when there is too much buildup to assess the conditions of the gums. If advanced periodontitis is diagnosed, a more advanced deep cleaning procedure called scaling and root planing (aka SRP) may be recommended as a first line of defense. Periodontal maintenance therapy is another procedure that occurs after the SRP to prevent the gum disease from worsening.
For the purpose of this post, we will refer to the SRP procedure as deep teeth cleaning. It is a non-surgical periodontal treatment routinely done by a hygienist, dentist, or periodontist and often used to treat advanced periodontitis. This blog post addresses some common questions that patients routinely ask us regarding the procedure.
What is Periodontitis?
Periodontitis is a complex and multifactorial serious gum disease that causes red, swollen and bleeding gums, bad breath, and sometimes discomfort. If left untreated, periodontitis can lead to the loss of teeth and supporting bone, systemic inflammation, and serious health problems, such as increased risk of heart disease and Alzheimer's. Certain factors increase the risk for periodontitis such as poor oral hygiene, smoking and diabetes.
Why Can’t I Just Have a Regular Dental 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.
What Does a Deep Teeth Cleaning Entail and Is It Painful?
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.
What Should I Expect After Deep Teeth Cleaning?
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.
Can I Have Regular Teeth Cleaning Every 6 Months After Deep Cleaning is Completed?
Regular dental cleaning is done as preventative care on patients with healthy gums and bone level. After scaling and root planing of all affected quadrants is completed, it is crucial that the patient commits to periodontal maintenance appointments every 3 months. The toxic bacteria that cause gum disease re-establish around 3 months after treatment. This re-care schedule disrupts this bacteria replication process. At each visit the patient’s pocket depths are measured and the periodontal status is reassessed and treated accordingly. In addition to regular periodontal maintenance appointments, an excellent oral hygiene routine is a must to promote healing and remission of the periodontal disease status.
For more information on gum disease and deep teeth cleaning procedure, please schedule an appointment online or give us a call. If you are already experiencing early signs of periodontal disease, like sudden bleeding of gums, bad breath or loose teeth, don’t wait to contact our dental office to book your periodontal appointment and get treatment. Our team will be happy to answer any questions and help you improve your oral health and stop the progression of gum disease.