When is Scaling and root planning necessary?

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Scaling and root planning (sometimes called “deep cleaning”) is the most common procedure for treating periodontitis, or gum disease. During the procedure, dentists use scalers to clean debris off the enamel surfaces of the teeth. Then, they use specially-curved instruments called “curettes” to remove calculus and other diseased tissue that accumulates on root surfaces in periodontal pockets beneath the gum line. That’s the root planning part. Removing calculus and debris from root surfaces that have periodontal pockets allows the gums to reattach to the root surfaces and helps stop the progression of gum disease and damage.


Healthy gum tissue forms a tight seal around each tooth just below the visible gumline. There is a small space called a “sulcus” between the top of the gums and where they attach to the tooth, just below and on the inside of that gum crest. For reference, the sulcus is where popcorn husks usually get stuck. In healthy gums, the sulcus is only 1 to 3 millimeters deep. When gums become inflamed because of gingivitis, however, they swell and pull away from the teeth. This swelling enlarges the sulcus and creates a bigger space between the teeth and gums. Even more bacteria and plaque get into that space, which leads to the gums pulling away from the tooth root.

If left untreated, this process continues. Eventually, the bacteria and acids in plaque deepen the space between the gums and teeth into a deeper hole called a “periodontal pocket.” Toothbrushes and floss can’t reach deep enough to clean periodontal pockets, so the bacterial plaque inside them transforms into hardened calculus. Calculus accumulation in a periodontal pocket causes all kinds of problems, including periodontal bone loss and tooth loss.

The only way to reliably remove calculus from periodontal pockets is to have your dentist perform a scaling and root planning operation. Scaling and root planning completely removes built-up calculus, bacterial plaque, and other diseased tissue from the periodontal pockets. Root planning smooths out root surfaces and helps the gums re-attach to those root surfaces. If you have gum disease, scaling and root planning is probably the first procedure your dentist will recommend.


Your dentist will recommend scaling and root planning if they diagnose that you have sulcus pockets deeper than 3mm. Your dentist measures these pockets with a probe during a regular dental exam. He or she can also locate calculus inside periodontal pockets using x-rays. If you have any of the following symptoms of gum disease, you should see your dentist right away:

  • Bleeding gums (a sign of an ongoing oral infection)
  • Swollen gums
  • Red, sensitive gums
  • Pain when brushing or flossing
  • Gum recession
  • Gum discoloration
  • Tooth pain
  • Constant bad breath, no matter how much you brush or use mouthwash

As always, the best way to figure out if you need scaling and root planning is to ask your dentist. They’ll be able to identify the cause of your symptoms and recommend the best solution. If you’re worried about gum disease, schedule an exam immediately.

What happens during the procedure for Scaling and Root Planning? 

The Scaling part of the procedure involves removing plaque and debris from these gum pockets. The hygienist will clean in and around your gumline to remove all built up bacteria and plaque. Once the deep cleaning has occurred, the root planning part of the procedure happens. This is when the hygienist will smooth the root surfaces which will allow the gums to properly reconnect and attach to your gums. Regular scaling and root planning help to prevent the progression of gum disease and to keep the teeth healthy. If you have periodontal disease, it is imperative that you come in for regular deep cleanings.

What are the Benefits of Scaling and Root Planning? 

If you maintain good dental care after the procedure, the progression of gum disease should stop, and your gums will heal and become firm and pink again. In most cases, if you have taken care to brush and floss properly, your gums will have begun to heal.

Typically, the deep cleaning process is highly successful if the patient is diligent about maintaining his or her periodontal health after the procedure has been completed. If the patient is diligent and the condition of the gumline and teeth was not too severe, the likeliness of long-term effectiveness is extremely high.

While the healing of tissue begins immediately after the procedure, patient diligence is also paramount in ensuring the potential periodontal disease process is not accelerated. If a patient is not consistent about his or her dental health, additional procedures may be required.

The Risks of Root Planning and Scaling

While root planning and scaling is not a high-risk procedure, there is the potential for additional infection in the gums once completed. A common practice for dentists to prevent this infection is to insert antibiotic fibers into your gums, which are removed within a week or so after the procedure. If a patient is particularly prone to infection, a dentist may prescribe additional antibiotics after the procedure. Additionally, if you have an impaired immune system in any way, additional antibiotics will be prescribed once the procedure has been completed.

What Happens After Scaling and Root Planning?

Once the dental scaling and root planning is done, you can simply go back home. You only have to return for dental deep cleaning on a regular basis so that the dentist can continue removing all of the accumulated plaque and tartar.

When you return for a dental cleaning appointment after your scaling and root planning, the dentist will make sure that your gum pockets have healed properly. You won’t need any more root planning if your gums are pink and healthy. However, if the dentist finds that the gum disease continues to spread, they may recommend some more advanced surgical treatments.

If everything is healthy, the dental hygienist will simply use the scaling procedure to remove accumulated plaque again and disinfect your mouth with a fluoride solution rinse.

Aftercare Instructions 

There are little things you can do to help with any of these symptoms. Here are a few tips:

  • Eating: Avoid chewing hard foods such as meat and vegetables or candy for a few days. Try soft foods until the discomfort fades and you can chew again
    without pain.
  • Discomfort/Pain/Sensitivity: Try taking an over the counter pain reliever such as Acetaminophen to reduce discomfort. If you experience tooth sensitivity try using a desensitizing toothpaste.
  • Oral Hygiene: If the tissue in your mouth is tender, try brushing more gently. Don’t stop brushing. After 4 days you can and should resume your normal oral hygiene. You should also try adding a mouth rinse to your hygiene routine for one to two weeks. Consider an antimicrobial rinse, or a warm saline rinse.

Cost of Scaling and Root Planning Procedure

The cost of scaling and root planning procedure depends on the extent of the bacterial infection. 


Does Repeated Scaling Damage our Teeth?

Seeking scaling procedures twice a year is perfectly healthy and it will only remove the accumulated plaque and tartar without affected your tooth surface. But you shouldn’t seek scaling more than is recommended by the dentist because that may lead to the wearing-away of enamel.

Does root planning and root scaling hurt?

Although this is traditionally an invasive procedure, recent technological advancements have given dentists the option of using an ultrasonic tool to complete the root planning and scaling procedure. Since this form does not require the type of digging and sanding that the traditional form includes, this tool relieves a considerable amount of discomfort a patient experiences during the procedure, but is only required in special circumstances.

Root planning and scaling is far less invasive than gum surgery, which has been a relief to many patients fearing potential surgeries for their condition. Root planning and scaling essentially consists of sanding your teeth, which will remove any rough spots on the roots of your teeth that may be hosting a large amount of bacteria.

How long does it take? 

Initial treatment is focused on scaling and the use of small instruments to remove the tartar. Then, the laser portion of the treatment is performed and normally only takes a few minutes. Depending on the severity of the patient’s periodontal disease, treatment may be accomplished in one office visit or in multiple visits. The estimated treatment time is reviewed with patients when the doctors discuss their treatment plan.

How to Avoid Scaling and Root Planning?

It is possible to avoid the need for deep cleaning and other periodontal treatments by following a proper oral health care routine. Besides brushing and flossing each day, regular dental check-ups are advised. When a person is unsure about the correct way to keep teeth clean, a dental hygienist will be happy to explain the best process.

Scaling and root planning are two procedures that prevent tooth loss. It is never too late to begin a better oral healthcare regime. The experts at Hoffman Dental want to help patients keep teeth healthy and beautiful. They educate patients and bring empowerment through effective services.