The Reasons for Deep Tooth Cleaning

Deep tooth cleaning is also known as scaling and root planing, and is performed when gum disease is present. There are two main stages of gum disease: gingivitis occurs when plaque and tartar build up and irritate the gums so that they bleed when the patient brushes or eats. If the gum disease goes untreated, the gums can become inflamed and pull away from the teeth to form pockets. Bacterial plaque can start to form under the gum line in these pockets and cause periodontal disease. In more advanced stages, deep tooth cleaning may be a preliminary measure before periodontal surgery.

How Gum Disease Begins

• As plaque builds up below the gum line in pockets, it combines with other minerals in the mouth to form tartar, also called calculus. This substance is hard and rough, clinging to the teeth and roots. It makes it easier for even more plaque to build up in these areas and can further widen the pockets. Without deep tooth cleaning to remove the hard-to-reach tartar, the teeth and roots can also deteriorate. To try to prevent this stage from occurring, a dentist might decide that deep cleaning is necessary.

How Scaling and Root Planing Works

• Scaling is the act of scraping the calculus off the teeth to remove the plaque buildup from the teeth and roots. It is done with a combination of hand instruments and ultrasonic tools. These tools usually consist of a dull-tipped, vibrating component to knock plaque and tartar off the teeth, and a water-based system to cool the area and wash away the loosened particles.

  The scaling process can often leave a rough surface on the tooth, so planing is performed at the same time to smooth the roots and remove any remaining calculus. Smoothing the roots allows the gums to attempt to heal without the potential for irritation. As they heal, the gums will become less swollen and the pockets will begin to re-tighten around the teeth. The ideal space between the gums and the teeth in this case is 1 to 3 millimeters, or 0.034 to 0.118 inches.

Discomfort and Time Investment

• The deeper the pocket, the longer the procedure will take and the greater the posible discomfort. The discomfort depends entirely on the individual patient, and may not be painful at all. Some patients experience only the scraping feeling and no particular discomfort. The dentist or hygienist can recommend methods to ease discomfort.

  Deep tooth cleaning is performed on one-fourth, half or the entire mouth during a visit, depending on the severity of the gum disease and patient preference. The first visit generally takes longer than subsequent visits due to the amount of calculus accumulation, and may be broken down into several smaller appointments.

Follow-Up

• Gum disease can be managed with proper oral hygiene and regular visits to the dentist.

  After deep cleaning, gums may be sore or sensitive to hot and cold for several days. The dentist can recommend over-the-counter painkillers to reduce the pain. Patients can switch to toothpaste for sensitive teeth to help manage the sensitivity. The dentist may also provide an antiseptic mouthwash for use after treatment.

  Unless the dentist instructs otherwise, patients should brush and floss as usual. Minor bleeding may occur for several days while the gums heal. Patients who experience excessive bleeding, swelling or pain should contact the dentist.

  Gum disease does not just go away; repeat cleanings will be necessary at predetermined intervals based on the severity of the gum disease. Damage to the roots is irreversible, but if the gum disease is caught in time, it is easily managed and in some cases, improved.