Scaling & Root Planing

Scaling and Root Planing Overview

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Depending on the severity of your disease, an initial stage of treatment for periodontal disease usually includes a thorough cleaning that may include scaling or root planing. The objective of these non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, which cause gingival inflammation and disease. Dr. Noraian can use scaling and root planing as a stand-alone non-surgical treatment or preventative measure, or as an adjunct to surgical intervention. He performs this procedure on cases of gingivitis and earlier forms of periodontal disease when used in a non-surgical application.

What do the procedures entail?

Dr. Noraian will only perform scaling and root planing after a thorough examination of the mouth, which may include taking x-rays and visually examining the mouth. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis, Dr. Noraian may recommend scaling and root planing. In some cases, he will use local anesthesia during the procedure.

• Scaling:
  When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process especially targets the area below the gum line, along the root. Dr. Noraian performs the procedure of scaling using a special dental tool called an ultrasonic or piezoelectric scaler, which usually includes an irrigation process that may deliver water or an antimicrobial agent below the gums to help reduce oral bacteria.

• Root Planing:
  Root planing is performed in order to remove infected cementum and surface dentin that is embedded with unwanted microorganisms, toxins, and tartar. Dr. Noraian will smooth the root of the tooth, which promotes healing, and helps prevent bacteria from easily colonizing in the future.

We may recommend antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Dr. Noraian may place antibiotics in the periodontal pockets after scaling and planing. He does this to control infection and to encourage normal healing in a specific area. Depending on the severity of the disease, we may even prescribe oral antibiotics along with the scaling and root planing procedure.

When deep pockets between teeth and gums are present, it is difficult for Dr. Noraian to remove plaque and tartar thoroughly.  Patients seldom, if ever, keep these pockets clean and free of plaque, which allows for healing by scar formation rather than regeneration. After sufficient healing time, Dr. Noraian will perform a comprehensive re-examination to determine if you need additional intervention with surgery to restore periodontal health

Benefits of Treatment

If treatment is successful, scaling and planing may have many periodontal benefits. One is that it can help prevent disease. Research has proven that bacteria from periodontal infections can travel through the blood stream and affect other areas of the body, sometimes causing heart and respiratory diseases. Scaling and root planing remove bacteria that cause these conditions.

Another benefit of treatment is protecting teeth against tooth loss. Access with your toothbrush and dental floss lessens when gum pockets exceed 3mm in depth, and the risk for periodontal disease increases. As pockets deepen, more bacteria colonize, eventually causing a chronic inflammatory response by the body to destroy gingival and bone tissue. This leads to tooth loss.

Finally, scaling and root planing may make the mouth more aesthetically pleasing, and should reduce bad breath caused from food particles and bacteria in the oral cavity. Dr. Noraian will remove the superficial stains on the teeth during scaling and planing, adding an extra bonus to the procedures.