Dental Deep Cleaning (Scaling and root planing)

Dental Deep cleaning also known as Scaling and root planing is the instrumentation of the crown and root surfaces of the teeth to remove plaque and calculus from these surfaces. This is different from a regular teeth cleaning in that it is therapeutic in nature not prophylactic. The Dentist would only prescribe this service if you have periodontal disease. Periodontal disease is a “quiet” disease. Frequently, there is no pain,and patients are often surprised to learn that extensive damage can occur without them ever feeling pain or discomfort.

The recent Centers for Disease Control estimate that approximately 50% of the adult population of the USA has periodontitis which represents a significant increase in the 2000’s over previous reports in the 90’s (Source)


Why are deep cleaning recommended at all, are they even necessary?

We all have a plethora of bacteria in our mouths. Those bacteria mix with other substances to form sticky plaque on teeth, which is mostly banished by regular brushing and flossing.

Plaque will get harden when calcium from saliva and blood settles on it and it will be difficult for you to be able to brush it away. This hardened substance is known as tartar or calculus and it can only be removed with a professional dental cleaning especially in hard/difficult to reach areas of the mouth. When tartar remains on the teeth, new plaque will form on it and that can cause inflammation of the gums, a condition called gingivitis. Gingivitis is only when the gum alone is affected and If gingivitis isn’t cured, it can advance to a more severe form of periodontal disease called periodontitis. Periodontitis is when the bacterial infection has spread to the bone under the gum. Once bone is involved, one way to slow or halt the process of this stages of gum disease is through deep cleaning.


What is Gingivitis:

Characterized by red swollen gums that can bleed easily. It is the inflammation of the gums or gingiva. It commonly occurs because a film of plaque, or bacteria, accumulates on the teeth. A mild form of gum disease, gingivitis can usually be reversed through regular brushing and flossing along with cleanings by a dentist or hygienist.

What is Periodontitis:

Periodontitis, is a common infection that damages the soft tissue and bone supporting the tooth. Tissues become inflamed and starts to pull away from the teeth, forming spaces, or pockets. As the pockets become deeper, more of the tooth below the gum line is exposed to bacteria, which can damage the bone holding teeth in place.Eventually, if the pockets become deep enough, teeth can become loose and may even be lost.


7 Symptoms of Gum disease that might indicate you need Deep cleaning

You may find that you look in the mirror one day to discover you’re faced with common symptoms of gum disease. If this happens, you will need to contact us right away. As you may have already assumed, a deep cleaning is in your future. Symptoms might include:

  • Tender or bleeding gums

  • Red or swollen gums

  • Persistent bad breath

  • Your teeth look like they’ve been getting longer as gums recede.

  • Teeth that are sensitive

  • Loose teeth

  • Pain when chewing

Are there alternative treatments to Dental deep cleaning

Deep cleaning also known as Scaling and Root planing is still the “standard of care’ for the initial phase in treating all stages of periodontal disease, this works for most patients especially at the early stage but sometimes adjunctive therapy options like local delivery of antibiotic under your gum is needed for moderate cases. If the gum disease is at the advance/ late stage, gum surgery is needed after the initial scaling and root planing (deep cleaning ) if there is no contraindicated medical condition.

Does deep cleaning hurt

The simple answer to this is NO. This is because anesthesia would be administered to numb patient before any work is being done. Any pain however will be moderate and before the deep cleaning procedure itself is being carried out. The gum measurements required to diagnose periodontal disease would be the cause of the discomfort because the inflammation that accompanies periodontal disease causes tenderness of the gums. Some patients cannot tolerate the mild stings that accompany pocket measurement. Our Dentist would normally apply a topical numbing gel to reduce the discomforts.

Benefits of deep cleaning

Scaling and root planing offers numerous benefits to patients with gum disease, including:

  • No surgical removal of gum tissue

  • Performed under local anesthesia

  • Minimal to no pain and discomfort after treatment

  • Does not damage teeth and gums

  • Reduces periodontal pocket depths

  • Progressive results after a single treatment
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Deep cleaning teeth before and after


​​​​​​​Can teeth fall out after deep cleaning

Deep cleaning will not remove the tooth’s attachment to the gum and bone.

In some cases, heavy accumulation of hard tartar buildup splints teeth together. This can mask the amount of bone loss and give a false impression of stability. When we remove that buildup, it can expose the looseness that is already present.

Thus, the teeth can feel loose after a deep cleaning. But they are not loosened by the deep cleaning itself.

What to expect during Deep cleaning Appointment

  1. After you’re seated in the dental chair, the dentist will apply a topical anesthesia gel to your gums and then inject a local anesthetic agent to numb your gum.

  2. The Cavitron scaler (a small scraping tool also used in a regular cleaning) or ultrasonic tool is used to remove the tartar and smooth the surface of the root. We use hand instruments with it.

  3. We will prescribe antimicrobial mouthwash to help control bacteria in the mouth using chlorhexidine gluconate solution, which has high substantivity in the oral tissues

If you have been diagnosed with periodontal disease, you will likely need more frequent cleaning and periodontal maintenance appointments than twice a year regular cleaning. Depending on the pocket depth, we may recommend three to four visits each year to maintain good periodontal health.

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How long does deep cleaning take

Typically, Deep cleaning would take about an hour to complete depending on the depth of the pocket. However, with deeper pockets measuring above 7mm, the Dentist might decide to break the deep scaling and root planning procedure down into quadrants of work per appointment. For example, the lower right and lower left of the mouth might be worked on one day, and the other half worked on at separate appointments. This allows for only a part of the mouth being frozen/numb at a time and makes for more manageable, shorter appointments. Usually, we are able to complete the procedure in one appointment here at Keem smile Dentistry Houston TX.


Deep cleaning is prescribed in certain stages of periodontal disease In certain stages where the perio pocket depth (space under the gum) is deeper than 7, the Dentist will refer you to a Periodontist for further surgery apically repositioned flap surgery

How Much Will a Dental Deep cleaning cost me ?

Dental Deep Cleaning costs $100.00 per quadrant here at keem Smile Dentistry Houston TX. There are 4 quadrants of the mouth (upper right, lower right, upper left and lower left.

Periodontal maintenance costs after undergoing deep cleaning cost $75 per visit on every four months or three times a year as the doctor may recommend depending how deep the pocket it.

DO YOU NEED A DEEP CLEANING?

Call today (832-906-6127) to schedule an evaluation with our dentist. We will take intraoral pictures, x-rays and gum measurements necessary to diagnose periodontal disease. If you have periodontal disease, we will discuss your treatment options with you in detail. Because periodontal disease is usually pain free, check up is recommended especially if you have not had a regular cleaning for some time.


Sources:
https://www.mouthhealthy.org/en/az-topics/s/scaling-and-root-planing
https://www.today.com/series/one-small-thing/do-you-need-deep-dental-cleaning-dentists-discuss-t127590
https://en.wikipedia.org/wiki/Scaling_and_root_planing
https://www.medicalnewstoday.com/articles/241721.php