The Purpose of Scaling and Root Planing

Scaling and root planing, also called conventional periodontal therapy, is a non-surgical process of deep cleaning that aims to remove dental plaque and tartar/calculus and also planing or smoothing the roots' exposed surfaces. This latter process helps to prevent further inflammation, gum disease, or periodontitis by removing dentine or cementum that is usually filled with toxins, microorganisms, and tartar. An examination of your gums and teeth at the Downey Dentist can quickly help you make a decision on how to protect you from gum disease.

Plaque and How It Leads to Gum Disease

Plaque is a sticky, soft film that constantly builds onto your teeth. Plaque is harmful because of the bacteria that it contains, which cause your teeth to decay and lead to gum disease if not treated properly through regular brushing and flossing.

These bacteria in the plaque produce acids from your food that destroy the enamel on your teeth.

Play can harden and turn into tartar if not properly removed by daily cleaning methods of brushing and flossing. If you allow tartar to build-up and collect at your gumlines, making it more difficult to brush and floss your teeth.

As this build-up continues, the bacteria, plaque, and tartar make your gum tissue red and swollen, which can make them bleed while brushing your teeth. At this point, your gums likely have gingivitis, which is a beginning stage of periodontal gum disease. The term gingivitis comes from the medical term gingiva, meaning gums, so gingivitis is the inflammation of your gums. While this sounds bad, gingivitis can be treated and reversed through personal and professional oral care.

Nonetheless, if the gingivitis is left untreated, it can worsen and cause periodontitis. This latter, more severe stage of gum disease is a bacterial infection that causes a breakdown in your gums as well as the bones that support your teeth.

If you have detected the early stages of gum disease, then a professional cleaning by a dentist as well as diligent oral hygiene care will take care of the problem. However, you might need scaling and root planing if the structures below your gumline have been damaged.

In 2015, the Journal of the American Dental Association found that for those with chronic periodontitis, or severe gum disease, the treatment of scaling and root planing can improve their oral health. With almost half of the adult population over 30 years old in the US having chronic periodontitis, root planing and scaling would benefit millions of patients.

Periodontitis (Gum Disease)

As previously discussed, bacteria and plaque build-up cause gum disease or Periodontitis. While these bacteria are natural in your mouth, certain conditions can let the bacteria become harmful to your health. This can occur due to a lack of proper brushing and flossing practices. If left alone, these harmful bacteria will grow, multiply, and produce dangerous by-products that will activate your body's natural defense response to inflame your gums. This inflammation will lead your jaw's bone to be destroyed if you let the disease progress and eventually lead to tooth loss. Thankfully, this is a process that develops over a long period of time, typically many years, so it can be detected before permanent damage occurs. However, in certain cases for young adults, an active condition of periodontitis can cause premature loosening and loss of teeth.

To prevent serious damage to your teeth and gums, it is important to be aware of the signs and symptoms of the disease. One early sign that you might notice is that your gums bleed while brushing your teeth. You might also notice that your gums look swollen and red. Your teeth might also look discolored due to a layer of plaque build-up on your teeth.

Depending on the stage of gingivitis or periodontitis, your dentist may advise utilizing different techniques; however, most cases can be resolved with scaling and root planing.

The Scaling and Root Planing Process

This process of deep cleaning contains two steps. First, your dentist or hygienist will remove all plaque build-up and tartar, or hardened plaque, both your gumline and below. This process, called scaling, is done to ensure that your teeth and gums are completely clean even down to your gum's pockets. The idea behind this first step is to provide an environment that is biologically compatible between your teeth and periodontal tissues that surround them.

The next step is for your dentist to carry out the root planing process, which consists of smoothing out the roots of your teeth to prepare your gums to grow back properly and reattach themselves onto your teeth.

This thorough cleaning process can take multiple sessions with the dentist, and frequently requires the use of local anesthetics to mitigate any pain.

Follow-Up and Caring For Your Teeth and Gums After the Cleaning

After the scaling and root planing cleaning process, you may experience sensitivity or pain in your teeth for up to two days. Your gums may also feel tender, swell up, and even bleed. A mouth rinse or a prescription medicine recommended by your dentist can help prevent an infection of your gums, help them heal, or control the pain. Your dentist might use oral medicine (subantimicrobial-dose doxycycline) inserted into your gum's pockets to help with the healing process as well.

A follow-up appointment with your dentist should be scheduled to check up on your gums and pockets and how they've healed. If your pockets have deepened, further treatment may be needed. For most patients, the swollen or red gum tissue will become pink and firm again meaning that they are healthy. If this is the case, bleeding of the gums is usually reduced or even eliminated completely. The pockets between the teeth and gums will also get smaller.

In certain advanced cases of periodontitis, surgical intervention may be required after the root planing and scaling procedure in order to stop further bone loss from occurring. However, having gone through the scaling and root planing process will typically help reduce the amount or need for surgery.

You must maintain quality dental care in order for your gums to recuperate and stay healthy. If you don't clean your teeth and gums properly at home, then the gum disease could become chronic and more serious. Twice a day, you should brush your teeth and floss between your teeth at least once a day. We also recommend that you eat healthy foods with fewer sugars, avoid the use of tobacco, and schedule visits with your dentist on a regular basis. Here are seven specific ways you can maintain healthier gums and prevent gum disease in the future:

  • When you brush your teeth, do so for two to three minutes using a toothpaste with fluoride. Make sure you brush along your gumlines as well as your tongue and inside your cheeks. These are places that people often forget to brush and can be filled with bacteria.
  • Flossing once a day removes plaque from hard to reach places for your toothbrush. Please check out the Downey Dentist’s page on dental cleaning for more detailed tips on brushing and flossing.
  • Mouthwash can be used in addition to flossing and brushing and has been shown to reduce plaque build-up by 20 percent.
  • Cigars, cigarettes, and even smokeless tobacco can lead to unhealthy gums, gum disease, and possibly oral cancer. We encourage you not to begin smoking, but for smokers, find help to reduce or eliminate your consumption.
  • Certain medications such as antidepressants, heart medicines, and oral contraceptives can exacerbate gum disease. Consult with your doctor and dentist to find out how your medications affect your gum health.
  • Regular checkups with your dentist are the best way to detect beginning signs of gum or periodontal disease. While seeing your dentist, ask them to correct issues, including faulty fillings, teeth grinding, and crowded teeth. Consult your dentist regarding your gum health at each visit. Your dentist may suggest a personalized hygiene program to fit your needs.
  • A healthy diet is an essential pillar to maintaining healthy gums. The following section will discuss which foods harm your gums and teeth (such as sugary and starchy foods) as well as which ones help your gums stay healthy.

Food and Drinks that Affect Gum Health

We've already discussed the need to brush your teeth twice a day, floss daily, and to visit a dentist regularly, but let's look at what foods and beverages you can reduce or eliminate in consumption to have a healthy mouth. You can work to prevent further procedures or needing scaling and root planing in the first place by maintaining good hygiene and diet habits. Beginning with your food and beverage consumption, let's look at what you can avoid putting in your body that could lead to gum disease. Many beverages and foods can lead to plaque build-up, especially those containing sugars. Bacteria-filled plaque feeds and grows on the sugars that pass through your teeth. These bacteria not only cause cavities to your teeth but also weaken your gums.

Two obvious ones are sour candies and carbonated drinks such as soda. Sour candy often contains more acids that are worse for your teeth than other candies or snacks that you can find. Also, the fact that they are chewy and stick to your teeth for a long time makes them more dangerous for your teeth and gums. Dark chocolate in moderation can be a good sweet alternative because you can chew it and wash it away from your mouth easier.

Carbonated sodas serve as food for the plaque on your teeth, which turn into tartar and can lead to gum disease. The plaque also turns the soda into acid, which destroys tooth enamel leading to tooth decay. However, if you do drink soda, don't immediately brush your teeth as this can quicken the decay.

Soda also dries out your mouth, and the lack of saliva can lead to gum disease, tooth decay, and more oral infections. Alcohol also has the same effect of reducing the saliva in your mouth and causing these oral problems. Saliva is so important because it flushes out plaque and bacteria that stick to your gumline. Reducing soda and alcohol consumption as well as drinking lots of water to keep your mouth hydrated will reduce the likelihood of gum disease.

Potato chips are a common snack that can lead to gum problems and the need for scaling and root planing. The starch that potato chips contain turn into sugar, which the bacteria in plaque feed on. Just like chips, bread turns into sugar in your mouth, which can cause these same problems. Less-refined bread such as whole wheat has fewer sugars added, so they don't break down as easily into sugar.

While it can be hard to avoid a lot of these tasty foods and beverages, there are plenty of other great ones that are healthy for your gums. To battle against the bacteria and reduce plaque build-up, try incorporating more of the following foods in your diet.

Microbial properties in onions target and naturalize many types of oral bacteria that lead to gum disease. Leafy greens such as spinach and kale contain many minerals and healthy vitamins for your mouth including vitamin C. The vitamin C contained in leafy greens increases your body's production of red blood cells as well as reduces inflammation of your gums and fights against gum disease. The high amount of chewing required to consume leafy greens makes more saliva, which keeps your gums healthier.

Antioxidants in green tea have been known to prevent inflammation generally throughout the body. The specific catechin antioxidants found in green tea target one type of oral bacteria that leads to gum disease. There is also evidence to show that catechins help prevent bone resorption, meaning that they prevent bone tissue in your mouth from breaking down. A daily cup of sugar-free green tea can lead to healthier gums.

The high amounts of Vitamin C found in peppers, sweet potatoes, kiwis, oranges, strawberries, and pineapples are natural anti-inflammatories, which means healthy gums. However, eat them in moderation as sugars, starch, and acids found in many of them are dangerous for your oral health.

The antibacterial compound Lentinan that is found in shiitake mushrooms fights against the bacteria-filled plaque in your mouth. Eating shiitake mushrooms both raw and cooked can help prevent bacteria build-up in those hard to reach places between your teeth and gums.

Crunchy and healthy foods such as celery, apples, pears, and carrots scrape both plaque, and excess food stuck on your teeth. These fiber-filled foods find themselves in the crevices between teeth and gums, so they help you maintain a fresh mouth between brushings. Crunchy and chewy vegetables and fruits such as these aid your mouth produce more saliva, which as we’ve discussed helps flush out the harmful bacteria build-up in your mouth before it turns into plaque or tartar.

If you are able and want to consume dairy products, the calcium and casein found in them can lead to healthier teeth and gums. It is well known that dairy due to calcium strengthens your bones and thus your teeth, but the casein in many dairy products is also very beneficial to gum health. Casein can neutralize the oral acids produced by oral bacteria, which attack the gum tissue and tooth enamel. Eating or drinking milk, cheese, or yogurt in moderation can be very healthy for your oral health.

Consult with your dentist and physician to best introduce healthier foods into your diet in a balanced way while also reducing the intake of harmful foods and beverages.

If You Have Gum Disease, Scaling Option Is the Best Option For You

A 2012 study published by the National Center for Biotechnology considers the scaling and root planing treatment to be the universal 'gold standard' for those with chronic gum or periodontal disease. The Journal of the American Dental Association confirms the benefits of the procedure in a 2015 meta-analysis review stating that scaling and root planing reduce the risk of gum further gum disease by closing the gap between the gums and teeth by an average of 0.5 millimeters. By closing the size of these pockets, patients are much less at risk for loss of gum tissue, bone, and teeth.

Not only are the scientifically proven benefits of the treatment significant for patients of scaling and root planing, but the risks are very minimal as there is no surgery involved for most people. In order to prevent possible infection of the gums, your dentist might prescribe you an antibiotic mouthwash.

Contact the Downey Dentist Near Me

It is best to make regular appointments with your doctor to check on your gum and tooth health. If you are experiencing inflamed, irritated, or sensitive gums, take the time to schedule an appointment with a dentist. Catching gum disease or periodontitis at an early stage before you need scaling and root planing or a more serious procedure. To make an appointment for an examination, you may contact the Downey Dentist by calling our office at 562-746-0350.

We have other convenient locations near you: Los Angeles Dentist, Lomita Dentist, Carson Dentist, Hawthorne Dentist