Understanding Root Planing and Scaling

You’re probably familiar with the signs. Perhaps your teeth are sensitive or your gums tend to bleed when you floss or brush. You may be anxious about your upcoming dentist appointment, worried about what news your dentist might have. Could it be gum disease? Does that mean you’ll need surgery?

Try not to worry too much. Even if you're noticing signs of gum disease, such as swollen or bleeding gums, sensitive or loose teeth, or persistent bad breath, there’s a good chance your dentist will opt for a non-surgical solution rather than going straight to surgery. One such common treatment is a combination of two procedures—root planing and scaling—performed by your dentist, hygienist, or periodontist together [source: National Institute of Dental and Cranial Research].

These treatments are essentially a thorough dental cleaning. Scaling involves the removal of accumulated plaque below the gum line, which is done using manual scraping tools or an ultrasonic device. During root planing, your dentist gently smooths your teeth, eliminating rough patches on the surfaces and roots that can attract bacteria [source: University of Maryland Medical Center].

Your dentist has two primary methods to choose from: mechanical, where dental tools are used to manually scrape off debris, and ultrasonic, which uses a tiny vibrating tool to break up plaque and clean your teeth [source: Healthwise]. The ultrasonic technique tends to be less uncomfortable, as it uses rapid side-to-side movements to disrupt and eliminate plaque and bacteria. Often, a combination of ultrasonic and mechanical tools, like dental chisels, are used to clear plaque from beneath the gum line [source: Turchetta].

Although root planing and scaling are generally safe procedures, there is still a slight risk of gum infection. To reduce this risk, your dentist may place antibiotic fibers into your gums, which will dissolve about a week after the treatment. If you're at a higher risk for infection, you may be prescribed antibiotics to take before and after the procedure to prevent bacteria from entering your bloodstream [source: Healthwise].

When is root planing and scaling the right option, and what should you do to care for your mouth once the procedure is complete?

The Importance of Root Planing and Scaling

Your dentist may refer to your gum disease using terms like gingivitis or periodontitis. Gingivitis is the mildest form of gum disease, where the gums become swollen and bleed easily. Periodontitis is more severe, causing damage to the bones that support your teeth [source: Healthwise]. If you have gingivitis, your dentist might recommend improving your at-home brushing and flossing routine, but if you have periodontitis, root planing and scaling can help restore your gums and teeth without the need for surgery [source: Healthwise].

Gum disease can be painful and lead to tooth loss. It’s also associated with an increased risk of other health issues, as it allows bacteria to enter the body, causing inflammation. This triggers the production of a protein that is linked to heart disease and stroke [source: Rohm]. The body focuses its energy on fighting this inflammation, stressing your immune system, which is supposed to protect you from disease.

If your dentist diagnoses you with periodontitis, root planing and scaling are typically the first non-surgical treatments they will suggest [source: American Academy of Periodontology]. Some patients find the procedure painful, while others experience discomfort. Your dentist will apply a local anesthetic to numb your mouth before starting the treatment [source: Healthwise]. This should keep you from feeling any pain, but you may feel pressure from the instruments during the procedure.

Root planing and scaling help combat gum disease in two ways: by eliminating deep plaque beneath the gum line and by smoothing areas on your teeth where bacteria tend to build up [source: NIDCR]. The sooner you begin treating gum disease, the better your chances of addressing the issue without resorting to surgery, and the lower your risk of losing teeth.

After the procedure, your dentist will provide you with post-care instructions. So, what should you expect?

Root Planing and Scaling Aftercare

Root planing and scaling are outpatient procedures, meaning you can head home to relax once the cleaning is done. Though it's not surgery, your teeth and gums will need extra care afterward to support the healing process.

If your dentist used anesthesia, avoid chewing right after the procedure. While your mouth is numb, you risk injuring yourself by accidentally biting your lips or tongue. Your dentist may also recommend over-the-counter anti-inflammatory medications like ibuprofen to help manage pain and swelling [source: Snydman]. If antibiotic fibers were placed in your gums during the procedure, a follow-up visit may be needed to have them removed [source: Healthwise].

Maintaining good oral hygiene is crucial for recovery, so be sure to brush, floss, and use mouthwash to keep bacteria and plaque under control. Your gums or teeth may feel more sensitive during the healing period. If brushing becomes painful, consider switching to a toothpaste formulated for sensitive teeth [source: Snydman].

Root planing and scaling typically require more than one session to complete. Because the deep cleaning process can leave your teeth sensitive, your dentist will treat one section of your mouth at a time. The total number of treatments depends on the severity of your gum disease and your oral care habits, usually spanning three to four visits. Your dentist will schedule your follow-up appointments, typically allowing about a week of recovery between sessions. After the procedure, she will likely suggest more frequent cleanings to help prevent the recurrence of gum disease [source: UMMC].