Periodontics & Dental Implants
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Root scaling and planning is a non-surgical procedure for removing plaque and dental calculus from the mouth. These substances adhere to the teeth as sticky or hardened residues and are the result of bacterial colonies under the gums. If these plaques and bacteria are not removed frequently they can produce acids which promote tooth decay and gingivitis. Root scaling and planing is a most effective way to treat gum disease before it becomes severe and chronic. It is also a usual first step in treating more advanced periodontal disease.

Root scaling and planing provides a much deeper effort than a standard teeth cleaning and is very often performed by a dental hygienist. The hygienists at Century City Periodontics are very skilled in this procedure.


The Procedure
Root scaling and root planning employ slightly different techniques and are usually used in combination. Both are of great value in combating periodontal disease from gingivitis to advanced periodontal disease.

Root scaling is generally performed with local anesthesia and involves cleaning the teeth below the gum line. The dental plaque (tartar) is carefully and firmly scraped away. In root planing the dentist or hygienist uses instruments to smooth the tooth's root surface which has become roughened from the disease process. This can help promote reattachment of the gum tissue and lead to a healthier mouth. In most cases the treatment will consist of four separate appointments to treat each quadrant of the mouth.

After scaling and root planing are completed the periodontist will re-evaluate the patient's gingival condition and together they will discuss and decide on any further treatment. Our team of professionals at Century City Periodontics in Los Angeles is highly qualified to guide our patients through the appropriate treatment planning for their individual situations.



 
This is severe plaque and calculus accumulation.   Tissues will respond to the accumulation by becoming inflamed swollen, red and bleeding.

 
Note the bone levels (unaffected) with Calculus accumulation.   Bone will recede if the teeth are not cleaned. The tissues will swell even more. Supra and sub gingival Calculus will remain.

   
Ultrasonic scaling instruments can dislodge the Calculus that is attached to the teeth. These instruments are excellent for calculus above the gums. Hand instruments can be used to remove the sub gingival calculus.    



 
Hand instruments have a better tactile advantage over ultrasonic instruments. There may sill be some stains left on the teeth after using the hand instruments.   The teeth can then be polished using a polishing cup and a polishing medium. The unique shape of the cups will allow it to polish teeth above and partially below the gums.

 
Even if the teeth have been perfectly cleaned the tissues will become inflamed if the pocketing is 4 mm or greater. Plaque will be firmed within 24 hours and the tissues will not have a chance to heal. The toothbrush cannot clean deep pockets.   A deep pocket is not a good situation for health and the tissues may respond to correct this on their own once they are not irritated by the plaque and Calculus deposits.

   
 The gums shrink and in turn decrease the pocket depth. Now the pockets and teeth can be maintained by the patient with proper home care. For optimum health the pocketing is 1-3 mm. This can be maintained by the patient between hygiene visits at the dental office.    



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