Non-surgical debridement (Scaling and root planning)

The first phase of treatment normally consist of "deep" cleaning of the root surfaces below the gum level (subgingival root debridement). This meticulous deep cleaning of the gums is carried out under local anesthetic.

The dentist or dental hygienist removes the plaque through a deep-cleaning method called scaling and root planing. Scaling means scraping off the tartar from above and below the gum line. Root planing gets rid of rough spots on the tooth root where the germs gather and helps remove bacteria that contribute to the disease.

How effective is this procedure?

A scaling and root planing procedure is to be considered effective if the patient is subsequently able to maintain their oral health without further bone or attachment loss and prevent recurrent infection with plaque and calculus.

Are there adverse effects of the treatment?

The gums may be sore for 2-3 days.
The reduction of the depth of the pockets is likely to show in the form of some gum shrinkage (recession/root exposure), which can vary greatly in its extent. This is inevitable in cases where the gum was very swollen in the first place. In some patients this may cause increased tooth sensitivity. However, this is usually temporary and rarely lasts more than a few weeks/months.

What is the long-term effect of this treatment?

The long-term effectiveness of this treatment depends upon a number of factors. These factors includes patient compliance, disease progress at the time of intervention, probing depth and other factors such as grooves in the roots of teeth and concavities. It is recommended that after the treatment that the patient returns every 3 to 4 months to sustain healthy gums.

For many patients deep cleaning will be sufficient to control the disease. However, in advanced cases of periodontal disease the "deep" cleaning alone may not be enough to control the disease. A second phase of therapy may include gum surgery to gain access to deep areas for cleaning.