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A healthy smile begins with a strong foundation, which means healthy gums and supporting bone. At Alpine Vista Dental, our team of skilled hygienists focuses on identifying, diagnosing, and treating gum disease at the earliest possible stages. Even if your teeth are in good shape, they need a solid foundation to stay firmly anchored to the jaw. While we prioritize prevention, gum disease can still occur. As plaque and tartar build up, harmful bacteria beneath the gumline can lead to gum inflammation and bone loss—a condition known as periodontitis.
Periodontitis is more common than many realize. According to the National Institute of Dental and Craniofacial Research, 42.2% of adults over age 30 are affected. If left untreated, this condition can cause bad breath, loose or shifting teeth, and eventually, tooth loss. In fact, periodontitis is the leading cause of tooth loss in adults. Moreover, it has been linked to systemic health issues like cardiovascular disease and diabetes.
At Alpine Vista Dental, Dr. O’Donnell and our experienced hygienists are committed to preventing and treating gum disease. We use scaling and root planing as a primary treatment to halt the progression of periodontitis, stabilize any attachment loss, and, in some cases, reverse the damage. Our goal is to help you keep your smile healthy and beautiful!
Deep cleaning is technically called periodontal scaling and root planing, and is generally performed as the first stage of treatment for gum (periodontal) disease. It is intended to stop the progression of gum disease by removing the tartar buildup from the crown and root surfaces of the teeth so the tissue can heal.
Your dentist will recommend scaling and root planing (a deep cleaning) if you have periodontitis. Periodontitis is gum disease that has progressed beyond just the soft tissue, which means it is affecting the bone that supports your teeth.
Periodontal disease, or periodontitis, is a chronic infection that develops in response to bacteria building up on the teeth and root surfaces. If you have not had your teeth cleaned for a few years, or if you do not do a thorough job of brushing and flossing daily, you are more likely to have tartar buildup on your teeth that will contribute to periodontal disease.
Periodontal disease is diagnosed by assessing bone levels on x-rays and taking measurements around the gums, which is known as periodontal probing. If your dental team sees bone loss between your teeth on your x-rays, or finds pockets that are 5 millimeters or more when they are probing, you have periodontitis.
The damage from periodontal disease is irreversible, so treating the disease as early as possible is critical. Even though the bone cannot be regrown, with proper care the disease is controllable, so further bone loss can be prevented. If periodontitis is left untreated, the bone loss around your teeth can cause gum recession, loose or shifting teeth, and can eventually cause your teeth to fall out.
Regular dental cleanings are called prophylaxis, which is “an action taken to prevent disease”. During a regular cleaning, the dentist or hygienist uses scalers and polish to remove bacteria and tartar buildup from above the gumline and 2-3mm below the gumline. Scaling and root planing is often called a “deep cleaning” because it gets into the deeper periodontal pockets (4mm to 7mm) to clean off the buildup on the root surfaces that is causing the infection around your teeth.
A regular prophylaxis cleaning will not treat periodontitis. Some dental offices will refuse to do a regular cleaning on patients that have periodontal disease and need scaling and root planing because it is substandard care. In some cases, cleaning the buildup from above the gumline but not getting to the bottom of the pockets can make periodontitis worse by causing abscesses when the tissue partially heals and traps the bacteria below.
The same tools are generally used for a regular prophylaxis cleaning and scaling and root planing, but the deeper cleaning will quite a bit take longer and be more detailed, so you may be scheduled for multiple appointments.
In order to keep you comfortable, you might need to have your gums numbed.
A combination of ultrasonic scalers and hand scalers are generally used during scaling and root planing procedures. Ultrasonic scalers are very effective instruments that use tiny vibrations to break up plaque and tartar buildup and water to flush debris and bacteria from between your teeth and under the gums. Hand scalers are the traditional dental instruments used to remove the deposits from the tooth surfaces. In some cases, a state of the art laser can be used to further encourage reattachment of the gums to the tooth. In all, a number of different techniques and instruments are used to ensure the highest likelihood of a successful treatment.
When the numbing wears off, you may find your gums or teeth are a bit sore, but it generally only lasts for a day or two. Many people choose to take over-the-counter pain medications like Advil or Tylenol to help, or they try a warm salt water rinse to help soothe the irritation.
In order for the gums to heal after scaling and root planing, it is critical to keep your teeth clean with twice a day brushing, and daily flossing and using a water flosser.
The bone that has been lost with periodontal disease very rarely grows back, but the gums can heal in several different ways after a deep cleaning. When the inflamed tissues heal, the gums can shrink around the bone, which may lead to root exposure, which is known as gingival recession. Sometimes the gums reattach to the tooth surface. In other situations, even though the inflammation is resolved, a pocket still remains as a type of scar tissue.
In any of these situations, the most important thing is that the progression of periodontal disease and bone loss is stopped. When your dentist or hygienist performs periodontal probing to see how your gums have healed after scaling and root planing, the most important factors are lack of bleeding and pocket measurements staying stable.
If your gums do not heal as expected after scaling and root planing, your dentist will send you to a gum specialist called a periodontist for evaluation. You may need more aggressive treatment to control your periodontal disease.
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The first step in treating gum disease involves a thorough cleaning by our amazing team. During scaling, Dr. O’Donnell or our dental hygienist removes plaque and tartar from above and below the gumline, reaching areas that are difficult to clean with regular brushing and flossing. We then, smooth the roots of the teeth to remove any rough spots where bacteria can accumulate.
After scaling and root planing, Dr. O’Donnell may recommend at-home treatments to help control infection and promote healing. This can include antibiotic mouth rinses, topical antibiotics applied directly to the gums, or oral antibiotics in severe cases. Your treatment plan will be designed to support your long term oral health and wellness.
Regular dental check-ups and cleanings are essential for monitoring your gum health and preventing future problems. Dr. O’Donnell may recommend more frequent cleanings, typically every three to four months, to help manage gum disease and keep it under control.