Your gums are like cushions for your teeth; they surround the tooth from its crown to its root in the jaw and help to support a healthy mouth. Looking after your gums is just as important as looking after your teeth, and without routine cleaning gum disease can occur.
Fortunately, this can be treated by attending regular hygiene check-ups at the practice and maintaining a good daily hygiene routine. Brushing between the teeth, flossing and replacing your toothbrush every three months will also benefit your gum health.
Scaling is the removal of calculus, plaque, tooth deposits and some stains. It can be done either above the gum (supra-gingival) or below the gum (sub-gingival).
Root planing is a more radical treatment. It involves the removal of dead (necrotic) substance from the surface of the tooth under the gum. Otherwise, it is similar to scaling.
Initially, the patient will have to be examined by a dentist. The treatment given will vary depending on the severity of the periodontal disease. In its least severe form, the patient may only need some oral hygiene instruction. If plaque and calculus is found above the gum scaling may be necessary. In more severe forms where plaque and calculus is found under the gum, scaling below the gum margin and root planing may be required.
Scaling and root planing are done using special scaling instruments or ultrasonic devices. Hand instruments are made in various designs appropriate for reaching and removing plaque and calculus from all areas of teeth. The use of hand instrument can be tedious and time consuming.
Ultrasonic devices fracture deposits off the tooth surface. They also use water to help clear blood, debris, necrotic tissue and calculus. They are quicker to use and less tiring for the operator.
During the first appointment sub-gingival scaling and root planing is carried out (and all pockets are measured) and this appointment usually lasts for one hour. The procedure is normally painless as we use a numbing gel. After thorough cleaning of the whole mouth, the Dentist will apply a topical antibiotic medication deep into the pockets. This will be reapplied over the next two appointments. The fourth and final appointment is at the four-week stage when all the pocket depths are measured again to assess improvement.
The teeth and gums can sometimes be tender a few days after scaling and root planing. Post-operative pain and sensitivity of the teeth can be treated with desensitising agents available from your dentist. Also, mouthwashes and desensitising toothpastes are helpful.
In the treatment of periodontal disease, the advantages of scaling and root planing outweigh the disadvantages. This is because if periodontal disease is left untreated, it will lead to tooth loss..
Gum disease and tooth decay are the leading causes of tooth loss in the UK, and preventative dentistry aims to stop these problems before they start.
Your dentist will take the time to explain how to maintain a good home oral hygiene regime, including brushing and flossing technique and use of special mouthwashes or specialist devices such as interdental brushes, which clean between the teeth.
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