Scaling and root debridement
What is Scaling and Root Debridement?
Scaling and root debridement is the professional removal of calculus (tartar) and plaque (bacterial biofilm) from the surface of the tooth crown and root. It is carried out on the tooth surfaces both above and below the gum line. It is usually done under local anaesthetic to increase patient comfort.
If gum disease is caught early and hasn’t damaged the structures below the gum line, a professional cleaning should do. If the pockets between your gums and teeth are too deep, however, scaling and root planing may be needed.
Scaling or root debridement, as it is technically known, is a conservative and very effective form of treatment for gum disease. In the early stages of gum disease, like gingivitis, scaling and root planning, along with an evaluation of contributing health factors that you may be causing gum disease, can be very effective and may be all that is needed to get the disease under control. Depending on the response to this treatment, further corrective surgical treatment may be indicated.
Why Scaling and Root debridement can help you save your teeth?
Scaling is the removal of calculus (tartar) and plaque from the tooth. Gum disease is particularly a problem when the calculus (tartar) gets below the gum on the root surface where you can no longer clean it. This then becomes a haven for pathogens which are harmful. Special ultrasonic scalers can be used to initially break down the hard calculus. Then, special hand-held instruments like scalers and curettes are used to do fine scaling. Bacteria are more likely to stick to the rough surfaces (the root). The root surface is cleaned in a process called root debridement. This helps removes any remaining calculus or ‘contaminated’ cementum on the root, and leaves the surface less susceptible to the bacteria.
Scaling and root debridement can be done in just one area of your mouth if the disease is just localised. Generalized periodontitis spreading throughout your mouth requires your periodontist typically treating a quarter (a quadrant), or half of the mouth at one time. This means that two to four visits may be necessary to complete the scaling and root debridement.
Outcomes
The outcomes of having treatment depend and vary from one person to the next. Treatment may only slow down the disease process or stabilise the disease. In some cases the disease will be cured. In spite of all the treatments, effort and expense to keep the tooth or teeth, they may still be lost. However treatment gives you a better chance of keeping your teeth and can alleviate some of the symptoms, such as the inflammation and bad breath.
Will this be uncomfortable to me?
Treatment involving scaling and root debridement could be uncomfortable without the areas being anaesthetised or numbed. For two to three days after the treatment, you may have some tenderness and increased sensitivity to hot and cold temperatures, so try to avoid any drastic temperature deviations. Warm salt water rinses or a special rinse e.g. chlorhexidine will be very helpful. Painkillers (whichever you find most effective) 1 hr before treatment and again 4-6 hours later can also be of benefit.
Potential risks & side effects of treatment
There is always a possibility and risk of unexpected and undesirable side effects. Each individual is unique and these complications, include and are not limited to: post-surgical infection, swelling, bleeding, headache, TMJ joint pain, tooth/gum pain, tooth sensitivity to hot, cold, sweets, shrinkage of gum tissues, muscle soreness, soft tissue numbness. While in most cases transient, some will require further treatment.
Please ask if you are unsure as to any of these effects or if any are of particular relevance to timing, e.g. before a speech or birthday, to occupation, e.g. teachers, tasters, talkers, or activities, e.g. sports etc. It is important to note here that certain conditions, nerve damage, infections, tooth trauma etc. may have pre-existed in a tooth as an asymptomatic, chronic state. Dental procedures in general can sometimes turn these states in a tooth to an acute one, therefore complications that sometimes arise in teeth after any type of dental or gum treatment may not have occurred as a direct result of the periodontal treatment.
After treatment, what is next?
The aim of treatment is to cure gum disease or at least slow the gum disease down as much as possible. To achieve these aims, the following are important:
- Keep your teeth thoroughly clean with soft toothbrushes and dental floss (you may need ‘interdental’ brushes – they are tiny brushes that look like Christmas trees)
- Attend for regular checkups and maintenance programs, including regular scaling and polishing
- Root debridement may have to occur every three months in some cases, to keep the gum disease under control.