Many times, the early stages of periodontal disease are best treated with non-surgical periodontal therapy. This includes periodontal scaling and root-planing, or deep cleaning, in the presence of local anesthesia. Scaling and root-planing can be performed with or without an antibiotic, which may be delivered either locally or systemically. Scaling and root-planing is usually performed using a combination of ultrasonic and hand instrumentation, such as dental curettes or scalers. Using these instruments bacterial plaque and dental calculus (tartar) are removed from the surfaces of the teeth, including the root surfaces above and below the gum line. The teeth are re-evaluated in four to six weeks. Many shallower periodontal pockets can be eliminated using scaling and root-planing. Then the goal is to maintain a healthy periodontal status by combining good oral hygiene practices, such as brushing and flossing, with regular professional dental cleanings (periodontal maintenance) at three-month intervals, often alternating between our office and the office of your primary general dentist. In this manner, we can prevent further periodontal breakdown and address early relapse when it occurs.
Even in more advanced cases of periodontitis, periodontal scaling and root-planing is necessary to prepare the teeth and gum tissue prior to surgical treatment. This ‘Initial Periodontal Therapy’ improves the overall quality of the gum tissue prior to surgery and helps us to evaluate the patient’s ability to heal. In this manner we can predict how the tissue will respond with additional surgical treatment. Also during Initial Periodontal Therapy we work to establish an effective oral hygiene regimen for each patient in an effort to prevent relapse after treatment is completed. Because scaling and root-planing can result in some decreased pocket depth, this procedure can often limit the number of areas that require surgical pocket elimination.