Eating and drinking allow for the formation of a pale yellow or colorless bacteria lining called plaque on the enamel. When left for long due to poor oral hygiene, the accumulation forms tartar which is difficult to clean through routine brushing. The accumulation of bacteria results in tooth decay and periodontal disease in the long run. For this reason, dentists encourage you to visit them twice annually for teeth examination and cleaning to remove the plaque.
Nevertheless, when dentists notice an aggressive gum disease during an examination, they recommend deep cleaning or scaling and root planing (SCRP). If you have been scheduled for this gum therapy, knowing what to expect can help alleviate anxiety and equip you with the tools necessary to recover from periodontal disease quickly. Your objective is to stop the infection from spreading and prevent tooth loss.
Deep Cleaning Definition
Also known as SCRP, deep cleaning extracts plaque and tartar from the gum line. Routine brushing and flossing only remove the bacterial film on the teeth surface but not beneath the gum line on your tooth root. When the buildup accumulates under the gum line, you will require deep cleaning to remove the sticky film and prevent periodontal disease.
Usually, when you have healthy gums, they fit perfectly on each tooth. The depth from where the gingiva attaches to a tooth to the gum line is approximately 1-3 millimeters. However, when there is plaque and tartar accumulation in this area, you develop periodontal or gum disease that results from deep pockets between the gingiva and teeth.
When your dentist notices signs of gum disease like heavy tartar accumulation, breath odor, and deep unhealthy pockets during a routine examination, it is a sign of aggressive periodontal disease, and they will recommend SCRP to rid you of the excessive plaque.
When tartar buildup below the gums continues resulting in excessive tartar, you develop chronic periodontal disease as the bacteria causes the gums to recede from the teeth. The pockets that form when the gum pulls away to allow for further bacteria accumulation that is difficult to remove with routine brushing. Nevertheless, scaling can reach these deep pockets and remove bacteria and toxins. Untreated, periodontal disease can have serious oral health repercussions:
- Tooth loss.
- Jaw bone deterioration.
- Tissue wear out.
- Loose teeth.
Periodontal Disease Causes
Also called gum disease or periodontitis, periodontal disease is a progressive oral condition that can cause tooth loss when left untreated. Gum disease starts with the inflammation of the gingival or gum tissue around the teeth. The swelling in the tissue is caused by the accumulation of toxins and bacteria in the plaque, which later causes oral infections.
The infection eats away the gum tissue causing deep pockets between the teeth and gums. The mild swelling, otherwise called gingivitis, is reversible with the help of a periodontist. However, when periodontal disease becomes chronic, it damages the gums and the jawbone leading to tooth loss. The infection can even travel through the bloodstream to other body parts or organs, leading to severe health conditions like:
- Cardiovascular disease.
- Infertility.
- Pneumonia.
- Erectile dysfunction.
- Uncontrolled blood sugar in diabetes patients.
- Dementia.
Periodontitis has several causes, which you should know about if you want to prevent the condition. These causes are:
Poor Oral Hygiene
The fight against gum disease starts at home with proper oral hygiene. You are at an elevated risk of developing periodontitis if you do not regularly clean and floss your teeth after meals. The food particles are trapped in the spaces in the mouth, like in the teeth and gums, allowing for bacteria breeding. However, proper hygiene removes the food particles every time you brush your teeth, lowering the risk of bacteria or toxin accumulation in the mouth.
In addition to regular brushing, you should visit your dentist twice annually for teeth examination and cleaning. The visits help the dentist identify tartar buildup and remove it before it develops into bacteria that cause gingivitis and periodontitis.
Tobacco Smoking
Tobacco use, primarily smoking, has been associated with tartar or calculus accumulation in the mouth, increasing the risk of gum disease. Again, smokers are at an elevated risk of slow healing due to reduced immunity.
Genetic Predisposition
Even with good oral hygiene, you could still be predisposed to gum disease due to genetics. If your family has a history of the condition, you should undergo genetic testing to test your vulnerability and take early measures to prevent the infection.
Hormonal Changes
Your body experiences hormonal changes during pregnancy or menopause, causing the gingiva tissue to wear out. Continued wear out of the gingiva tissue exposes you to periodontal disease.
Poor Nutrition and Chronic Stress
Excessive consumption of certain foods like cakes, fats, or carbohydrates can enable plaque buildup in the mouth, making you vulnerable to periodontitis. Also, a poor diet lowers your body’s capacity to fight bacterial infection, making you susceptible to periodontitis. Also, stress elevates gum disease risk by lowering immunity, preventing the body from fighting bacterial infection.
Underlying Medical Conditions Like Diabetes
Health conditions like heart disease or arthritis accelerate the development and progression of gum disease. Diabetes hinders the use of insulin by the body, making it difficult to control the growth and spread of bacterial infections in the gingiva tissue, causing periodontitis.
Deep Cleaning vs. Regular Cleaning
Routine teeth cleaning focuses on the enamel and the gums and is usually performed during biannual visits to the dentist. The treatment is aimed at helping you maintain healthy oral hygiene. On the other hand, deep cleaning incorporates special tools and techniques to remove plaque, calculus, and toxins underneath the gum line and the tooth root. The procedure helps prevent the advancement of periodontitis and tooth loss. Regular cleaning prevents oral conditions, while deep cleaning aims to arrest the spread of gum disease.
Candidacy for Deep Cleaning
When you start developing gum disease, you will barely notice the symptoms. The best way to know when you have the disease, particularly in the gingivitis stage, is to visit the dentist at least twice a year for a checkup. Many patients rely on routine brushing and flossing to remove plaque, which is ineffective. Deep cleaning through gum scaling reaches the area below the gums where plaque has accumulated to remove toxins and plaque. Also, if the gums have deep sockets, your dentist will use root planing to remove the plaque and bacteria.
Therefore, you will know you need a deep cleaning procedure if you develop deep pockets. Also, you can tell you have developed gum disease if you have red, tender, or swollen gingiva tissue.
Similarly, you should visit a dentist if you notice gum bleeding. Although the bleeding can stem from aggressive brushing, if it becomes frequent, it is a sign of periodontitis, and you should consult with a dentist.
Besides, when your teeth and gingiva tissue start to decay, you will notice an unpleasant odor in your breath that does not go away, even when you brush your teeth and floss them with mouthwash. This is a sign something is wrong in your mouth, and you should visit a dental professional.
Furthermore, when you experience pain in the teeth and gums when chewing hard food, you could develop periodontitis.
Lastly, permanent teeth should fit perfectly in the mouth and remain stable. When the teeth start to move or shift, it indicates that your gum tissue is not holding them in place, a sign of periodontal disease, and you should see a periodontist.
These signs could be caused by other problems apart from gum disease, so you are encouraged to visit a dentist for an oral evaluation. An experienced dentist will utilize their advanced tools to examine your teeth and gums to make a diagnosis. If you have aggressive gum disease, the dentist will use deep cleaning to arrest the condition. Who will perform the procedure?
The severity of the gum disease, whether in the gingivitis stage or chronic periodontitis, and your response to treatment will determine the expert to perform the treatment.
A dental hygienist or general dentist can perform a preventative SCRP procedure or treat the gum disease at the gingivitis stage. Nevertheless, when you have chronic periodontitis, your general dentist will refer you to a periodontist for diagnosis, preventative care, and treatment. A periodontist has advanced training as they undergo thirty-six months of specialized gum teaching and treatment procedures after completing their dental school education. For example, when you suffer from chronic periodontitis that has caused hard plaque accumulation below the gum line, a periodontist will perform a minor surgery by cutting the gum tissue to remove the buildup.
Preparing for Deep Cleaning
Once your dentist has confirmed that you are a candidate for deep cleaning, they will schedule the procedure. The dental hygienist performing the treatment will need time to prepare you for the process, usually spanning two visits. On the first visit, the hygienist or periodontist will deep clean half of the mouth, while the other half is left for the second visit.
Dress comfortably for the appointment and load your phone with your favorite music. If you suffer from anxiety in dental offices, you can talk to your general dentist or hygienist about administering nitrous oxide to stay comfortable during the treatment.
After the procedure, do not return to work or school immediately. You need to rest for a few hours and return the following day. Again, you should expect some tenderness because of the local anesthetic administered for the treatment or in the gingiva tissue. You should have some ibuprofen to help with the soreness, although you will only need it for the first few days. There are no diet restrictions, but you should stick to soft meals that are neither hot nor cold, as the mouth will still be numb hours after the procedure.
The procedure
The steps involved in deep cleaning, or the SCRP procedure, are:
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Initial Examination
Before the procedure, your general dentist or dental hygienist will review the plaque buildup and check your gum tissue for periodontitis. Your dental expert will then use a periodontal probe to measure the space between your teeth and the gum line, known as the sulcus. In a healthy mouth, the sulcus measures no more than 3mm. Nevertheless, when you have periodontal disease, you will have pockets with a depth exceeding the standard 3mm, allowing plaque accumulation that requires SCRP.
Your dental professional will perform a gum SCRP procedure when the pocket depth exceeds three millimeters. Scaling removes the tartar and plaque above and underneath the gum line. At the same time, root planing smooths the root surfaces to prevent future accumulation of calculus and plaque, allowing the gums to heal and attach to the teeth.
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Administering Local Anesthesia or Mild Sedation
Scaling can cause discomfort, so your dental expert will administer a local anesthetic, mild sedation, or numbing gel to lower sensitivity. Some prefer not to use sedation, while others do not want to feel pain. Therefore, the application of local anesthetic should depend on your preference.
If you are anxious about dental procedures, you should go for nitrous oxide or laughing gas, which keeps you relaxed. The sedation is also reversible and appropriate if you drive home after treatment.
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Scaling of the Gums, Teeth, and Pockets
After sedation, your dental hygienist or dentist will use a scaler or ultrasonic cleaner to remove plaque from periodontal pockets. These instruments are made to reach deep periodontal pockets and under the gums to remove any bacterial deposits. Once the whole area is clean, the dental hygienist plans the root surface to make it as smooth as possible so that the gum tissue attaches without leaving any spaces that could allow for plaque accumulation.
It will help to know that if the gum pockets are severely infected, your dentist will strategically place antibiotic capsules using syringes to kill the toxins and bacteria left in the periodontal pockets and allow fast healing. Sometimes the dentist will even prescribe a strong mouthwash.
For gingivitis, the SCRP can be performed at three-month intervals, combined with daily flossing and string mouthwash. However, for advanced periodontal disease, you will be referred to a periodontist for periodontal or laser surgery. Here, the periodontist will cut the gum tissue to expose the root surface and remove bacteria and plaque. After scaling, the periodontist will refer you to the dental hygienist for a checkup. You will alternate dental examinations with these two experts until you fully recover.
Deep Cleaning Aftercare
The aftercare process is the most crucial part of gum therapy, preventing infection relapses or new buildup. Because you are eating, drinking, and breathing, plaque will build up in twenty-four hours. Therefore, you must brush your teeth regularly and use a water flosser to flush out the food particles and bacteria in the gum pockets.
You will return to the dentist two to four weeks after the procedure for an examination and a final deep cleaning. Once you complete the treatment, you must practice good oral hygiene to prevent the recurrence of gum disease.
Gum Therapy Cost
On average, expert tooth cleaning ranges from $100 to $130, while deep cleaning costs approximately $140-$300 per quadrant. Active periodontal therapy involving the direct administration of antibiotics into the periodontal pocket costs $75 for each tooth. The maintenance cost after the active treatment is approximately $115. The elements affecting the price of the therapy include the dentist's location, treatment frequency, the professionals involved, and the necessary follow-up care.
Depending on your insurer and the type of dental insurance policy, insurance coverage can cover 50% to 80% of the treatment. Insurance pays the total cost of the biannual dental examinations and cleanings. Sadly, because deep cleaning is not preventative, insurers categorize the therapy in the next tier after 100% coverage, paying 50-80 percent. Even though the coverage is reduced, it helps cover a significant portion of the therapy cost.
Deep Cleaning Advantages
SCRP has several benefits. The treatment suits individuals with low to moderate gum disease and periodontitis. These patients risk severe health conditions if the infection spreads to the bloodstream. Therefore, undergoing deep cleaning offers multiple benefits, including:
- Stopping periodontal disease advancement.
- Protecting your tooth roots.
- The procedure treats existing bacterial infections and heals gum disease.
- It enables gum cleaning on the surface and underneath.
- It rids you of unpleasant breath.
The Downside of Deep Cleaning
The disadvantages of the treatment are minimal compared to the benefits. One of the disadvantages is that it is more expensive than regular cleaning. Also, it is time-consuming as you need two visits to complete the therapy. Also, after the treatment, you will experience soreness or sensitivity for several days because the removed bacteria acted as your tooth cover. When experiencing sensitivity, you must purchase sensitivity toothpaste, which can prove costly.
Find an Experienced General Dentist Near Me
Now that you know what to expect in a deep cleaning procedure, you are asking where to schedule the treatment if you need to address your gum disease symptoms. At Ganji Dental, we provide quality deep cleaning services to eradicate the foul odor in your mouth and enhance periodontal disease healing. Call us today at 310-643-8045 to arrange a meeting in Hawthorne, CA.