Scaling and Root Planing

Scaling is the process by which plaque and calculus are removed from tooth surfaces. Root planning is the process by which residual embedded calculus is removed from the roots to provide a smooth, hard and clean surface. The primary objective of scaling and root planning is to restore gingival health by completely removing the tooth surface elements that provoke the gingival inflammation.

SCALING

This is the process by which plaque and calculus are removed from both supragingival and subgingival surfaces of teeth. Scaling can be done with the help of hand instruments or ultrasonic scaler tips. Ultrasonic scaler tips are often preferred over hand instruments as it is faster and both the doctor and the patient would feel more comfortable. The ultrasonic tip vibrates parallel to the tooth surface which leads to less removal of the tooth surface and reduction in pain perception by the patient.

Objectives of scaling

• To reduce the number of microorganisms
• Elimination of gingival inflammation
• To restore gingival health

ROOT PLANING

Root planning is the process by which residual embedded calculus and portions of cementum are removed from roots to provide a smooth, hard and clean surface. This procedure is also known as root surface debridement, root detoxification or closed deep scaling. Root planning is done with the help of instruments known as curettes.

Objectives of root planing

• Remove elements that provoke gingival inflammation
• To facilitate oral hygiene
• Biologically acceptable root surface

Scaling and root planning can be used as either a preventive measure against periodontal disease or as a stand-alone treatment. Some reasons for seeking scaling and root planning are as follows :

• Disease prevention: The bacteria that are present in periodontal infection can travel to other parts of the body through the bloodstream. Scaling and root planning stop the progression of periodontal infection and prevent the spread of infection.
• Tooth protection: In gingival diseases, the body will respond with a chronic inflammatory response which may destroy the gingival tissues and bone. This process can eventually result in tooth loss and bone loss. Scaling and root planning could stop the progression of the periodontal disease and provide tooth protection.
• Aesthetic reasons: Scaling and root planning help in removing plaque and stains present on the teeth and below the gum line thus improving the aesthetics.
• Reduction of bad breath: Bad breath is one of the most common signs of periodontal disease. Food particles and bacteria in the mouth can cause bad odor in the oral cavity. Scaling and root planning eliminate the odor causing particles from the oral cavity thus reducing bad breath.

Failure of scaling and root planning can be due to the following reasons :

• Poor oral hygiene
• Improper removal of plaque and calculus
• Genetic susceptibility
• Smoking
• Presence of systemic disease

It is recommended to get scaling done once in 6 months as a prophylactic measure. Scaling and root planning is one of the most effective ways to treat gum disease before it becomes severe. You don’t have to lose teeth to periodontal diseases. They often can be treated successfully.