Scaling and Root Planing

Definition to Patient: If plaque and tartar are left on the teeth, it provides the right conditions for bacteria to thrive. The bacteria irritate the gum, which means that they bleed more easily. You may notice this if you are brushing your teeth. This is the early stage of periodontal disease. If you are diagnosed with periodontal disease, hygienist will scale and root plan. This removes bacteria in the pocket and provides the necessary conditions for healing to occur. If gingivitis is not treated the inflammation will work its way down towards the foundations of the tooth causing a "periodontal pocket". Periodontal disease will break down the support (bone) structures of the teeth, so that eventually they will become loose. The problem is that periodontal Disease can become quite severe, and the patient often has no symptoms.

Clinical Information for Patient: There is some confusion about the difference between scaling and root planing. Scaling is basically the process of removing dental tartar from the surfaces of the teeth. Root planing is the process of smoothening the root surfaces and removing any infected tooth structure.

Outcome Assessment: Discomfort can vary after root planing, but one can expect the area to be tender afterwards. The teeth themselves can become a bit more sensitve to temperature, and bledding might occur a little while. Over-the-counter painkillers such as Tylenol or Advil work very well to alleviate discomfort.

Fine Scale and Polish

Definition to Patient: Your teeth come under constant attack from the starches and sugars present on our food which are released as we eat. When this combines with plaque, the sticky bacterial film that forms on the teeth over time, it produces an acid which is harmful to our teeth. This plaque forms on the surface of and between our teeth and can also affect the gum line. If it is not removed then it will harden and form calculus or 'tarter' - a yellow or brown mineral deposit which causes the teeth to have a rough or ‘crusty’ appearance. This makes them vulnerable to further plaque attacks. Plaque can corrode the teeth over time which causes cavities and tooth decay as well as bad breath. If it leads to tartar formation, especially around the gums then gingivitis can occur. The danger with this is that it can lead to the more serious periodontal gum disease.

Clinical Information for Patient:
This tends to be relatively painless. The hygienist will use a series of hand tools called scalers and curettes to remove smaller deposits as well as smoothing the surface of the teeth. Your hygienist will use these to scrape away these deposits. Once your teeth are beautifully smooth the hygienist will then give them a polish. This means using a hand piece with a soft, spinning rubber cup which is applied to your teeth. A special paste called a ‘prophylaxis’ is inserted into this cup and together with the spinning cup, will give your teeth a shiny appearance. As a final flourish the hygienist may apply fluoride. Fluoride is good at strengthening the teeth as well as providing essential minerals to any teeth that have been eroded by acid.

Outcome Assessment: A fine scale & polish tends to be painless with many patients reporting ‘tickling’ or ‘scraping’ sensations. It is likely to be painful if you have sore gums or badly worn teeth. However, a topical numbing gel can be used which is a form of local anesthetic and will freeze the area to be treated.