- Scaling and root planing (SRP) aims to remove bacteria and infection from the soft tissues around the gums.
- SRP helps to reduce inflammation and increased tooth support.
- Preventive treatment is recommended 1-2 times a year. If you have periodontal disease, you can receive SRP therapeutically.
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Do you need scaling and root planing treatment? Here's everything you need to know.
Signs you need deep teeth cleaning
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Periodontal scaling and root planing are necessary if your probing indicates you may have gum disease. It is not a routine procedure. Instead, preventive treatment, such as prophylaxis, is recommended 1-2 times per year.
If you have not been to the dentist in a while, the calculus and plaque that would typically be removed migrate down below the gumline. The bacteria and their by-products gather around the tooth, infecting the gums and causing bone loss.
Symptoms you can look for yourself include:
Bad breath or taste,
Gums bleeding easily,
Red, swollen, or tender gums,
Gums pulled away from the teeth,
Loose or separating teeth,
Changes in the bite, and
Partial dentures no longer fit properly.
Scaling and root planing types
A deep dental cleaning can be preventive or therapeutic, but counterintuitively, both address active periodontal disease. Other methods, commonly used by holistic dentists, include laser treatment.
If your periodontitis has not spread to more than 30% of your mouth, you may get away with preventive or localized SRP. Otherwise, you will be rescheduled for another appointment after an oral exam. The SRP type is the primary factor determining the procedure's cost.
Preventive SRP
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Scaling and root planing (SRP) is a preventive treatment. This procedure is meant for those with active periodontal disease, and it is the only one needed to treat it. In more complex cases, time-release antibiotics may be injected to help fight bacteria for an extended period.
Periodontal disease can be caused by not visiting the dentist regularly for a cleaning. It is recommended that you do this at least twice a year.
In terms of dental health, it does not make much difference whether you get your teeth done at once or over a more extended period. Long-term effects are comparable. What is more, not all of your teeth may need SRP.
Therapeutic SRP
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If the patient displays moderate to severe inflammation on more than 30% of the mouth, the SRP is no longer considered “preventive. Symptoms of such a situation include swollen, bleeding, or inflamed gums.
In such a case, the procedure can only be conducted after an oral examination. A dentist must first assess the state of the mouth. Often, periodontal disease cannot be fully cured, but rather maintained. This means you may have to come in for SRP regularly.
Lee stresses: "The stakes are higher than many realize, as CDC data indicates that nearly half of American adults over age 30 suffer from some form of periodontal disease. When we perform SRP, we are not just cleaning teeth; we are stopping an active infection that triggers bone loss."
"By smoothing out those rough root surfaces—the 'planing' part of the process—we make it much harder for toxic plaque to retake hold. It is a targeted, therapeutic intervention designed to manage a chronic condition that, if ignored, eventually leads to tooth loss," he explains.
Scaling and root planing procedure
The SRP procedure should not take more than 2 hours. It all depends on the severity of the problem and what portion of the mouth is being treated.
The process of a deep teeth cleaning may be similar to that of a regular prophylaxis.
Preliminary chat
Any changes in your dental history or new medication should be reported to the dentist. After that, he or she will let you know what will happen step by step. An X-ray is likely to take place.
Periodontal charting/probing
The hygienist will use a special tool to measure the depth of your gum pockets. Healthy pockets should not be 4 mm or above.
X-ray
If those pockets do turn out to be concerning, a radiograph will be taken. If it shows significant bone loss or calculus below the gums, scaling and root planing will be performed.
Anesthetic
Some anesthetics will most likely be used. This might be a local injection or a topical gel.
Scaling
A handheld scaler will be used to remove plaque from teeth and roots manually. An ultrasonic tool may be used to aid this process.
Root planing
The dental professional will use a rubbing motion to scrape off roughness from your roots. Those spots are where the bacteria reside.
Application of antibiotics
Time-release antibiotics might be used to manage gum inflammation. You will be given instructions on how to care for your mouth for the next few days or weeks.
Referral to a periodontist
The effectiveness of scaling and root planing depends on patients maintaining or beginning proper oral hygiene and care.
In very extreme cases, surgical treatment might be necessary. The patient is often, but not always, referred to a specialist.
A single deep cleaning procedure might take one to two hours. If the periodontitis has spread over a significant area of your mouth, the procedure might need to be spread out over several appointments.
After the procedure is complete, you will need to wait 4 to 6 weeks before returning for a check-up. There might also be a follow-up appointment with a periodontist if the situation in your mouth does not improve or if your bone needs intervention.
SRP aftercare instructions
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There are a few things to bear in mind after your scaling and root planing procedure.
Take ibuprofen if you feel sore after the procedure. It also has anti-inflammatory properties, so it can help heal your gums faster. Your mouth will feel numb after the anesthetic, so it is easy to burn your mouth on hot food. Try to abstain from eating for at least 2 hours.
Use saltwater rinses 2-3 times a day for a few days. This will help soothe your mouth. Brush your teeth twice a day with a soft-bristle toothbrush. You can also floss the night of the procedure. Use a water flosser if you have one.
You might feel sensitivity to hot and cold temperatures for a few days. Desensitizing toothpaste can help there. Avoid products with “whitening” properties and baking soda, as those can irritate the soft tissues in your mouth.
Moreover, lastly, do not smoke for 24-48 hours after your procedure. It can slow down healing significantly.
FAQ
Is periodontal scaling and root planing necessary?
Not for every patient. SRP is required when there is considerable tartar and plaque buildup that cannot be removed during a simple teeth cleaning.
Does scaling and root planing hurt?
Patients describe the procedure as uncomfortable but not painful. Either way, a local anesthetic can be administered to minimize pain during scaling and root planing.
What to eat after deep teeth cleaning?
Hard and sticky snacks may cause sensitivity or reduce the effectiveness of scaling and root planing. You'd best stick to soft foods such as soups and pasta for at least a day. Drink plenty of fluids, ideally water.
Does scaling and root planing carry any risks?
Generally, there are few risks with scaling and root planing if the procedure is performed correctly. There is no way teeth fall out after deep cleaning, unless you grossly fail to follow post op instructions. This may also lead to bacteria in the bloodstream, a fever, and tooth sensitivity.
If you suffer from any diseases that make you particularly vulnerable to infection, you may have to take a course of antibiotics. This may start before the procedure.
Harry Lee, DMD
I often see patients brace themselves when I mention a "deep cleaning," but I prefer to call scaling and root planing (SRP) a "biological reset." In my practice, the conversation usually starts after we have measured gum pockets. If those numbers hit 4mm or higher, it is a sign that bacteria have migrated south, creating hidden spaces where your toothbrush cannot reach. Think of it like removing barnacles from the hull of a ship; we are scraping away hardened calculus from the root surfaces to provide a clean slate for the gums to reattach.