Deep Cleaning

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Deep Cleaning

What is Deep Cleaning in Encinitas (Deep Scaling & Root Planing)?

You may notice that your gums bleed a bit when you are brushing or flossing. This is the early stage of gum disease called gingivitis. If plaque and tartar are left on the teeth, it provides the right conditions for bacteria to thrive. The bacteria irritates the gums, which means they bleed more easily. If you have gingivitis, your dentist will clean your teeth by scaling and polishing them. He may also recommend an antiseptic mouthwash containing chlorhexidine and show you how to brush and floss your teeth effectively. Most adults have some degree of gum disease.

Should I be concerned with my dental health?

If gingivitis is not treated and nothing is done about it, the inflammation will work its way down towards the foundations of the tooth causing a “periodontal pocket”. The bacteria inside the pocket will multiply causing infection that in turn deteriorates the bone surrounding the teeth.
Periodontal (Gum) disease can break down the support (bone) structures of the teeth, so that eventually, they will become loose. The problem is that until it gets quite severe, the person often has no symptoms. Sadly, the damage or bone loss to the teeth is irreversible. The good news is that if periodontal (gum) disease is caught in time, its progression can be halted and stabilized, the active infection is reduced or eliminated.
To stop periodontal (gum) disease from progressing, your dentist may advise periodontal therapy, or deep cleaning. This gets rid of the bacteria in the pocket and provides the necessary conditions for healing to occur.

What is the difference between a regular cleaning and a deep cleaning?

Regular dental cleaning is the process of removing plaque and tarter that is above the gums and deep cleaning is the process of removing plaque, tarter and calculus (hard form of plaque) that is below the gums.

Does it hurt?

Depending on the depth of the pocket and severity of the gum disease, Dr. Dena may make the area numb so that the process is comfortable for you. Don’t hesitate to discuss with Dr. Dena how to best manage any discomfort.
Sometimes if the pockets are not too deep, there may be little or no discomfort during the procedure – even without numbing. The only sensation may be the physical scraping feeling along the teeth as the area is cleaned and smoothened. Dr. Dena uses an Ultrasonic Scaler, which is more effective and comfortable for the patient, in addition to hand instrumentation. A tooth that is free of tartar has a better chance of allowing the gum tissues to heal and reattach to it. As a result, some deep gum pockets can be reduced after a deep cleaning.

How long does it take?

Typically with deeper pockets, the deep scaling and root planing procedure might be broken down into two appointments. For example, the right side of the mouth might be worked on one day, and the left side at a separate appointment. However on some cases Dr. Dena may be able to perform the deep cleaning in one appointment. Dr. Dena may use antibiotic gels within the periodontal pocket to decrease bacteria and may irrigate the pocket with various medications such as chlorohexidine.

What can I expect afterwards?

Discomfort can vary after root planing, but one can expect it to be tender afterwards since it’s usually in a deeper region under the gums.
The teeth themselves can become a bit more sensitive to temperature, and bleeding might occur for a little while.

Over-the-counter painkillers such as Tylenol or Ibuprofen work very well to alleviate discomfort

Brushing and flossing can be done more gently to avoid aggravating any bruised or tender gum areas.

Your dentist may recommend salt water or chlorhexidine rinses.

Generally though as health returns to your gums, sensitivity and soreness tend to resolve. Remember though, if diagnosed with periodontal disease, you did not get there overnight and we cannot treat it overnight. If you are faithful with your home care it usually will resolve. Successful treatment is 70% what you do at home to treat the disease and 30% what we do when you come in for treatments. Left alone it will only get worse. If you go through the non-surgical therapy and do not continue with the maintenance therapy the disease will come back again.

Periodontal Disease

The objective of scaling & root planing is to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus).
These non-surgical procedures which completely cleanse the periodontium, work very effectively for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease.
Reasons for scaling and root planing
Scaling and root planing can be used both as a preventative measure and as a stand-alone treatment. These procedures are performed as a preventative measure for a periodontitis sufferer.

Here are some reasons why these dental procedures may be necessary:

Disease prevention – The oral bacteria which cause periodontal infections can travel via the bloodstream to other parts of the body. Research has shown that lung infections and heart disease have been linked to periodontal bacteria. Scaling and root planing remove bacteria and halts periodontal disease from progressing, thus preventing the bacteria from traveling to other parts of the body.

Tooth protection – When gum pockets exceed 3mm in depth, there is a greater risk of periodontal disease. As pockets deepen, they tend to house more colonies of dangerous bacteria. Eventually, a chronic inflammatory response by the body begins to destroy gingival and bone tissue which may lead to tooth loss. Periodontal disease is the number one cause of tooth loss in the developed world.

Aesthetic effects – Scaling and root planing help remove tartar and plaque from the teeth and below the gumline. As an added bonus, if superficial stains are present on the teeth, they will be removed in the process of the scaling and root planning procedure.

Better breath – One of the most common signs of periodontal disease is halitosis (bad breath). Food particles and bacteria can cause a persistent bad odor in the oral cavity which is alleviated with cleaning procedures such as scaling and root planing.

What do scaling and root planing treatments involve?

Scaling and root planing treatments are only performed after a thorough examination of the mouth. The dentist will take X-rays, conduct visual examinations and make a diagnosis before recommending or beginning these procedures.
Depending on the current condition of the gums, the amount of calculus (tartar) present, the depth of the pockets and the progression of the periodontitis, local anesthetic may be used.

Scaling – This procedure is usually performed with special dental instruments and may include an ultrasonic scaling tool. The scaling tool removes calculus and plaque from the surface of the crown and root surfaces. In many cases, the scaling tool includes an irrigation process that can also be used to deliver an antimicrobial agent below the gums that can help reduce oral bacteria.

Root Planing – This procedure is a specific treatment which serves to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed in order to promote good healing. Having clean, smooth root surfaces helps bacteria from easily colonizing in future.
Following these deep cleaning procedures, the gum pockets may be treated with antibiotics. This will soothe irritation and help the gum tissues to heal quickly.

During the next appointment, Dr. Dena, Encinitas Dentist will thoroughly examine the gums again to see how well the pockets have healed. If the gum pockets still measure more than 3mm in depth, additional and more intensive treatments may be recommended.