A dental deep cleaning, formally known as Scaling and Root Planing (SRP), is a specialized therapeutic procedure prescribed when routine cleanings are no longer sufficient to maintain gum health. This treatment targets infection and inflammation that has progressed beyond the surface of the gums and is distinct from the prophylactic cleaning performed during regular checkups. A standard cleaning removes plaque and tartar from above the gum line, but SRP is necessary to clean the tooth and root surfaces far below it. Understanding this process can help patients feel prepared and confident about their treatment. This article will guide you through what to expect from this comprehensive treatment.
Why a Deep Cleaning Is Necessary
A dental professional determines the need for a deep cleaning through a thorough clinical examination focused on diagnosing a condition called periodontitis. The most specific diagnostic tool used is a periodontal probe, which measures the depth of the space between the gum tissue and the tooth, known as a periodontal pocket. Healthy gum pockets typically measure between one and three millimeters. Pocket depths of four millimeters or greater often indicate periodontitis and the necessity for SRP.
This deeper pocketing signals that the infection has caused the gum tissue to detach from the tooth root, allowing bacteria, plaque, and hardened tartar (calculus) to accumulate out of reach of normal brushing and flossing. The condition differs significantly from gingivitis, which is gum inflammation without bone loss. Periodontitis involves the beginning of bone loss supporting the teeth, which is often confirmed by reviewing dental X-rays. Addressing periodontitis with a deep cleaning is necessary to remove the bacterial irritants that cause this tissue and bone destruction.
The Deep Cleaning Procedure
The deep cleaning procedure is an intensive, non-surgical treatment focusing on the tooth root surfaces below the gum line. To ensure comfort, the dental professional administers a local anesthetic to numb the gum tissue and surrounding area. Since the entire mouth is generally not numbed at once, the treatment is typically divided into two or more appointments, focusing on one or two quadrants of the mouth during each visit.
The first phase is scaling, where the hygienist or dentist uses specialized instruments to meticulously remove all plaque and tartar deposits from the tooth crown and root surfaces. This removal is performed using a combination of hand instruments (curettes) and ultrasonic scalers, which use high-frequency vibrations and a water spray. Following the scaling, the second phase, called root planing, is performed to smooth the tooth root surfaces.
Smoothing the roots eliminates rough areas where bacteria can easily adhere, helping to prevent future bacterial colonization. This smoothing action encourages the gum tissue to tighten and reattach to the cleaner, healthier root surface, which ultimately reduces the periodontal pocket depths. The entire procedure, which can take one to two hours per visit, is designed to create a clean environment for the gums to heal.
Immediate Aftercare and Recovery
Immediately following the procedure, patients should expect a period of temporary discomfort and sensitivity as the gum tissues heal. It is recommended to wait until the local anesthetic has completely worn off before eating to prevent accidentally biting the lips, cheeks, or tongue. For the first 24 to 72 hours, mild gum soreness, tenderness at the injection sites, and slight bleeding when brushing are common parts of the healing process.
Managing soreness can be accomplished with over-the-counter pain relievers, such as ibuprofen or acetaminophen, as directed by your dental provider. Patients should stick to a soft diet for the first day or two, avoiding foods that are hard, crunchy, spicy, or excessively hot in temperature. Aftercare includes gentle oral hygiene, such as rinsing the mouth two to three times a day with a warm saltwater solution (a half-teaspoon of salt in eight ounces of water) to soothe the gums and aid healing. Patients should continue to brush gently with a soft-bristled toothbrush.
Long-Term Follow-Up and Maintenance
Following the initial series of deep cleaning appointments, the focus shifts to a specialized maintenance plan to prevent the recurrence of the chronic disease. Periodontitis is a condition that requires ongoing management, and the standard six-month cleaning schedule is often insufficient for patients who have undergone SRP. Instead, patients transition into a Periodontal Maintenance Program (PMP), which involves more frequent visits.
These maintenance appointments are typically scheduled every three or four months, depending on the individual’s disease severity and response to the initial treatment. The purpose of this increased frequency is to disrupt the repopulation of harmful bacteria and remove any new plaque or tartar accumulation. During PMP visits, the dental team performs a meticulous cleaning of the root surfaces and assesses the health of the gum pockets to ensure the condition remains stable.