A deep cleaning, formally known as Scaling and Root Planing (SRP), is a specialized dental procedure used to treat periodontal disease. This treatment involves cleaning surfaces far below the gum line, which can cause significant discomfort without intervention. Numbing is a standard and highly recommended part of the deep cleaning process to ensure patient comfort. The decision to numb and the type of anesthetic used depends on the severity of the condition being treated.
Understanding Scaling and Root Planing
Scaling and Root Planing is a non-surgical treatment that differs significantly from a routine professional cleaning. A typical cleaning focuses on removing plaque and calculus (hardened tartar) from the visible tooth surfaces above the gum line. SRP is necessary when periodontal disease causes the gum tissue to pull away from the tooth, creating periodontal pockets. Pockets measuring five millimeters or more generally indicate the need for this procedure.
Scaling involves meticulously removing bacterial plaque and calculus accumulated inside deep pockets and along the tooth root. This requires instruments, such as ultrasonic scalers and manual curettes, to access sensitive and inflamed areas. Following scaling, root planing smooths the tooth root surface, removing residual toxins and discouraging bacteria from reattaching. This smoothing action allows the gum tissue a better chance to reattach firmly to the tooth, which is the primary goal of the treatment.
Types of Anesthesia Used
To manage the discomfort of cleaning below the gum line and addressing inflamed tissue, dentists employ several effective methods of anesthesia. The mildest approach is topical anesthesia, applied directly to the gum tissue as a gel or cream before an injection. This compound temporarily numbs the surface of the gum, reducing the sensation of the needle stick.
The most common method is a local anesthetic injection, which uses a drug like lidocaine or articaine to block nerve signals in a specific area. This is done through local infiltration, where anesthetic is injected directly near the tooth or teeth being treated. The effect is localized, numbing the tooth and surrounding gum tissue for the duration of the procedure.
When a larger area, such as an entire quadrant, needs to be treated, a dentist may opt for a nerve block injection. This technique involves injecting the anesthetic near a main nerve trunk, which effectively numbs a much larger region. This region includes the teeth, gums, lip, and tongue on that side, ensuring the patient remains comfortable throughout the longer cleaning session.
How the Dentist Decides on Numbing
The decision regarding the necessity and extent of numbing is determined by objective clinical factors and patient considerations. A primary indicator is the severity and depth of the periodontal pockets being treated. Deeper pockets require more aggressive instrumentation closer to the tooth root and bone, which significantly increases the likelihood of pain and necessitates anesthesia.
The overall extent of the required cleaning also guides the use of numbing agents. Because a deep cleaning can be lengthy and invasive, the procedure is often split into two or four separate appointments, treating one quadrant at a time. Numbing only the treated section prevents the patient from having an entire side of their face numb for the rest of the day. The dentist also considers the patient’s individual pain or anxiety threshold. Even in less severe cases, local anesthesia may be recommended to help an anxious patient relax during the procedure.
Post-Procedure Care and Expectations
After the deep cleaning is complete, the area will remain numb for a period of time. Local anesthesia typically lasts between one and four hours, depending on the type and amount of drug used. Patients are advised to avoid chewing until the numbness has completely worn off to prevent accidentally biting the cheek, lip, or tongue.
Once the anesthetic wears off, it is common to experience mild gum tenderness, soreness, or slight swelling for a few days. This discomfort can usually be managed effectively with over-the-counter anti-inflammatory medications like ibuprofen or acetaminophen. Temporary tooth sensitivity to hot, cold, or sweet temperatures is also a normal occurrence as the gum tissue heals.
For the first few days, a soft diet is recommended, and patients should avoid hard, crunchy, or spicy foods that could irritate the healing gums. Rinsing the mouth gently two or three times a day with warm salt water can help soothe the tissues and promote healing. Patients will be scheduled for a follow-up re-evaluation appointment, typically within six to twelve weeks, to confirm that the gum pockets are reducing in depth.