A deep cleaning, formally known as scaling and root planing (SRP), typically involves local anesthesia for patient comfort. This procedure is significantly more extensive than a routine cleaning, targeting bacterial deposits far below the gum line. Due to the depth of treatment and the sensitivity of nerve endings, an anesthetic is usually required to numb the gums and tooth roots.
Defining Deep Cleaning and Its Purpose
A dental deep cleaning is a two-part procedure called scaling and root planing (SRP), which is the standard treatment for early to moderate periodontitis, or gum disease. The first part, scaling, involves meticulously removing plaque and hardened tartar, known as calculus, from the surfaces of the teeth both above and below the gum line. This process is necessary because these deposits harbor bacteria that cause inflammation and infection.
The second part, root planing, focuses on smoothing the exposed root surfaces. This action eliminates minute irregularities where bacteria can cling and multiply, making the environment less conducive to future plaque accumulation. The goal is to allow the gum tissue to heal and reattach firmly to the clean, smooth tooth root, reducing the depth of periodontal pockets. Since instruments must reach several millimeters below the gum tissue, the procedure causes considerable sensitivity.
The Decision to Use Anesthesia
Local anesthesia for scaling and root planing is standard practice for most patients. The severity of periodontal disease is a primary factor; deeper gum pockets (4 millimeters or more) make the procedure more uncomfortable as instruments reach sensitive root surfaces. Inflammation associated with gum disease also increases tissue sensitivity, making anesthesia beneficial for a thorough cleaning.
The clinician also considers the patient’s anxiety level and pain tolerance. Deep cleaning is often performed in sections, or quadrants, of the mouth, over multiple appointments to limit the amount of numbing required. Anesthetizing an entire quadrant allows for a comprehensive, pain-free cleaning of that area.
Methods of Local Anesthesia Used
Local anesthesia for deep cleaning is often a combination of methods to provide profound numbness. The process begins with applying a topical anesthetic gel or cream (containing agents like benzocaine or lidocaine) directly to the gum tissue. This numbs the surface, minimizing discomfort from the subsequent injection.
Following the topical application, the dental professional administers an injectable local anesthetic to achieve deeper, longer-lasting numbness. This injection may be a local infiltration, numbing a small area around one or two teeth, or a nerve block, which numbs a larger region like a full quadrant of the jaw.
Injectable agents are typically part of the “-caine” family, such as lidocaine. They are often combined with a vasoconstrictor like epinephrine to prolong the numbing effect and reduce bleeding. For patients with significant anxiety, adjunctive methods like nitrous oxide (laughing gas) may be used for conscious sedation, supplementing the local anesthetic that blocks the pain.
Managing Comfort After the Numbing Wears Off
Once the local anesthesia wears off (typically one to three hours), patients can expect temporary discomfort. Mild soreness and tenderness in the gums are common as tissues heal. There may also be a temporary increase in tooth sensitivity, particularly to cold temperatures, as the cleaned roots are initially more exposed.
Taking an over-the-counter anti-inflammatory medication, such as ibuprofen, before the numbness fades can help manage initial soreness. For the first 24 to 48 hours, stick to a soft diet and avoid hard, crunchy, or spicy foods to prevent irritation. Rinsing gently with a warm salt water solution a few times a day can also promote healing and reduce swelling.