Dental scaling is a professional procedure performed by a dentist or a dental hygienist to remove hardened deposits from the surfaces of teeth. This treatment involves meticulous cleaning both above and sometimes below the gum line. Scaling is necessary to maintain the health of the gums and the underlying supporting bone structure. It is distinct from routine polishing, which is performed afterward to smooth surfaces and remove minor stains.
Why Scaling is Necessary
The necessity for scaling begins with the constant formation of plaque, a sticky, colorless biofilm composed primarily of bacteria. If plaque is not removed completely through daily brushing and flossing, it absorbs minerals from saliva within 24 to 72 hours and hardens into calculus, commonly known as tartar. Calculus is a calcified deposit that is harder than bone and cannot be removed by regular oral hygiene methods alone.
The accumulation of calculus, particularly along the gum line, harbors more bacteria, leading to inflammation called gingivitis. This mild gum disease causes the gums to become red, swollen, and prone to bleeding. If gingivitis is not addressed, the inflammation can progress to periodontitis.
In periodontitis, chronic inflammation causes the gums to pull away from the teeth, creating deep pockets where calculus accumulates further below the gum line. This sub-gingival calculus harbors bacteria that destroy the bone and connective tissue supporting the tooth. Scaling effectively removes these hardened deposits both above and below the gum line, stopping the progression of bone loss and preventing eventual tooth loss.
The Professional Scaling Procedure
The professional scaling procedure typically employs a combination of ultrasonic scaling and manual scaling. The process begins with the ultrasonic scaler, which efficiently removes the bulk of the hard calculus deposits. This device uses a handheld wand with a fine tip that vibrates at a high frequency to fracture and dislodge the stubborn tartar.
The ultrasonic scaler tip also emits a gentle stream of water, a process called lavage. This water spray cools the vibrating tip, preventing heat buildup, and flushes away the dislodged calculus and debris. This method is faster and often more comfortable than manual techniques for removing heavy buildup.
Following bulk removal, the dental professional transitions to manual scaling instruments, such as curettes and sickle scalers, for precision work. These specialized hand instruments meticulously remove any residual deposits the ultrasonic device may have missed, particularly in deep pockets. The hygienist ensures every tooth surface, including the root surfaces below the gum line, is entirely smooth.
The combination of ultrasonic efficiency and manual precision is the gold standard for comprehensive cleaning. When the procedure involves deeply smoothing the root surfaces, it is referred to as scaling and root planing. This is a treatment for active gum disease, and smoothing the root surface helps the gum tissue reattach and makes it difficult for bacteria to re-adhere.
Managing Expectations and Maintenance
Discomfort and Anesthesia
Patients undergoing standard scaling for routine maintenance generally experience minimal discomfort, often managed by the rapid efficiency of the ultrasonic tools. However, for deep cleaning (scaling and root planing) used to treat existing gum disease, a local anesthetic is frequently administered. This ensures patient comfort while the hygienist works below the gum line to remove deep sub-gingival calculus and smooth the tooth roots.
Post-Procedure Side Effects
Temporary side effects are common immediately following a deep scaling procedure. These include mild tenderness, gum swelling, and minor bleeding for a few days. Increased sensitivity to hot and cold temperatures is also an expected temporary outcome, as calculus removal can expose previously covered tooth root areas. This sensitivity typically subsides within a few days to a week or two as the gums heal.
Frequency and Home Care
The frequency of professional scaling depends on the patient’s periodontal health status. For individuals with healthy gums, a standard professional cleaning every six months is recommended. Patients treated for periodontitis often require more frequent visits, known as periodontal maintenance, which may involve scaling every three to four months to manage the disease and prevent recurrence.
Maintaining excellent home care is crucial for long-term success following any scaling procedure. This involves consistent brushing and daily flossing to prevent surfaces from quickly becoming re-colonized by plaque. The dental professional may also recommend using a sensitivity toothpaste or an antimicrobial rinse temporarily to aid healing and manage discomfort.