Scaling and Root Planing (SRP), commonly called a “deep cleaning,” is a non-surgical medical treatment for gum disease. This therapeutic intervention addresses an active infection, setting it apart from a routine professional cleaning, which is preventive. When bacteria compromise the supporting structures of the teeth, SRP is necessary to remove deposits unreachable by standard tools. The goal is to halt the progression of periodontal disease and restore the health of the gum tissue and underlying bone.
Understanding the Need for Deep Cleaning
The distinction between simple gum inflammation, or gingivitis, and the more serious condition of periodontitis determines the necessity of a deep cleaning. Gingivitis involves inflammation and bleeding of the gums without bone loss and can typically be reversed with routine cleanings and improved home care. Periodontitis, however, is a chronic bacterial infection that causes irreversible destruction of the bone and tissue supporting the teeth.
The need for SRP is established through a comprehensive periodontal examination, which measures the periodontal pocket (the space between the tooth and gum). Healthy pockets measure one to three millimeters. Depths of four millimeters or greater, especially with bleeding upon probing, indicate periodontitis. These deeper pockets allow hard bacterial deposits, called calculus, to accumulate below the gumline, which cannot be removed by regular home care.
The dental professional also assesses radiographic bone loss visible on X-rays. When deep pockets, bleeding, and bone loss are confirmed, deep cleaning is the required initial therapy. This procedure mechanically removes subgingival calculus and smooths the root surfaces. This smoothing, or planing, discourages bacteria from reattaching and allows the gum tissue to potentially reattach to the cleaned root.
The Initial Deep Cleaning Treatment Schedule
The initial deep cleaning is a finite event, meaning it is performed once to treat the diagnosis of periodontitis. To ensure patient comfort and clinical effectiveness, the procedure is typically not completed in a single visit. The mouth is often divided into four sections, known as quadrants: the upper right, upper left, lower right, and lower left.
The standard protocol involves treating two quadrants per appointment, usually on the same side of the mouth, spaced one or two weeks apart. This allows the professional to concentrate on a smaller area for thorough debridement. Splitting the procedure also manages patient comfort, as local anesthesia is administered to numb the treated sections.
Treating only two quadrants at a time limits the area of the mouth that is numb, allowing the patient to eat and speak more comfortably between appointments. For patients with mild or localized disease, the entire procedure might be completed in one longer session. Conversely, individuals with severe disease may require four separate appointments to maximize healing. Once all affected quadrants have been treated, the initial therapeutic phase of the deep cleaning is complete.
Long-Term Maintenance After Deep Cleaning
After the initial SRP procedure, ongoing care shifts from a routine cleaning schedule to Periodontal Maintenance (PM). This long-term strategy manages the chronic nature of periodontitis and prevents recurrence. Once treated for periodontitis, a patient is considered a periodontal patient for life.
Periodontal Maintenance replaces the standard twice-yearly prophylactic cleaning because the patient has a history of bone and tissue breakdown. Deeper pockets and areas of past attachment loss are susceptible to rapid recolonization by bacteria. Therefore, maintenance visits are typically scheduled more frequently, most commonly every three months.
This increased frequency is based on the biological reality of bacterial growth. Pathogenic bacteria can repopulate the periodontal pockets within approximately 90 days, making the three-month interval a clinical necessity to disrupt this cycle. The PM appointment involves carefully cleaning the root surfaces below the gum line, removing new accumulation, and re-evaluating pocket depths and overall gum health.
Adherence to this rigorous schedule is paramount, as failure to attend Periodontal Maintenance appointments can lead to a relapse of the disease. If the infection returns and progresses, it can necessitate another full Scaling and Root Planing procedure or, in severe cases, require surgical intervention to access and clean the deep root surfaces. The goal of continuous maintenance is to stabilize gum health and preserve the remaining supporting bone structure for the long term.