Dental curettage is a specialized dental procedure aimed at treating moderate to advanced gum disease. This therapy involves meticulous cleaning deep beneath the gum line to remove infected material that standard cleaning cannot reach. The goal is to create a healthier environment within the gum tissue to prevent further destruction of the structures supporting the teeth.
Understanding Periodontal Disease
The requirement for curettage arises from the progression of periodontal disease, a serious condition where chronic inflammation attacks the soft tissue and bone surrounding the teeth. This disease begins when bacterial plaque and hard deposits, known as calculus or tartar, accumulate below the gum line. The body’s immune response causes the gum tissue to detach from the tooth surface, forming a deepening space called a periodontal pocket. While healthy pockets measure one to three millimeters, periodontitis causes pockets four millimeters or deeper, creating a sheltered environment where harmful bacteria thrive. The lining of this deep pocket becomes chronically inflamed and infected with diseased tissue.
The Curettage Procedure Explained
The process begins by ensuring patient comfort, typically through the administration of a local anesthetic to thoroughly numb the specific area being treated. The dental professional first performs scaling and root planing, which is the mechanical removal of plaque and calculus from the tooth root surface. The actual curettage action follows this initial deep cleaning.
A specialized instrument called a curette, which has a rounded toe and cutting edges, is carefully inserted into the periodontal pocket. The operator then uses precise, controlled scraping strokes to physically remove the diseased, inflamed soft tissue lining the inner wall of the gum pocket. Removing this infected tissue encourages the formation of new, healthy connective tissue and promotes the reattachment of the gum to the tooth root.
Curettage in Modern Dentistry
Soft tissue curettage is often considered an inherent part of a thorough Scaling and Root Planing (SRP) procedure, a non-surgical treatment commonly referred to as a deep cleaning. When diseased soft tissue removal occurs unintentionally during the necessary scraping of the root surface, it is termed “closed curettage.” Contemporary practice recognizes that the primary goal of SRP is to meticulously clean the root surface, allowing natural healing to resolve inflammation.
Historically, a more aggressive, dedicated procedure known as “gingival curettage” or “open curettage” was performed as a standalone surgical technique. This involved intentionally scraping the soft tissue lining. Today, this standalone soft tissue curettage is performed less frequently, as research suggests it may not provide significant additional benefits over SRP alone. When advanced pocket reduction is necessary, periodontists often opt for more predictable surgical procedures like flap surgery or regenerative techniques to correct bone defects.
Post-Procedure Recovery and Maintenance
Following the procedure, patients should expect temporary discomfort, including mild soreness, sensitivity, and slight swelling of the gum tissue. This initial discomfort typically lasts only a few days and can be managed effectively with over-the-counter pain relievers. Complete healing of the gum tissue generally occurs within one to two weeks, depending on the severity of the initial disease.
Post-operative care is crucial for the success of the treatment and involves specific instructions to aid healing.
- Patients are advised to eat a soft diet for the first few days and avoid hot or spicy foods that could irritate the treated areas.
- Rinsing with a prescribed antimicrobial mouthwash, such as one containing chlorhexidine, is often recommended for a short period to control the bacterial load.
- Long-term success relies on a renewed commitment to diligent oral hygiene, including consistent brushing and flossing.
- Adhering to a strict schedule of follow-up maintenance appointments, usually every three to six months, is necessary.