The procedure commonly known as a deep cleaning is a specialized, non-surgical periodontal therapy formally termed Scaling and Root Planing (SRP). This treatment addresses gum disease that has progressed beyond the initial, reversible stage. It becomes necessary when bacterial accumulation threatens the underlying structures that support the teeth, requiring a more intensive approach than a routine cleaning. The goal is to halt the progression of infection and allow the gums to reattach to the tooth roots.
The Difference Between Deep and Regular Cleaning
A standard dental cleaning, or prophylaxis, is a preventative measure for maintaining oral health. It focuses on removing plaque and hardened calculus, or tartar, from the visible surfaces of the teeth and slightly above the gumline. Prophylaxis is typically recommended every six months to manage the accumulation of bacterial deposits.
The fundamental difference lies in the depth and purpose; a regular cleaning is preventative, while deep cleaning is curative. Deep cleaning is prescribed when the gingival tissue has pulled away from the tooth, forming periodontal pockets that harbor infection. A healthy gum pocket measures between one and three millimeters, but measurements of four millimeters or more indicate the need for SRP. This deeper approach targets infectious material collected far below the surface, where standard tools cannot reach.
Why Deep Cleaning Becomes Necessary
The need for deep cleaning arises from the progression of gum disease, which begins as gingivitis, characterized by inflammation and bleeding gums. If plaque and calculus are not removed, the condition advances to periodontitis, a chronic inflammatory disease. In periodontitis, bacterial toxins trigger the body’s immune response, causing the tissue and bone supporting the teeth to break down.
As the underlying bone is lost, the space between the tooth root and the gum tissue deepens, creating a periodontal pocket. These deeper pockets provide an ideal environment for harmful bacteria to multiply and continue the cycle of destruction.
Scaling and Root Planing is necessary to remove irritants from these pockets, eliminating the infectious agents causing the loss of tooth support. The treatment is a medical necessity to stop the disease from progressing to a stage that could result in tooth mobility and eventual tooth loss.
The Scaling and Root Planing Procedure
Scaling and Root Planing is a two-part procedure performed by a dentist or dental hygienist, often requiring a local anesthetic for patient comfort. Because the treatment involves extensive cleaning below the gumline, the mouth is typically divided into two or four sections, or quadrants. Treatment is then performed over separate appointments, with the local anesthesia numbing the gum tissue and surrounding bone.
The first step, scaling, involves meticulously removing all plaque and calculus from the tooth surface and the root, extending to the bottom of the periodontal pocket. This is accomplished using specialized instruments, including ultrasonic scalers that use high-frequency vibrations to break up hard deposits. Following the removal of deposits, the second step, root planing, smooths the tooth root surfaces. This smoothing action removes bacterial toxins and eliminates rough areas where bacteria might easily reattach, facilitating gum healing.
Recovery and Follow-Up Care
After the procedure, patients can expect side effects, including mild soreness and heightened tooth sensitivity for a few days to a week. The gums may appear swollen or tender, and a small amount of bleeding is not uncommon following this intensive cleaning. Patients are advised to wait until the local anesthesia wears off before eating to prevent accidentally biting their cheek or tongue.
Short-term care involves maintaining gentle but thorough oral hygiene and often includes rinsing with warm salt water to soothe the tissues and promote healing. A soft food diet is recommended for the first 24 to 48 hours to minimize irritation to the healing gums.
Following the initial healing period, the dental team will recommend a long-term strategy known as periodontal maintenance. This maintenance involves more frequent cleanings, typically every three to four months, rather than the standard six-month interval. This schedule helps consistently manage the chronic nature of periodontitis and prevent disease relapse.