A deep cleaning, formally known as Scaling and Root Planing (SRP), is a therapeutic dental procedure required when gum disease has progressed beyond its initial stage. Unlike a standard prophylactic cleaning, which focuses on removing plaque and tartar from the visible surfaces of the teeth and slightly above the gumline, a deep cleaning addresses issues that have developed beneath the gums. This intensive treatment is specifically designed to treat active periodontal disease, where bacterial buildup has created spaces between the teeth and gums. The goal is to remove infection and prevent the disease from causing further destruction of the supporting structures of your teeth.
Understanding Periodontal Disease
The need for a deep cleaning arises when gingivitis, the earliest stage of gum inflammation, advances to periodontitis. Periodontitis is a more serious condition characterized by the formation of “pockets” between the gum tissue and the tooth root, which harbor disease-causing bacteria and hardened plaque, known as calculus or tartar. These pockets are measured by the dental professional using a small probe, and the depth is a primary diagnostic indicator for the need for SRP.
A healthy gum pocket measures three millimeters or less. When measurements consistently reach four millimeters or more, it signals that the infection has progressed beyond the reach of a standard cleaning. This deepening of the pocket is often accompanied by bleeding upon probing, a sign of active inflammation. In moderate stages, pockets are typically up to five millimeters deep, and X-rays may show visible loss of the bone that supports the teeth.
Bone loss is the most significant consequence of periodontitis, as it is an irreversible process that compromises the stability of the tooth. Visible signs a patient might notice include persistent bad breath, gums that appear red, swollen, or bleed easily, and a recession of the gum tissue, making the teeth look longer. A deep cleaning is considered the initial definitive treatment to halt this progression and manage the infection before surgical intervention becomes necessary.
The Scaling and Root Planing Procedure
The deep cleaning procedure, SRP, is a non-surgical treatment that specifically targets the infection below the gumline. Local anesthetic is typically administered to numb the sensitive area, ensuring patient comfort and allowing for a thorough cleaning.
The first part of the treatment is scaling, where specialized instruments, such as ultrasonic scalers or hand instruments, are used to meticulously remove the plaque and hard calculus deposits from the tooth surfaces and deep within the periodontal pockets. This cleaning extends all the way down to the bottom of the pocket, eliminating the bacterial colonies. Root planing involves smoothing the surface of the tooth roots.
Smoothing removes bacterial toxins and rough spots that allow bacteria to adhere. A smooth root surface encourages gum tissue to reattach more firmly, reducing pocket depth and helping the gums heal. SRP is often completed over multiple appointments, dividing the mouth into quadrants. Following the procedure, temporary soreness and increased tooth sensitivity are common for a few days.
Maintaining Gum Health After Treatment
After the initial Scaling and Root Planing procedure, the patient moves into a long-term care phase known as Periodontal Maintenance. This specialized, more frequent cleaning schedule is necessary because once a patient has been diagnosed with periodontitis, they are permanently susceptible to the recurrence of the disease.
Periodontal maintenance appointments are typically recommended every three to four months. This increased frequency is based on the fact that colonies of harmful bacteria can repopulate beneath the gumline in as little as 12 weeks. These frequent visits allow the dental team to proactively disrupt the bacterial cycle before it can cause re-inflammation or further bone loss.
During these maintenance visits, the dental professional monitors the periodontal pockets for any increase in depth and meticulously cleans the areas below the gumline. The success of this program relies heavily on the patient’s commitment to diligent home care, including effective brushing and daily flossing. Sometimes, prescription antimicrobial rinses may be incorporated to control the bacterial load in the mouth.