Scaling & Root Planing

Scaling and root planing, otherwise known as conventional periodontal therapy, non-surgical periodontal therapy, or deep cleaning, is the process of removing or eliminating the etiologic agents – dental plaque, its products, and calculus – which cause inflammation, thus helping to establish a periodontium that is free of disease.

Current treatment for periodontitis involves scraping dental plaque, the polymicrobial biofilm, off the tooth, a procedure called scaling. Root planing involves scaling the tooth’s root. Scaling and root planing are often referred to as deep cleaning.

The objective for periodontal scaling and root planing is to remove dental plaque and calculus (tartar), which house bacteria that release toxins which cause inflammation to the gum tissue and surrounding bone. According to Brentwood periodontists, Dr. Alina Krivitsky and Dr. Alexandre Aalam, scaling and root planing is one of the most effective periodontal methods of treating gum disease before it becomes severe.

However, according to the Evidence-Based Dentistry website, the Cochrane Oral Health Group in 2005 found two relevant studies, with neither showing any clinical benefit to scaling.[3] In 2013 the Cochrane Oral Health Group examined three new studies. The most pertinent study found no benefit for regular scaling treatments when compared to a no-scale regimen.[4]

Also, cleaning pockets deeper than 5mm is difficult, and the deeper the pocket, the harder it is to clean effectively.[5] Since a periodontal pocket is defined as 4mm or more, scaling and root planing are ineffective at cleaning the deep pockets associated with periodontitis. Thus, the deep cleaning that scaling and planing is supposed to provide is not deep at all, and probably has little impact, if any, on gum disease.