Non-surgical Treatment

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Scaling and Root Planing

Treatment of periodontitis typically begins with a “deep cleaning,” called scaling and root planning, to remove plaque and tartar deposits beneath the gum line. The roots of the teeth may also be planed to smooth the root surface, allowing the affected gum tissue to heal and reattach to the root surface.

Despite what you may have heard, scaling and root planning is painless! This treatment is completed with the use of local anesthetic in affected areas. Typically, when full mouth scaling and root planning is necessary, it is scheduled in two, one and a half hour appointments. Following this procedure, your at home oral hygiene is of key importance to helping your body heal and your pockets shrink.

Six weeks after scaling and root planning, a re-evaluation appointment is critical to determine how you responded to this treatment. If at this appointment it is determined that your gums are healthy, a long term periodontal maintenance program will be recommended, typically requiring you to come in for a cleaning every 3 months. If at the re-evaluation your gums still have not reached a healthy state, other treatment options will be discussed with you aimed to continue to improve your oral health.


When periodontal disease occurs, the bacteria accumulate below the gum line. If allowed to sit for long periods of time, the bacteria become embedded in the tissue and hardened on to the root structures, creating deeper pockets that are no longer accessible with regular tooth brushing. Part of your treatment includes the removal of the calculus from the root structure by using a combination of specially designed ultrasonic and hand instruments. Once the debris is removed, the gum tissue should reattach to the clean root structure.

Case Study

65 year-old female presents with chief concern, “I don’t like the way my front teeth look and I would like new crowns. Also my last dentist told me I have gum problems.”

To discuss this case, we will focus on the upper front teeth, although all teeth were affected. Below you will see photos and measurements taken prior to any periodontal treatment.  Note the heavy calculus and plaque accumulation, bleeding sites, and deep pockets on the backside of these teeth.  By just looking at this patient, you may not guess she had gum disease, as the majority of her disease is occurring on the backside of her teeth.  This illustrates the importance of scheduling regular check-ups at both your dentist’s and periodontist’s offices so together, they will be able to catch problems early on.

Just 6 weeks after scaling and root planning was completed, the patient’s tissue health improved dramatically and her pockets shrunk considerably