When you brush and floss your teeth every day you are able to remove the majority of bacteria and plaque that has accumulated on your teeth since the last time you brushed. If this routine is missed or is not done on a regular basis then plaque can harden into tartar (also known as calculus) which is much more difficult to remove. Tartar generally cannot be removed through simple brushing and flossing and instead must be addressed in the dentist’s office. When the dental hygienist and dentist go over your teeth they will usually perform teeth scaling to get rid of tartar build up.
You may not have heard of the term teeth scaling before but if you have ever been to the dentist than you have probably had it done to you. One of the first things that will happen when you visit the dentist for a checkup is that the hygienist will bring out a tool with hooks on either end, one pointy and one dull. They will then go through your mouth and scrape up any hardened plaque or tartar that has accumulated on the surface, along the gum line, and in between the teeth. This process is called scaling. It seems very simple but there is more to it than just scraping off some hardened gunk.
One of the reasons that it is important to go to the dentist no matter how good your oral hygiene is that it is almost impossible to prevent build-up even with twice daily brushing and flossing. The bacteria in our mouths are always hard at work trying to build up and take over. So, while regular brushing, flossing, and rinsing with mouthwash can keep bacteria mostly at bay, plaque and tartar can still build-up in hard to reach places. Even going a day without brushing, or several days without toothpaste or flossing can be enough to allow for plaque to take hold.
If this build-up goes untreated it can lead to gum disease. While hardened plaque and tartar on the surface of the teeth are undesirable, the build-up specifically at the gumline irritates the gums and pushes downward beneath the gumline. This eventually can cause deep pockets to form and periodontal disease to worsen.
Aside from the standard scaling procedure that is performed during a routine checkup, there is another scaling procedure that those with gum disease might have recommended to them. This is called scaling and root planing, also known as a deep clean. In this deep clean procedure, the hygienist or dentist will first perform a standard scaling on the portion of the tooth that is above the gum line. They will then rinse the teeth to remove debris and do a second sweep of the teeth below the gum line down to the root. Finally, they will perform what is called root planing which smoothes the surface of the root.
The gums usually attach to the teeth around 1 to 3 millimeters below the gumline. This pocket between the top of the gum line and where the gum attaches can have a build-up of plaque and tartar in the same way that the exposed surface of the tooth can. Unfortunately, this cannot be reached through conventional brushing and, therefore, needs to be removed by a professional before it causes further damage.
This root planing procedure is meant to smooth out the surface of the root to make it more difficult for plaque to build-up and attach. By smoothing out the root this is also encouraging the gums to reattach and reverse the damage that was done. If the hardened plaque below the gum line is not removed then it will continue to build-up and increase the depth of the pockets beneath the gum line. The build-up of plaque irritates the gums and causes them to further pull away, leaving the root exposed. This can lead to periodontal disease and even threaten the underlying jawbone. When periodontal disease advances the teeth can become loose and require splinting or even removal if they cannot be saved. However, with proper oral care after the deep clean it is possible to promote the healing of the gums and reverse the situation.
Scaling may be done either manually with the basic scaling tool or with an ultra-sonic type scaling tool. And ultra-sonic scaling tool is usually used in more difficult cases. Similar to an electric toothbrush, this powered tool has a head that vibrates and often also will squirt a stream of water that rinses at the same time. The vibrating head acts to chip away built-up plaque like a mini jackhammer.
If you have sore and bleeding gums on a regular basis and are recommended to have a deep cleaning then your dentist may also recommend using a desensitizing toothpaste both before and after the treatment. If the situation is very bad, then they may also use an anesthetic to numb the area. In cases where there is an extensive amount of build-up, it may take more than one session to completely address all areas of the mouth. If the deep clean must be split into multiple sessions, then the dentist will likely work on a single quadrant of the mouth at a time.
Eventually, however, they will get through the whole mouth and you will be amazed at the difference in your smile and gum health. It may take a few days to a week but eventually, the redness and inflammation in your gums should go away. After having had a deep clean it is very important that you follow all instruction for future dental hygiene. You do not want to have another build-up of plaque that requires another deep clean. This deep clean scaling and root planing procedure can usually be avoided through regular brushing and flossing as directed by your dentist, as well as going to regular checkups so that buildup is addressed on a more routine basis.