scaling and root planing

What is “Scaling and Root Planing”?

Scaling is the removal of calculus and biofilm from the surface of teeth. Biofilm (plaque) is basically oral bacteria that start depositing on the surface of teeth and in between the tooth and the gums. Calculus (or tartar) is when these deposits become mineralized and hard – making them hard to remove with the soft bristles of the toothbrush or a floss. Biofilm can easily be removed with a tooth brush on easily accessible surfaces of teeth and by flossing for in between the teeth.

Root Planing is the smoothening of the root surfaces to allow the gum tissue to reattach to the tooth with gingival and periodontal fibers. This reduces periodontal pockets around teeth which is a place for bacteria to grow.

Why Do I need to see the Hygienist?

Biofilm (plaque) and Calculus (tartar) can form either above the gum level (supragingival) or below the gum level (subgingival). While good brushing and flossing can remove the biofilm (plaque) from above the gum level, it can never reach under the gums. Our hygienists go under the gum level to clean the plaque and tartar from those areas using specialized instruments and techniques.

At Stouffville Smiles Dentistry, we use the most gentle and modern ultrasonic instruments (which produce tiny vibrations) called piezo units (vs the older cavitron units) that cause minimal discomfort and pain. Your hygienist may also use hand instruments called scalers and curettes to aid in removal of the biofilm and calculus and in smoothening the root surfaces to allow regeneration of the health of the gums.

What is the “water machine”?

Water machine is a common term used to describe the ultrasonic scaling devices. There are generally two types: 1. Piezo type and, 2. Magneto-restrictive type.

The piezo type is generally the more expensive of the two. It is gentler and requires less water as it doesn’t heat up like the other one. The tips designed for a piezo device are generally smaller and give the hygienist better access for difficult to reach areas. Also as opposed to the magneto-restrictive type, the whole handpiece along with the tip is sterilized eliminating the possibility of any cross infections.

Acteon B.LED Technology Video (this is what we use)

With a Magneto-Restrictive Device, only the insert (grey part) is sterilized.

Image result for cavitron wiping

I don’t Like The Water – Can The Cleaning Be Done With Hand Instruments Only?

The short answer is Yes. However, ultrasonic powered instruments can greatly enhance the results within a much short time. Some people have concerns about scratching of the enamel or teeth with the ultrasonic machines. Electronic microscope studies have shown no scratches forming at all on the enamel and for them to be more consistent and less harsh on the root surfaces. If your teeth are sensitive to the water, please note our dental chairs use warm water! We also recommend numbing the gums and/or the teeth if the sensitivity is very high. Whichever is the case, our hygienists will always tend to your needs and listen to you – after all you’re the patient!

See the following image to see the difference in the results from each instruments on the root surface:

Before Treatment

With Hand Instruments

With Magneto-Restrictive Instruments

With Piezo Instruments (this is what we use)

How Often Should I get a “Cleaning”?

We often get asked, why 3 months vs 4 months vs 6 months or a year for regular cleaning! The answer is simply in the biology of the gums and teeth. Studies have shown that the gums and the periodontal tissues can typically fend off the bacteria without irreversible damage for about 3 months in an average patient. This is why for most people with deeper than normal periodontal pockets or bleeding gums, we recommend a 3 month cycle for the cleaning appointments. Children and completely healthy adults with no signs of periodontal or gingival disease are usually seen every 6 months to ensure their gums remain healthy and that any biofilm and calculus formed under the gums can be removed.

These recommendations follow the standards set by the American Academy of Periodontology (AAP) and are based on evidence based studies and clinical research and experience. At some of your visits, including your first visit with us, our hygienists will “measure” your gums. These measurements tell us if you have any unhealthy pockets, recession of the gums and/or bleeding of the gums. Based on these numbers and various other factors and findings, we quantify your periodontal condition as various stages (as set out by the AAP) with each one warranting a different type and frequency of treatment.

As opposed to the old idea of cleaning is just a cleaning – we consider the scaling and root planing appointment with your hygienist “a treatment” that is based on accurate diagnosis and treatment planning.