Scaling & Root Planing (SRP)

The initial stage of treatment for periodontal disease is usually a thorough cleaning that may include scaling and root planing. The objective of this non-surgical procedures is to remove etiologic agents such as dental plaque and tartar, or calculus, which cause gingival inflammation and disease. Scaling and root planing may be used as a stand-alone treatment in early forms of periodontitis.  Scaling and root planing are commonly preformed on cases of mild to severe periodontal disease, as an initial step.

What do the procedures entail?

Drs. Palermo-Edwards & Cacchillo will only perform scaling and root planing after a thorough examination of the mouth, which may include taking x-rays and visually examining the mouth. Depending on the condition of the gums, the amount of tartar present, the depth of the pockets, and the progression of periodontitis.  In many cases, a local anesthesia may be used during the procedure.

  • Scaling:
    When scaling is performed, calculus and plaque that attaches to the tooth surfaces is removed. The process targets the area above and below the gum line, along the root. Scaling may be performed with a special dental tool called an ultrasonic scaling tool. The scaling tool usually includes an irrigation process that can be used to deliver an antimicrobial agent below the gums to help reduce oral bacteria.
  • Root Planing:
    Root planing is performed in order to remove cementum and surface dentin, from the root surface, that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future.

An animated illustrion showing the process of scaling An animated depiction of a root planning procedure

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. In some cases, Drs. Palermo-Edwards & Cacchillo may place an antibiotic powder in the periodontal pockets after scaling and planing. This may be done to control infection and to encourage normal healing.

When deep pockets between teeth and gums are present, it is difficult for Drs. Palermo-Edwards & Cacchillo to thoroughly remove plaque and tartar. Patients can seldom, if ever, keep these pockets clean and free of plaque. Consequently, surgery may be needed to restore periodontal health in patients with more advanced disease.

Benefits of Treatment

If treatment is successful, scaling and planing may have many periodontal benefits. One is that it can help prevent the progression of disease. Research has proven that bacteria from periodontal infections can travel through the blood stream and affect other areas of the body, sometimes causing heart and respiratory diseases. Scaling and root planing remove bacteria that cause these conditions.

Another benefit of treatment is protecting teeth against tooth loss. When gum pockets exceed 4mm in depth, the risk for periodontal disease increases. As pockets deepen, more bacteria are able to colonize, eventually causing a chronic inflammatory response by the body to destroy gingival and bone tissue. This leads to tooth loss.

Finally, scaling and root planing may make the mouth more aesthetically pleasing, and should reduce bad breath caused from food particles and bacteria in the oral cavity. In cases of more advanced disease, scaling and root planing can often minimize the amount of gum surgery needed to restore health.  Superficial stains on the teeth will be removed during scaling and planing, adding an extra bonus to the procedures.