Scaling and Root Planning
Scaling and root planing is a non-surgical periodontal disease treatment that involves a deep cleaning beneath the gumline. Local anaesthetic is used to numb the area to be treated before the surgery begins.
After that, plaque and tartar behind the gums are removed manually or with an ultrasonic tool. Root planing is the final process, which smooths uneven surfaces and removes microorganisms beneath the gum line.
- You may have some discomfort for a day or two after a scaling and root planing procedure, as well as sensitivity for up to a week. We’ll go through the cost of scaling and root planing, as well as whether or not insurance will cover the operation and how financing can help.
Scaling and root planing is a thorough dental cleaning of tooth root surfaces to remove plaque and tartar (calculus) from around teeth and periodontal pockets in the gums and to smooth the tooth roots to remove bacterial toxins.
Why Is Scaling and Root Planing Performed?
Gingivitis, an early stage of gum disease, can be effectively treated with scaling and root planing, as well as thorough daily brushing and flossing.
Scaling and root planning are also low-cost, minimally invasive, and non-surgical techniques to prevent and/or cure periodontitis, a more serious form of gum disease. Periodontitis is a more serious kind of gum disease that takes longer to heal.
Gingivitis is a milder, more easily treated form of gum disease. Periodontitis may have more severe consequences and treatment options.
Inflammation and infection of the gums and adjacent oral tissues are symptoms of periodontal disease. Bacterial plaque (a sticky, white film that forms on teeth) hardens into a rough, porous substance that produces toxins, which is the main cause of gum disease.
These toxins cause the gum fibers that keep the teeth in place to loosen and break down, resulting in periodontal pockets that can fill up with bacteria and toxins. If left untreated, the pockets would deepen and the bone that holds the teeth in place will be damaged, resulting in tooth loss (edentulism).
Who Performs Scaling and Root Planing?
The severity and progression of gingivitis and periodontal disease, and how well you respond to therapy, determines your treatment and who performs it.
Preventive scaling and root planing are performed by dental hygienists and general or family dentists, who also treat cases of early-stage gum disease. Treatment of more sophisticated, difficult cases necessitates additional training.
In such cases, a general dentist may recommend you to a periodontist, an expert in periodontal disease diagnosis, prevention, and treatment. A periodontist completes a three-year post-dental school education that includes specific gum training and treatment approaches.
A periodontist, for example, can perform surgical procedures such as creating incisions in the gums to remove hardened plaque accumulation and improve the boney abnormalities in more severe cases.
The Scaling and Root Planing Procedure
A dental hygienist and/or general dentist will review your plaque buildup and inspect your gums for suspected periodontal diseases during the initial examination. The depth of the crevices between your teeth and gums, known as the sulcus, will be assessed using a periodontal probe.
Healthy gum tissue generates a sulcus, a shallow, v-shaped groove between the tooth and gums, at the gumline’s border. The depth of a normal sulcus is 3 mm or less.
The sulcus widens as a result of periodontal disease, resulting in a deeper pocket of more than 3 mm and dangerous plaque buildup that cannot be removed without skilled dental treatment.
When pockets are larger than 3 mm, scaling and root planing are performed. Plaque and tartar are removed from above and below the gum line during scaling.
Tooth scaling can be uncomfortable depending on the amount of tartar and plaque accumulation on your teeth and your level of sensitivity; a numbing gel or anaesthetic injection is usually used to alleviate discomfort.
After your dental expert has administered numbing or anaesthesia, he or she will use a small scaler, an ultrasonic cleaner, or both to carefully remove plaque and tartar from the bottom of each periodontal pocket. Planing – or smoothing – the tooth surfaces prevents plaque from forming around the root surfaces and allows gum tissue to repair.
Scaling and root planing may be performed quadrant by quadrant, depending on the severity of your problem.
Typically, the upper and lower quadrants on one side of the face are done at one appointment, and the upper and lower quadrants of the other side are done at a second appointment.
At the treatment appointment, your dentist also may administer local antibiotics, antimicrobials and other medications directly into the periodontal pockets to help control infection or pain, as well as encourage faster healing.
Early stage gum disease treatment may include tooth scaling and cleaning at three-month intervals, as well as the use of medicated mouthwash and daily flossing. Later stage gum disease treatment may include deep plane scaling, periodontal surgery and laser surgery.
Dental Lasers for Scaling and Root Planing
Using dental lasers during periodontal therapy typically results in less bleeding, swelling and discomfort during surgery. However, periodontal tissue damage may occur if inappropriate laser wavelengths and/or power levels are used during the periodontal procedure.
Therefore, it is very important that only dental professionals trained and experienced in the proper and safe use of lasers perform this adjunct laser procedure.
After-care and Recovery
For the first few days after scaling you may experience some bleeding that should gradually subside. At a follow-up appointment, your dentist will evaluate gum healing and verify a decrease in the size of periodontal pockets. If pockets greater than 3 mm are still present after initial treatment, additional treatment may be recommended.
Maintaining good oral hygiene practices and continued, long-term follow-up by your dental professionals are essential to prevent periodontal disease from developing into a more serious and/or chronic condition that may require surgery.
This is important, especially given the growing body of clinical evidence indicating the strong connection between periodontal disease and secondary health conditions such as cardiovascular disease, low birth weight babies and premature births.
Certain differences must be made in order to provide the best possible patient education and protection. “Polishing” is the process of smoothing a surface, while “cleaning” is the process of eliminating waste and other foreign particles from teeth.
Scaling and polishing plaque, calculus, and stains off exposed and unexposed tooth surfaces are usually referred to as oral prophylaxis. To avoid periodontal disease, the prophylaxis procedure is conducted on a healthy mouth.
Procedures that are solely for the purpose of polishing are considered cosmetic and have no therapeutic significance.
While many patients mistakenly associate tooth polishing with oral prophylaxis, this is a misunderstanding. Tooth polishing alone does not constitute preventative oral health treatment.
Scaling and Root Planning Costs
Normal dental prophylaxis (professional teeth cleaning) can cost anywhere from $50 to $100+ depending on a variety of circumstances (examine all costs — they may be low in general), whereas periodontal scaling and root planing can cost anywhere from $140 to $300. (per quadrant).
Active periodontal therapy costs about $75 per tooth and comprises a locally injected antibacterial substance delivered into the gum pockets. The average cost of periodontal maintenance following active therapy is $115.
The technology utilized in the operation, the dentist’s location, the type of dental insurance, the type and frequency of treatment and follow-up care, and the type and quantity of dental professionals participating in the treatment plan are all factors that influence the cost of gum disease treatment.
For example, your general dentist may perform the initial diagnosis and some treatment but may refer you to a periodontist more adept at performing advanced surgical procedures.
Before undergoing any gum disease treatment, consult with your insurer to determine what procedures your plan covers. Being covered by insurance or not does preclude the need for treatment.
How can I Pay for Scaling and Root Planing?
If you are in need of scaling and root planning and don’t have dental insurance or if you need a way to pay for co-pays, deductibles, or other out-of-pocket costs there are several payment options you can consider. If you have the funds readily available, of course, you can use them.
You may also be able to use a tax-free Health Savings Account (HSA) or Flexible Spending Account (FSA) to pay for scaling and root planning procedures.
If you are interested in paying overtime, it’s important to know very few providers extend credit to patients through their practice where patients would receive bills from, and pay the provider directly.
Almost all accept general-purpose credit cards and many accept the card, which may be a convenient way to pay for the procedure.
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