Scaling, Root Planing and Prophylaxis.
The initial stage of treatment for periodontal disease is a thorough cleaning that usually includes scaling, root planing and prophylaxis. The objective of these non-surgical procedures is to control the bacteria within the dental plaque, and remove the calculus (tartar – calcified dental plaque) from your teeth. Scaling, root planing and prophylaxis can be used as a stand-alone treatment or as a preventive measure for periodontal disease.
Scaling, root planing and prophylaxis are usually performed under local anaesthetic at the initial stages but during the maintenance phase of treatment they may be performed with topical anaesthetic.
Scaling is performed to remove plaque and calculus which is attached to the tooth surfaces. The process targets the areas of plaque accumulation both above and below the gum line. Scaling can be performed with either a special dental tool called an ultrasonic scaler or with hand instruments. The ultrasonic scaler usually includes an irrigation process and sprays water in to the mouth. However studies have shown that the ultrasonic scaler is more efficient per unit of time compared with hand scaling.
Root planing is performed in order to remove more difficult to remove calculus as well as the surface irregularities of the tooth surface where bacteria and their toxins may be retained.
Antibiotics or irrigation with anti-microbial (chemical agents or mouth rinses) may be recommended to help control the growth of the bacteria that cause periodontal disease. These additional approaches may be added to the treatment in patients with aggressive disease but not done for patients with mild to moderate disease.
When deep pockets between teeth and gums are present, or if defects are present in the tooth surfaces which make it difficult for the periodontist to thoroughly remove the plaque and calculus, surgical access may be the only treatment alternative which allows these areas to be treated. The skill of the periodontist at scaling and root planing usually inversely relates to the frequency of surgical access used.
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