Getting to the Root of a Dental Deep Cleaning

Getting to the Root of a Dental Deep Cleaning

By Kristina Mackie, DDS
Loretto Family Dentistry, PLLC

A scaling and root planing, commonly referred to as a “deep cleaning,” is the procedure involving instrumentation of the crown and root surfaces of the teeth to remove plaque and calculus (tartar). It is unlike a prophylaxis or “basic cleaning” in that a prophylaxis involves scaling and polishing the coronal tooth structure only. A prophylaxis is preventive in nature whereas a deep cleaning is therapeutic, meaning it is a procedure to control a disease process. Consider eating healthful foods to prevent heart disease vs. taking medication to lower high cholesterol; medication is not needed in a state of health.

When you see your dentist or dental hygienist, careful measurements are taken of the gum pockets. Healthy measurements fall in the 0-3.5 mm range. Measurements above this range may indicate the presence of periodontal (gum) disease. Radiographs paired with your exam will be used to determine the severity of the disease. The disease typically originates from bacteria, calculus, and plaque which are left undisturbed for too long. The gum and bone surrounding the tooth cannot tolerate the byproduct of the bacteria and will become red and swollen with eventual destruction of the bone and gum tissues. Teeth become loose, gums bleed, and halitosis may be present. A deep cleaning is designed to intercept the disease process and remove the toxins under the gum line. Root surfaces are involved and require instrumentation and smoothing to remove debris and prevent further adherence
of debris.

Patients with gum disease may ask why they can’t get a basic cleaning. The answer is a basic cleaning is designed to ONLY remove debris ABOVE the gum and bone levels. It is not treating the disease where the disease lives; on the roots. Furthermore, if a basic cleaning is erroneously done, it may lead to complications in accessing the root surfaces at a later date. Roots should not be exposed in a healthy mouth. If they are, it is indicative of some level of periodontal disease and should be treated accordingly.

As with anything related to one’s health and well-being, when in doubt, seek a second opinion.

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