The American Academy of Periodontology guidelines stress that periodontal health should be achieved in the least invasive and most cost-effective manner. This is often accomplished through non-surgical periodontal treatment, called scaling and root planing (SRP). SRP is a non-surgical treatment usually recommended to most periodontal patients as the first mode of treatment. It is a careful cleaning of the root surfaces below the gum line to remove plaque, toxins and tartar from the root surfaces of the teeth. This procedure is more intensive than a routine general dental prophylaxis or cleaning, which traditionally occurs every six months.

For your comfort, the area may be numbed prior to treatment. In some cases, systemic antibiotics (antibiotics taken orally) or locally administered antibiotics (antibiotics placed into periodontal pockets) are prescribed at the time of the SRP procedure. Antibiotics will help fight infections caused by the bacteria. Each time you take a systemic antibiotic, you increase your chance of developing drug resistant bacteria. That said, it is important to take antibiotics only as prescribed when necessary.

Research has consistently demonstrated that SRP reduces gingival inflammation and probing depths, and shifts the bacterial composition living in these pockets from one that is associated with disease toward one associated with health.

Most periodontists would agree that after scaling and root planing, many patients do not require any further active treatment, including surgical therapy. However, the majority of patients will require ongoing maintenance therapy to sustain health. It is important to remember that some patients may not respond optimally to SRP with or without the antibiotics. These patients often respond favorably to advanced periodontal procedures that may include measures aimed at regenerating the natural anatomy that was lost to disease and to facilitate oral hygiene practices.

Scaling
Scaling is a procedure that  meticulously removes contamination  toxins, micro-organisms, plaque, tartar, cementum, dentin that is rough and/or permeated by calculus from around, below and under the gum line down to the bottom of the pocket. This is done to remove biofilm, calculus, and toxin down to the bottom of each periodontal pocket in order to obtain a healing response.

Root Planing
Because this procedure goes deeper than a regular cleaning, your mouth may be numbed. Depending on the extent of the disease you may need one or more sections (quadrants) of the mouth to treated with scaling and root planing. Treatment may require one or more visits.

Root planing involves smoothing the root surfaces of your teeth with thin curettes so gum tissue can firmly reattach. The procedure makes it more difficult for plaque to accumulate along the root surfaces.

Home Care After Scaling and Root Planing

• Rinse with warm salt water every few hours (1/2 tsp. salt in 8oz water) to encourage healing and sooth discomfort.

• Be careful not to bite or chew your lip, cheek or tongue while they are numb. Avoid chewing for 2 hours after this procedure or until numbness has worn off.

• Keep your fingers and tongue away from the areas that have been treated.

• Drink 8 glasses of water or fruit juice a day.

• Take pain medication according to directions on label for a couple of days to help with the discomfort, do NOT take Aspirin.

• Do not drink hot liquids or eat hot spicy food after this procedure.

• Use your Chlorhexidine and fluoride as instructed to keep the area clean and free of the bacteria that causes plaque and calculus build-up during the healing period.

• An acceptable rinse after being told to discontinue the chlorhexidine is Crest ProHealth, which will reduce oral bacteria without damaging your soft tissue.

• Eat a soft healthy diet like yogurt, soft cooked eggs, or soups.

• Do not  smoke or chew tobacco after the procedure to allow for healing.

• Gently brush and floss your teeth after each meal.

• Since you have periodontal disease it is advised that you disinfect or change your toothbrush head between brushing to prevent self infection from periodontal germs that remain on your toothbrush for 4 hours or more after use.

• Remember that a side effect of aspirin is it can increase bleeding by inhibiting blood clotting making it unsuitable following root planing and scaling.

• If an infection should occur after Scaling and Root Planing, antibiotics or other treatment modalities will be provided as medical history allows.