Periodontal scaling procedures “include the removal of plaque, calculus and stain from the crown and root surfaces of teeth. Root planing is a specialized skill involving scaling of the root of the tooth, made up of cementum. Because cementum is softer than enamel, it is affected more by ongoing build-up and inflammatory byproducts. A smooth cementum provides less opportunity for bacteria to accumulate and form calculus. So root planing is an important part of stopping the progression of periodontal disease, especially once deeper pockets have formed in the gums, which is really in the bone. Thus root planing is a specific treatment that removes the roughened cementum and surface dentin that is impregnated with calculus, microorganisms and their toxins.
The objective for periodontal scaling and root planing is to remove etiologic agents which can cause inflammation to the gum tissue and surrounding bone. Common etiologic agents removed by periodontal therapy include dental plaque and tartar (calculus). Scaling and root planing is one of the most effective periodontal methods of treating gum disease before it becomes severe.
Because in periodontal disease pockets form that are deeper than the usual gingival depth, such scaling and root planing are often referred to as deep cleaning, and may be performed using a number of dental tools, including ultrasonic instruments and hand instruments, such as periodontal scalers and curettes.
A dental hygienist demonstrates scaling.
Removal of adherent plaque and calculus with hand instruments can also be performed prophylactically on patients without periodontal disease. A prophylaxis refers to scaling and polishing of the teeth in order to prevent oral diseases. Polishing does not remove calculus, but only some plaque and stains, and should therefore only be done in conjunction with scaling.
Often, a device may be electric, known as an ultrasonic or sonic scaler. Ultrasonic scalers vibrate at a frequency that breaks down bacterial cell membranes and removes both plaque and calculus. Hand instruments are used to complete the fine hand scaling that removes anything the ultrasonic scaler left behind.