Deep dental cleaning: What you need to know

root planing
Regular dental cleaning is what you do every day - brushing, flossing, and using other tools to keep your teeth and gums healthy.

On the other hand, deep dental cleaning is an advanced procedure that can only be done by your dentist. It's not something everyone needs, just people with gum disease.

Deep cleaning is more thorough. It cleans all the parts of your teeth, both above and below your gum line. There are two main parts: scaling and root planing.

When do you need a deep dental cleaning?

periodontal tissues

You might only need deep cleaning if you have an advanced stage of gum disease affecting the deep parts of tissues surrounding your teeth, like bone, ligaments, and cementum.

But if your gums are healthy, just keeping up with brushing, flossing, and seeing your dentist regularly should be enough to keep your teeth and gums in good health.

Here are some signs you might have gum disease and need deep cleaning:

  • Your gums are pulling away from your teeth

  • Your teeth feel loose or are moving around (for example, you notice gaps between your teeth that weren't there before)

  • Your gums are red, swollen, or bleeding

  • You see pus coming from your gums

How does deep dental cleaning work?

At your first appointment, your dentist will check your gums to see if they're inflamed.

The first thing to do is to improve your oral hygiene because it's so vital for keeping your gums healthy in the long run. Without good hygiene, treatment might not be successful, and the gum problem might come back later.

dental floss

If you have gingivitis, which is the early stage of gum disease, just working on your hygiene might be enough to reverse it and make your gums better.

But if you have a serious form of gum disease called periodontitis, you might need deep cleaning.

The first step of deep cleaning is scaling. It involves removing tartar from your teeth surfaces, above and below the gum line, with special instruments.

Once tartar is removed, the next step is root planing, which completes the scaling work. The goal is to clean up any leftover tartar from the roots and smooth them out. This will provide the perfect conditions for your gums to heal and stick back to your teeth.

After that, you'll have to see your dentist or periodontist every few weeks to make sure your gums are recovering and that you're keeping up with your oral hygiene.

What to expect from deep dental cleaning?

Deep dental cleaning before and after
The benefits of deep dental cleaning include:

  1. Gets rid of bad bacteria.
  2. Helps the good bacteria.
  3. Makes your teeth smooth and clean.
  4. Decrease gum swelling and the depth of periodontal pockets.
  5. Helps your gums become firm and healthy.

Keeping good oral hygiene is crucial in stopping gum disease. But when it comes to periodontitis, brushing and flossing aren't enough.

Periodontitis breaks down the tissues that hold the teeth in place and leads to the formation of pockets. Periodontal pockets are like gaps that form between your teeth and gums. They're perfect spots for bad bacteria to thrive and release toxins.

The tricky part is that these abnormal gaps can't be cleaned with a toothbrush alone. That's where scaling and root planing come in.

Deep cleaning helps remove tartar from your teeth so that the tissues can reattach to the roots. This process allows the pockets to close up and disappear.

As your gums heal and improve, they might shrink and pull back a bit. This is actually a good thing—it shows the swelling is fading, and your gums are getting stronger and healthier.

Deep dental cleaning limitations

Scaling and root planing are non-surgical ways to treat gum disease. It's straightforward, works well, and is less invasive, which means fewer side effects like bleeding and pain, but still gives good results.

Sometimes, deep tooth cleaning isn't sufficient, especially for advanced periodontitis or deep defects in the bone. Your dentist might recommend periodontal surgery for optimal cleaning.

Additionally, some defects may persist in the bone or gums after the recovery. In such cases, surgery might be needed to fix them.

Does deep cleaning carry some risks?

Scaling and root planing are generally safe procedures with minimal risks.

However, people with certain medical conditions may have a higher risk of infection, as certain bacteria can travel from the mouth to the bloodstream during the procedure.

In healthy individuals, this is usually temporary and resolves on its own within 30 minutes.

However, in people at risk, some bacteria might persist and could possibly impact vital organs like the heart. Medical conditions that raise this risk include:

  • Cardiovascular diseases.
  • Diabetes.
  • Neutropenia.
  • Some treatments, such as radiotherapy and chemotherapy.
  • Weakened immune system.

When is surgery necessary?

surgical root cleaning

Deep tooth cleaning is usually enough to treat mild to moderate periodontitis cases. It's the first line of treatment because it's simpler and has fewer side effects afterward.

However, in more severe cases, even after deep cleaning, you might still have deep pockets and bleeding gums. That's when surgery comes in.

Surgical cleaning involves opening the gums to remove tartar and infected tissue below the gum line, under direct vision. The gums are then stitched back together to help them heal.

So, surgery can be used to clean those hard-to-reach areas that regular scaling and root planing can't reach.

  1. Bacteremia following scaling and root planing: A clinico-microbiological study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3917200/
  2. Subgingival bacterial recolonization after scaling and root planing in smokers with chronic periodontitis https://pubmed.ncbi.nlm.nih.gov/25283721/
  3. Color Atlas of Dental Medicine: Periodontology