Medically accurate 3D illustration showing Scaling and root planing (conventional periodontal therapy).

The Complete Guide to Dental Root Planing

Root planing is a non-surgical dental procedure that effectively treats moderate to severe cases of gum disease, also known as periodontitis. This treatment involves the removal of plaque and tartar from the surface of the tooth roots, as well as smoothing out any rough areas to facilitate the reattachment of gums to teeth.

In this article, we will take a closer look at the importance of root planing, the procedure’s benefits, and any potential risks and complications you should be aware of. 

Signs and Symptoms of Gum Disease

Periodontitis is often preceded by gum inflammation, also known as gingivitis. While not all gingivitis cases lead to periodontitis, gum inflammation may worsen and progress to periodontitis without proper treatment.

Poor dental hygiene habits are a common cause of gum disease. Improper brushing or neglecting to brush and floss can lead to plaque buildup, a sticky film of bacteria, and food residue.

But that’s not the worst part. Plaque hardens into tartar, a yellowish-brown mineral deposit, within 72 hours. Tartar makes it hard to clean your teeth entirely since it can only be removed by a dental professional using special tools. 

Over time, bacteria in tartar irritate gums and cause them to recede, forming small pockets between teeth, a symptom of periodontitis. As plaque moves below the gum line, oral bacteria infect these pockets. Although your body’s immune system fights the infection, this reaction can often cause more harm than good.

Your immune system enzymes and bacterial toxins attack the connective tissue supporting your teeth, causing its deterioration. If this disease is not treated, it can destroy more gum tissue, leading to tooth loss and jaw bone damage.

While plaque buildup is the leading cause of gum disease, other factors can contribute to gum disease. These include:

  • Smoking: Cigarette smoke impairs blood flow to the gums and hinders the body’s ability to heal and fight off infections.
  • Hormonal changes: Gums become more sensitive as your body undergoes hormonal changes during menopause, puberty or pregnancy. These hormonal changes can make your gums susceptible to gum disease.
  • Medication: Certain types of medication can inhibit saliva production, leading to dry mouth, a condition that increases the risk of gum disease.
  • Poor nutrition: A poor diet lacking essential vitamins and nutrients can compromise the immune system and increase your risk of gum disease.

 Though gum disease has severe consequences if left untreated, early detection of its signs and symptoms can help you take the necessary steps to prevent further damage to your gums and teeth. Some signs and symptoms of gum disease include:  

  • Bleeding gums: Bleeding gums are often a sign of gingivitis, an early stage of gum disease. It would be best to consult your dentist if you notice blood on your toothbrush or dental floss.
  • Persistent bad breath: Bacteria that cause gum disease produce a foul odor that doesn’t go away after brushing your teeth or rinsing with mouthwash.
  • Receding gums: Gum disease can cause gums to pull back and form pockets between teeth. The infection worsens as these pockets become infected over time.
  • Changes in bite alignment: Advanced gum disease can cause significant damage to supporting tissues and bones, changing the way your teeth fit together when you chew or bite.

Root Planing Procedure

Root planing is a non-surgical procedure that can be performed in multiple sessions depending on the severity of your gum disease. Here’s what you can expect during a root planing procedure:

Evaluation

Your dentist will schedule a consultation session to evaluate the extent of your gum disease. They will use a periodontal probe – a thin, long, and narrow instrument – to measure gum pockets. Pockets that are deeper than 3 millimeters may indicate the presence of gum disease. 

Additionally, your dentist may take dental X-rays to assess the condition of your jawbone and determine the extent of the infection.

Administration of Local Anesthesia

Though root planing is a non-surgical procedure, cleaning below the gum line can cause discomfort. As such, your dentist or dental hygienist will administer local anesthesia to numb the area being worked on. If you have a bad case of dental anxiety, you can request that your dentist or hygienist use numbing gel to desensitize your gums before injecting the anesthesia. 

Dental Scaling

After your dentist or hygienist ensures you’re comfortable, they will proceed with removing tartar from the surface of the teeth and below the gum line through a process called dental scaling. 

Using specialized tools like ultrasonic scalers, curettes, and manual scalers, your dentist or hygienist will carefully remove plaque and tartar buildup above and below the gum line. Your dentist or hygienist will use a water-spraying tool to cool down your teeth and remove the loosened debris.

Root Planing

Once your dentist or hygienist has finished scaling your teeth, they’ll proceed with the root planing procedure. Root planing involves smoothing out the rough surfaces of the tooth roots to remove residual bacteria and food debris. It is crucial to restoring your oral health since it makes it easier for gums to reattach to the teeth and helps prevent the future buildup of plaque and tartar. 

Root planing is a delicate procedure, and your dentist or hygienist may only use manual tools such as periodontal scalers and curettes to avoid damaging the delicate gum and connective tissues. However, they may use ultrasonic instruments that produce high-frequency vibrations to disintegrate stubborn tartar deposits, making them easier to remove.

Your dentist or hygienist will work methodically, smoothing all sides of the tooth roots. Depending on the extent of your gum disease, the root planing procedure may be performed over several sessions to minimize discomfort and ensure proper healing.

After the root planing, your dentist or hygienist may apply an antimicrobial agent to the treated areas to prevent infection and kill residual bacteria.

Benefits of Root Planing 

Root planing has several benefits for patients struggling with gum disease. They include the following:

  • Promotes gum reattachment: Receding gums are a symptom of advanced periodontitis. Root planing can promote the healthy reattachment of gums to the teeth by removing bacteria and tartar buildup that cause gums to pull away.
  • Gets rid of halitosis: Oral bacteria that cause gum disease produce a persistent foul odor that remains despite brushing or rinsing with mouthwash. Root planing eliminates these bacteria, restoring fresh breath and improving your oral hygiene.
  • Prevents tooth loss: Tooth loss is a devastating consequence of gum disease, as oral bacteria gradually weaken the connective tissues of the teeth, ultimately resulting in their loss. However, root planing can effectively prevent this outcome by eliminating harmful bacteria before they can cause permanent damage.
  • Improves gum health: Root planing eliminates harmful bacteria, plaque, and tartar from the tooth’s root, which has the effect of improving gum health. For example, root planing reduces gum inflammation and prevents the formation of pockets between the gum line.
  • Improve overall health: Not only does root planing benefit your oral health, but it also improves your overall health. Gum disease has been linked to diabetes, heart disease, and stroke. Root planing eliminates gum disease before it progresses, reducing your chances of developing these health problems.

Aftercare and Recovery

It’s crucial that you take proper care of your gums after a root planing procedure to avoid complications and ensure proper healing. Your dentist or hygienist will provide aftercare instructions that may include the following: 

  • Avoid smoking: Cigarette smoke contains substances that may irritate the gums and slow down the healing process. If you cannot quit entirely, abstaining from smoking for at least one week following the procedure is vital.
  • Observe a soft food diet: Your gums will be sensitive after a root planing procedure. Eating only soft foods such as applesauce, soups, and smoothies would be best. Additionally, avoid spicy foods as they can irritate your gums and cause complications.
  • Take pain medication: It’s normal to experience discomfort after a root planing procedure. Your dentist will prescribe over-the-counter pain medication to help alleviate discomfort and manage pain. Make sure that you take the medication as prescribed for the best results.
  • Rinse with saltwater: Using warm salt water to rinse your mouth can alleviate discomfort and reduce the risk of infection. Rinse your mouth for at least 30 seconds several times daily to help reduce swelling and promote healing.
  • Observe oral hygiene: Be sure to brush and floss your teeth after the procedure. However, be gentle when cleaning around the treated areas to avoid irritating the gums.
  • Attend follow-up appointments: It’s crucial that you attend any follow-up appointments scheduled by your dentist or hygienist. They will be able to monitor your healing progress and address any complications before they worsen.

Risks and Complications

Though root planing is considered a safe and effective treatment for gum disease, there are potential risks and complications that you should be aware of. These may include the following: 

  • Infection: In rare cases, you may develop an infection after a root planing procedure. Symptoms may include pus, swelling, and fever. To prevent this, your dentist or hygienist will apply an antimicrobial agent to your gums after treatment. However, you should contact your dentist’s office immediately if you notice any infection symptoms.
  • Tooth sensitivity: Though rare, you may experience increased tooth sensitivity after the procedure, especially when consuming hot or cold foods. While this sensitivity typically subsides after a few weeks, you should contact your dentist if it persists.
  • Pain and discomfort: It’s normal to experience pain and discomfort after a root planing procedure. Taking pain medication as prescribed by your dentist can help manage this. However, you should contact your dentist if the pain doesn’t subside despite taking medication.
  • Swelling and bleeding: While some swelling and bleeding may occur after the procedure as the inflamed gums heal, you should contact your dentist if the issue doesn’t resolve on its own after a few days  .

Root planing is a safe and effective procedure that helps manage periodontal disease, improves oral health, and prevents further damage to teeth and gums. This non-invasive treatment removes plaque and tartar from the root surfaces of teeth, promoting gum health and reducing the risk of future infections.

If you’re experiencing symptoms of gum disease, it’s important to consult your dentist. They can provide more information about the procedure and help you determine if root planing is the appropriate treatment for you.

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