Scaling and Root Planing

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Scaling Calculus

Periodontal Disease (gum disease) is a bacterial infection of the gums and bone surrounding a tooth.  When plaque bacteria is not controlled by Brushing and Flossing and Routine Preventive Cleanings, it begins to harden on the tooth creating Tartar or Calculus.  As this expands, an inflammation of the gingival tissue and bone loss occurs.  If left untreated, Periodontal Disease can destroy the gum and bone surrounding a tooth, causing it to become loose.  Then a tooth, which may be otherwise healthy, is lost to Periodontal Disease.  Periodontal Disease has also been shown to contribute to other serious medical conditions.

Without removing the cause of the infection, the body is unable to overcome the disease process on its own.  The plaque bacteria must be removed for the area to have a chance of healing. Depending on the severity of the case, there are two accepted treatment paths.

Scaling & Root Planing 

To remove the hard Calculus layer of bacteria from below the gum line, Scaling & Root Planing is required.  At the offices of Old Dominion Family Dental, we perform this treatment during Quadrant Scalings.  Quad Scaling is when the Doctor or skilled Hygienist goes deep below the gum line with hand-held scalers and UltraSonic Instruments to remove the bacterial growth in the deep pockets around the tooth.  It is typically done under local anesthesia for the patient's comfort.

Scaling & Root Planing
(Quadrant Scaling)
Scaling:  Removing the upper level of infected calculus.

Root Planing:   Smoothing the root making it is difficult for bacteria to reattach.

Depending on the severity of the case and the tolerance level of the patient, Quad Scaling can be done over four appointments, one section of the mouth at a time, or in two appointments, completing one half of the mouth per visit.  Once a Quad is complete, Periodontal Pocket Depths are taken to get true depth measurements of the clean pockets around the tooth.  If a pocket measures greater than 5 mm, Arestin is placed to aid in healing.  Arestin is a medicated powder containing Minocycline (a tetracycline derivative) which prevents plaque bacteria from developing and allows deep periodontal pockets to heal.  The patient will be given Oral Hygiene Instructions to help improve their Home Care, and a Philips SoniCare Toothbrush will be recommended.  Sonicare cleans the tooth with an ultrasonic wave, helping to remove plaque build up below the gumline better than an ordinary hand-held brush.  After all Quad Scalings are completed, the patient will be placed on a 3 month Periodontal Maintenance Recall, where additional cleaning will be done and the healing process of the periodontal pockets will be checked.

Periodontal Surgery

If Periodontal Disease has created pocketing around the tooth to a depth that our Doctors and/or Hygiene Staff do not feel they can clean adequately, a surgical procedure may be needed.  The success of Periodontal Treatment hinges on the removal of all plaque and calculus below the gum line.  It is essential that no bacteria is left at the bottom of the pocket.  A referral will be given to a Periodontist (gum specialist) who our Doctors work with and trust.  Our Doctors will consult with the Periodontist about your case and will do everything required to make sure your case gets the best possible results.

After Periodontal Surgery, additional Restorative and Cosmetic Dentistry may be needed to complete the case.  The Periodontist will ask to monitor the progress by rotating Periodontal Maintenance Recalls between our offices for a prescribed amount of time.

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