Periodontal therapy – Johnston, IA

The initial stage of treatment for periodontal disease is usually a thorough periodontal treatment that includes scaling and root planing. The objective of this non-surgical procedure is to remove dental plaque and calculus, which cause gingival inflammation and disease. Scaling and root planing can be used as a stand-alone treatment, or in conjunction with laser and medicinal therapies.

What Does Periodontal therapy Entail?

Dr. Emily or Dr. Derek will only recommend periodontal therapy after a thorough examination of the mouth, which includes x-rays, periodontal probing (gingival pocket measurements), and visually examining the mouth. Depending on the condition of the gums, the amount of calculus present, the depth of the pockets, and the progression of bone loss, Dr. Emily or Dr. Derek may recommend periodontal therapy (scaling and root planing).  Generally, a local anesthetic is used during the procedure.

An animated illustration showing the process of scaling


When scaling is performed, calculus and plaque that attach to the tooth surface is removed. The process especially targets the area below the gum line, along the root surface. Scaling is performed with a special dental tool, called a cavitron. This scaling tool includes high-frequency vibrations and an irrigation process that removes build-up and rinses below the gum line.

An animated depiction of a root planing procedure

Root Planing:

Root planing is performed in order to remove cementum that is embedded with unwanted microorganisms, toxins, and calculus. The root of the tooth is literally smoothed, which promotes healing, and also helps prevent bacteria from easily colonizing in the future.

Antibiotics or irrigation with anti-microbials (chemical agents or mouth rinses) may be recommended to help control the growth of bacteria that create toxins and cause periodontitis. 

When very deep pockets between teeth and gums are present, patients can seldom, if ever, keep these pockets clean and free of plaque.  It is also difficult for hygienists to thoroughly remove the plaque and calculus with non-surgical methods when this is the case. Consequently, periodontal surgery may be necessary to restore periodontal health.

Benefits of Treatment

If treatment is successful, scaling and planing has many periodontal benefits. One benefit is that it can help prevent systemic diseases. Research has proven that bacteria from periodontal infections can travel through the blood stream and affect other areas of the body, sometimes causing heart and respiratory diseases.  Periodontal disease also increases the A1c level in Diabetics and has been linked to Alzheimers.  Scaling and root planing removes bacteria that cause these conditions.

Another benefit of treatment is protecting the mouth against tooth loss. When gum pockets exceed 3mm in depth, the risk for periodontal disease increases. As pockets deepen, more bacteria are able to colonize, eventually causing a chronic inflammatory response by the body to destroy gingival and bone tissue. This leads to tooth loss.

Finally, scaling and root planing may make the mouth more aesthetically pleasing, and should reduce bad breath caused from food particles and bacteria in the oral cavity. Superficial stains on the teeth will be removed during scaling and planing, adding an extra bonus to the procedure.

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