Root Planing Waterloo
The objective of scaling & root planing is to remove etiologic agents which cause inflammation to the gingival (gum) tissue and surrounding bone. Common etiologic agents removed by this conventional periodontal therapy include dental plaque and tartar (calculus).
These non-surgical procedures which completely cleanse the periodontium, work very effectively for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease.
Reasons for Scaling and Root Planing
Scaling and root planing can be used both as a preventative measure and as a stand-alone treatment. These procedures are performed as a preventative measure for a periodontitis sufferer.
Here are some reasons why these dental procedures may be necessary:
- Disease prevention – The oral bacteria which cause periodontal infections can travel via the bloodstream to other parts of the body. Research has shown that lung infections and heart disease have been linked to periodontal bacteria. Scaling and root planing remove bacteria and halts periodontal disease from progressing, thus preventing the bacteria from traveling to other parts of the body.
- Tooth protection – When gum pockets exceed 3mm in depth, there is a greater risk of periodontal disease. As pockets deepen, they tend to house more colonies of dangerous bacteria. Eventually, a chronic inflammatory response by the body begins to destroy gingival and bone tissue which may lead to tooth loss. Periodontal disease is the number one cause of tooth loss in the developed world.
- Aesthetic effects – Scaling and root planing help remove tartar and plaque from the teeth and below the gumline. As an added bonus, if superficial stains are present on the teeth, they will be removed in the process of the scaling and root planing procedure.
- Better breath – One of the most common signs of periodontal disease is halitosis (bad breath). Food particles and bacteria can cause a persistent bad odor in the oral cavity which is alleviated with cleaning procedures such as scaling and root planing.
What Do Scaling and Root Planing Treatments Involve?
Scaling and root planing treatments are only performed after a thorough examination of the mouth. The dentist will take X-rays, conduct visual examinations and make a diagnosis before recommending or beginning these procedures.
Depending on the current condition of the gums, the amount of calculus (tartar) present, the depth of the pockets and the progression of the periodontitis, local anesthetic may be used.
Scaling – This procedure is usually performed with special dental instruments and may include an ultrasonic scaling tool. The scaling tool removes calculus and plaque from the surface of the crown and root surfaces. In many cases, the scaling tool includes an irrigation process that can also be used to deliver an antimicrobial agent below the gums that can help reduce oral bacteria.
Root Planing – This procedure is a specific treatment which serves to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar. The root of the tooth is literally smoothed in order to promote good healing. Having clean, smooth root surfaces helps bacteria from easily colonizing in future.
Following these deep cleaning procedures, the gum pockets may be treated with antibiotics. This will soothe irritation and help the gum tissues to heal quickly.
During the next appointment, the dentist or hygienist will thoroughly examine the gums again to see how well the pockets have healed. If the gum pockets still measure more than 3mm in depth, additional and more intensive treatments may be recommended.
If you have any concerns or questions about scaling and root planing, or periodontal disease, please ask your Waterloo dentist.
What to Expect During Scaling and Root Planing
Scaling and root planing (often called "deep cleaning" by patients) is the non-surgical treatment for periodontal disease. It removes plaque, tartar (calculus), and bacterial deposits from above and below the gum line, and smooths the tooth root surfaces so they're less hospitable to future bacterial colonization. It's the cornerstone of periodontal treatment.
The procedure is performed by our registered dental hygienists, typically in two appointments (one side of the mouth at a time) so each session is more manageable. Local anaesthetic is used to numb the area so the work below the gum line is comfortable. The hygienist uses hand instruments and ultrasonic scalers to remove deposits from both above and below the gum line, then planes the root surfaces smooth.
Each appointment runs 60 to 90 minutes. After treatment you'll be numb for a couple of hours; some mild gum tenderness for a day or two is normal. We see you back at a re-evaluation appointment about 4 to 6 weeks later to measure pocket depths, check bleeding on probing, and decide what comes next — whether ongoing periodontal maintenance every 3 to 4 months is sufficient or whether the case needs additional treatment.
Who Is a Candidate for Scaling and Root Planing
Scaling and root planing is appropriate when periodontal disease has progressed beyond gingivitis (reversible gum inflammation) to active periodontitis with measurable bone loss and pocket depths over 4 mm. We measure pocket depths around every tooth at periodic exams and recommend root planing when:
- Pocket depths are 4 mm or deeper around multiple teeth
- There's bleeding on probing — a key sign of active inflammation
- Bone loss is visible on x-rays
- Standard preventive cleaning hasn't kept the disease in check
Patients with active medical conditions (uncontrolled diabetes, immune suppression, recent cardiac valve work) need clearance and sometimes antibiotic prophylaxis before treatment. We screen for these at the consultation and coordinate with your physician when warranted.
After the Appointment
Most patients return to normal activity the same day. The treated areas may feel tender for two to four days, especially when brushing. Cold sensitivity often increases for a week or two as the gum tissue begins to heal and tighten back against the cleaned root surfaces — this is expected and usually resolves on its own.
Home care matters as much as the in-office treatment. Brush twice a day with a soft brush, floss daily (a water flosser helps many patients), and consider an antimicrobial mouth rinse for the first few weeks if recommended. Diabetes control, smoking cessation, and stress reduction all support better gum healing.
At the 4 to 6 week re-evaluation, we measure pocket depths and bleeding to assess response. Pockets that have shrunk and stopped bleeding indicate the disease is under control; we transition to periodontal maintenance every 3 to 4 months. Pockets that remain deep or continue to bleed may need re-treatment, local antibiotics, or surgical referral.
Cost and Insurance Coverage
Scaling and root planing is billed in units based on how many teeth are treated and the time involved. We follow the current Ontario Dental Association (ODA) Suggested Fee Guide and explain the units before treatment begins so you know what to expect.
Scaling and root planing is generally covered under basic services on extended dental insurance — typically at 80% or higher, subject to your annual maximum and any frequency limitations (most plans allow root planing every 24 or 36 months per area). We submit claims directly where the plan permits and apply for predetermination on larger cases. The federal Canadian Dental Care Plan (CDCP) covers periodontal cleaning for eligible patients.
Scaling and Root Planing — Frequently Asked Questions
Does scaling and root planing hurt?
It shouldn't. We use local anaesthetic to fully numb each section before we begin. You'll feel pressure and water but not pain. Many patients describe it as similar to a longer cleaning.
How is it different from a regular cleaning?
A regular cleaning (prophylaxis) removes plaque and tartar above the gum line on patients with healthy gums. Scaling and root planing goes below the gum line into the periodontal pockets that develop with disease, and includes planing the root surfaces. Different procedure, different codes, different goals.
Will I need it again?
Periodontal disease is chronic. After scaling and root planing, patients move to periodontal maintenance cleanings every 3 to 4 months rather than the typical 6-month schedule. Re-treatment of specific sites may be needed if specific pockets re-deepen — we monitor at each maintenance visit.
Why do I need it in multiple appointments?
Treating one or two quadrants per appointment makes each session more manageable, allows better anaesthetic control, and gives the tissue a chance to start healing between sessions. Some lighter cases can be completed in one appointment; more involved cases benefit from the staged approach.
What happens if I don't get it done?
Periodontal disease is progressive. Untreated, pockets continue to deepen, supporting bone continues to be lost, and teeth eventually become loose and need extraction. The bone loss is not reversible — it can only be prevented from progressing further. Earlier intervention preserves more.