What Is a Deep Cleaning? Scaling and Root Planing Explained

Hearing that you need a "deep cleaning" instead of your usual cleaning can be surprising, especially if your teeth don't hurt. But gum disease often causes no pain until it's advanced. A deep cleaning, called scaling and root planing, treats it early, before it damages the bone that holds your teeth in place.

Regular cleaning vs. deep cleaning

A regular cleaning removes plaque and tartar from the tooth surfaces and just under the gumline. It's preventive and meant for healthy gums.

A deep cleaning goes below the gumline into the pockets that form when gum disease takes hold. It has two parts:

• Scaling removes hardened tartar and bacteria from the tooth and root surfaces below the gums.
• Root planing smooths the root surfaces so the gums can reattach and bacteria have a harder time collecting again.

Why it's recommended

Healthy gums fit snugly around each tooth, with shallow spaces of about 1 to 3 millimeters. When plaque and tartar collect below the gumline, the gums become inflamed and pull away, forming deeper pockets. Those pockets trap more bacteria, and the cycle continues. Left alone, the infection can break down the bone that supports your teeth, leading to loose teeth and eventually tooth loss.

We may recommend a deep cleaning if we find:

• Pocket depths of 4 millimeters or more
• Bleeding when the gums are measured
• Tartar below the gumline
• Bone loss on X-rays

If you've noticed bleeding when you brush, gums that look red or puffy, or persistent bad breath, those can be early signs. Our post on signs of gum disease covers them in more detail.

What the visit is like

Scaling and root planing is usually done one or two sections of the mouth at a time, over one or more visits:

1. The area is numbed so you're comfortable throughout.
2. Tartar and bacteria are carefully removed from the root surfaces with ultrasonic and hand instruments.
3. The roots are smoothed so the gums can heal against them.
4. In some cases, an antimicrobial treatment is placed in deeper pockets.

Most patients find it much easier than they expected. If you're anxious about dental visits, let us know; sedation options are available.

Recovery

Your gums may be tender for a few days, and your teeth may be more sensitive to cold for a little while. To help healing:

• Take over-the-counter pain relievers as directed if you need them.
• Rinse gently with warm salt water.
• Keep brushing and flossing, gently but thoroughly.
• Use a desensitizing toothpaste if cold bothers you.

As the gums heal, they typically become firmer, pinker and less likely to bleed, and pocket depths often decrease.

Keeping gums healthy afterward

Gum disease can be controlled but tends to come back without ongoing care. After a deep cleaning, most patients do best with periodontal maintenance cleanings every three to four months instead of every six. At home:

• Brush twice daily and clean between your teeth every day.
• Don't smoke or vape; tobacco is one of the biggest risk factors for gum disease.
• If you have diabetes, keeping your blood sugar in range helps your gums heal.

Learn more about our approach on the periodontal treatment page.

Is insurance coverage available?

Many dental plans cover scaling and root planing, although it's often classified differently from routine cleanings. We'll check your benefits and explain any costs before treatment begins.

Take care of your gums now

Treating gum disease early protects your teeth for the long term. If you've been told you need a deep cleaning, or you're noticing bleeding gums, request an appointment online or call Zen Family Dental at (703) 385-2772.