Periodontal Deep Cleaning

Periodontal refers to the gums and tissue that attach to the teeth and jawbone. The gums can harbor bacteria both above and below the gumline, where they attach to the teeth. Having bacteria below the gumline can lead to several forms of gum disease. Bleeding, swollen gums are an indication that bacteria is present below the gumline. For severe cases of bacteria and plaque beneath the gums, deep cleaning is needed to treat the condition.

Periodontal Disease

The main reason for periodontal deep cleaning is to treat gum disease. Gum disease is often caused by bacteria in the mouth; bacteria can form plaque beneath the gums as well as above. When plaque and bacteria are allowed to reside beneath the gums it can cause many problems.
The gums can begin to pull away from the teeth, which makes it even more difficult for an individual to keep the gums clean and healthy. Gums can become swollen and filled with pus, which is painful and unsightly. Severe cases of gum disease can lead to tooth and jawbone-density loss.

Root Planing

There are two main types of deep-cleaning procedures used by periodontists (dental professionals who deal with issues involving the gums): root planing and scaling.

Root planing removes spots of plaque or bacteria from below the gums. Dr. Dan Peterson describes root planing as a procedure that, "...involves smoothing the root surfaces of your teeth with thin curettes so gum tissue can more firmly reattach to roots that are clean and smooth to prevent tooth loss and sensitivity problems. The procedure makes it more difficult for plaque to accumulate along the root surfaces."

Scaling

Scaling is a procedure that removes toxins, plaque, tartar and dentin that is rough from around and under the gum line. Pockets and recesses in the gums caused by gum disease can also be cleaned out with scaling, which will increase the chance of them healing.

According to Dr. Jeffrey Wissot, "One common side effect of periodontal scaling is sensitivity to hot and cold, due to exposed roots after the gum shrinks. Conscientious oral hygiene, use of a desensitizing toothpaste, and 'tincture of time' usually minimizes the sensitivity."

Flap Surgery

Sometimes a more intense treatment is needed to clean below the gums. Flap surgery is a procedure where the dental professional cuts a flap in the gums, pull it back and removes the tartar and any other debris from the lower tooth and root. The gums are then stitched back in place so they firmly adhere to the teeth again.

Flap surgery is generally used in more advanced cases of gum disease or if root planing or scaling weren't effective at removing all of the debris below the gum line.

Antibiotics

Sometimes, in addition to these procedures, antibiotics are used to treat infections and help the gums heal. Local antibiotics can be placed below the gums in one of a variety of forms, including gel, chip, capsule or strips. They are able to continually release medicine below the gums, which gives the tissue a longer time frame for healing.

Oral antibiotics are generally used before surgery to help lower bacteria levels in the mouth and the body in general. They aren't favored for long-term treatment of gum disease due to building antibiotic-resistant bacteria and the stress it puts on the body.

References

• American Dental Association gum disease information
• Dr. Dan Peterson's information about deep cleaning
• Article about root planing and scaling