What scaling and root planing is
Scaling and root planing is a deep cleaning for people with gum disease. The American Dental Association describes it as a nonsurgical treatment that cleans below the gum line. It is often the first treatment for periodontitis, the stage of gum disease where the gums have pulled away from the teeth and formed deep pockets.
In plain terms, it does two jobs. Scaling removes the plaque and tartar (hardened plaque) from your teeth, both above and below the gums. Root planing smooths the surfaces of the tooth roots, so your gums can heal and reattach, and so bacteria have a harder time sticking.
You may also hear it called a "deep cleaning," "periodontal scaling" or simply "SRP." They all mean the same treatment. It is not surgery. No cuts are made, and no stitches are needed.
Does it hurt?
It should not hurt during the treatment. Your dentist or hygienist numbs the gums with a local anesthetic first. You may feel pressure and hear scraping or the hum of an ultrasonic tool, but sharp pain is not expected. If you feel pain, say so and they will add more numbing.
Afterward, as the numbness fades, your gums can feel sore. Cleveland Clinic says the soreness lasts a couple of days. Your teeth may also be more sensitive to hot and cold. This usually goes away within a month or two.
If you get nervous in the chair, tell the team before you start. You can agree on a hand signal for a break, and some practices offer extra comfort options. It is much easier to help when we know how you feel.
Your gums may feel tender when you brush for the first few days. This is normal. Use a soft brush and be gentle, but keep cleaning. Healing is faster when the area stays clean.
Fear is the thing we hear about most. Many patients tell us the worry was worse than the visit. If it helps, bring headphones, ask for breaks and tell us if you need more numbing. You are in charge.
Step by step: the appointment
Cleveland Clinic says the whole treatment takes one to two hours. Many dentists split it into two visits, treating half the mouth at a time. Whether you do one visit or two often depends on how much disease you have, how you feel and your insurance plan.
Every office has its own routine, but a visit usually looks like this:
- Exam and measurements. The team checks your gums, measures the pocket depths and reviews your X-rays.
- Numbing. A local anesthetic is applied to the area being treated.
- Scaling. The hygienist or dentist removes plaque and tartar using hand tools, an ultrasonic scaler, or both.
- Root planing. The roots are smoothed so the gum can reattach.
- Rinse and instructions. The area is flushed clean. You get tips for the next few days.
- Medication, if needed. Sometimes the dentist places an antibiotic around the roots or prescribes one to take by mouth.
How well does it work?
Scaling and root planing is the standard first step for periodontitis, and it works for many people. Research reviewed by the Canadian Agency for Drugs and Technologies in Health found that it improves gum health measures such as pocket depth and bleeding. In general, pockets get shallower and gums become firmer and less inflamed.
But results depend on you. The treatment cleans the roots, and then your daily habits keep them clean. People who brush twice a day, clean between their teeth and come in for regular follow-ups do best. Smoking, uncontrolled diabetes and skipped visits make it harder for the gums to heal.
No treatment can bring back bone that has already been lost. The goal is to stop the disease from moving forward and give the gums a chance to tighten around your teeth. Some deeper pockets may need more care, such as gum surgery, if they do not improve.
Your dentist will measure your pockets before and after. Those numbers tell the story. A pocket that goes from 6 millimeters to 3 or 4 millimeters is much easier to keep clean, and bacteria have less room to hide. That change is one of the best signs that the treatment is working.
What recovery looks like
Most people go back to normal activities the same day. Plan for a calm evening, though. You may notice:
Mild soreness for a day or two.
Some bleeding when you brush at first.
Sensitivity to hot, cold and sweet foods.
Teeth that feel a little loose. As the gums heal and tighten, this usually settles.
To feel better faster:
Take an over-the-counter pain reliever as your dentist advises.
Eat soft, cool or lukewarm foods for the first day or two, such as yogurt, eggs, soup and mashed potatoes.
Avoid hot, spicy, crunchy or very hard foods until the area feels better.
Keep brushing and flossing, gently, in the treated areas.
Rinse with warm salt water if your dentist suggests it.
Do not smoke. It slows healing.
Call your dentist if bleeding does not stop, if pain does not improve with medication or if you have swelling that gets worse. Fever or a bad taste that grows can also signal an infection.
Recovery is usually short. If you take any blood thinners or have a heart condition or joint replacement, tell your dentist ahead of time. Sometimes extra steps are needed to keep you safe.
The follow-up visit and upkeep
About a month or so after treatment, you will return so the dentist can see how the gums healed and measure the pockets again. If they are smaller and the bleeding is gone, the treatment did its job.
After that, most people need cleanings more often than twice a year. A schedule of every three to four months, called periodontal maintenance, helps keep the bacteria in check. Skipping those visits is the most common reason gum disease comes back.
Ask your dentist about your risk. If you have diabetes, smoke or have a history of gum disease, the schedule may need to be tighter.
If your gums do not respond as hoped, do not be discouraged. Some areas need a second round of cleaning, medicine or a visit to a gum specialist. The aim is steady progress, and your dentist will walk you through each step.
Gum care at KDA
At Kendall Dental Associates, our team treats gum disease and explains every step before it starts. We use digital X-rays and 3D scans to see what is going on under the gums. Our hygienists, Kenny Brocard and Cristina Dominguez, have a combined 50 years of experience, and patients know Kenny for her gentle touch. We are dedicated to treating every patient with kindness, compassion and dignity.
If your gums bleed, feel loose or have been told they need a deep cleaning, call 305-271-1421. We are at 8833 SW 107th Ave in Miami, in the Kendall Mall, open Monday to Friday, 8:00 AM to 5:00 PM. We accept most dental insurances and most Medicare supplemental plans, and financing is available. For a dental emergency, our care is available 24/7.
Common questions
Will I be awake for scaling and root planing?
Yes. The gums are numbed with a local anesthetic, and you stay awake. Tell your team if you feel anxious so they can help you relax.
How long does scaling and root planing take?
Cleveland Clinic says one to two hours in total. It may be done in one visit or split into two.
Can I go to work afterward?
Most people can return to normal activity the same day. Some prefer a quiet evening because of the numbness and soreness.
What should I eat after a deep cleaning?
Soft, cool or lukewarm foods for the first day or two, such as yogurt, eggs, soup and mashed potatoes. Avoid very hot, spicy or hard foods until you feel better.
Is it normal for my teeth to feel loose afterward?
Slightly, yes. Swelling can make teeth feel looser at first, and this usually settles as the gums heal. If a tooth stays loose, tell your dentist.
Will my gums grow back?
Gums can tighten and get healthier, but lost bone does not grow back by itself. Treatment aims to stop further loss.
This article is general information, not medical advice. Your dentist will confirm what is right for you at your exam. General information checked against: my.clevelandclinic.org, mouthhealthy.org, ncbi.nlm.nih.gov, mayoclinic.org.