Deep Teeth Cleaning (Scaling & Root Planing): What to Expect

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Hi, I’m Dr. B, practicing functional dentist for 35 years. I graduated from the Dugoni School of Dentistry in San Francisco, CA in 1987 and am a member of the American Academy of Dental Sleep Medicine (AADSM), Academy of General Dentistry (Chicago, IL), American Academy for Oral Systemic Health (AAOSH), and Dental Board of California. I'm on a mission to empower people everywhere with the same evidence-based, easy-to-understand dental health advice that my patients get. Learn more about Dr. B
Procedure

Scaling & Root Planing (Deep Teeth Cleaning)

Scaling & root planing (SRP) is a procedure your periodontist will typically do every 3 years and is a deeper form of a dental cleaning focused on clearing your gum pockets of debris and toxic buildup.

  • Ibuprofen before and after the procedure, if needed
  • CBD oil for inflammation relief
  • Local anesthetic during the procedure

$600-1,000 per treatment, usually covered at 80% by dental insurance (after your deductible) once every 36 months

Has your dentist mentioned the need for you to have a deep cleaning for your teeth?

This is an important procedure used in the treatment of gum disease. It may leave you with a bit of sensitivity, but it can help improve gum pocket depth significantly.

Let’s talk about this procedure, who needs it, and what to expect.

What is a deep teeth cleaning?

A deep teeth cleaning is referred to as SRP, otherwise known as a dental scaling and root planing. So, what the heck is that and how is it different than a cleaning?

In a nutshell, a deep cleaning is just a little bit deeper than a regular cleaning. Your dental hygienist goes below the gum line to remove toxins like calculus, tartar, and other substances that have stuck onto your tooth surfaces.

If these materials are not removed, the gum disease or the immune response of the gums, gets worse. This will likely lead to bleeding gums deeper and deeper gum pockets.

Long-term effects of pockets getting increasingly bigger include tooth loss and even bone loss.

This deep teeth cleaning is literally a planing or cleaning/scraping of the root surface, which is technically below the gum line.

Who needs scaling and root planing?

Some of the signs of gum disease that may be present before your dentist identifies it at a checkup are:

  • Bad breath
  • Bleeding gums (gingivitis, or stage I periodontitis)
  • Inflamed/sensitive gum tissue
  • Tenderness when flossing

If you notice any of these symptoms, set up an appointment with your dentist right away.

This procedure is prescribed when your pockets are deeper than expected, which is the first sign of periodontal disease beyond gingivitis. It’s done only after pocket readings are taken at a pocket depth of more than 3 millimeters.

In order to recognize bone loss or find cysts or an abscess, your dentist may perform an x-ray before your scaling and root planing.

As you continue to work to halt gum disease, your periodontist may prescribe regular dental deep cleanings like this (sometimes as often as every 3 months).

In patients with chronic periodontal disease, SRP may help reduce pocket depth by up to 0.5 millimeters.

Scaling & Root Planing vs. Normal Teeth Cleaning

If you have deep periodontal pockets with significant buildup, it will take more time than just a regular cleaning to resolve the buildup. That’s why an SRP is typically done by the quadrant and is a markedly longer procedure.

This type of dental cleaning procedure for patients with periodontitis is also a bit more likely to cause tooth sensitivity.

How to Prepare for a Deep Teeth Cleaning

There’s really not much to do to prepare for a scaling and root planing, although some dentists may recommend you rinse with a very strong antiseptic mouthwash. This is because there will be a lot of bacteria transferred to your blood during the root planing.

However, I don’t recommend this because it disrupts the delicate oral microbiome. Instead, I suggest supporting oral health with habits like oil pulling, oral probiotics, and eating a low-carbohydrate/low-sugar diet to drive down inflammation.

This will not only help prepare your immune system for brief exposure to more bacteria, but also help you make the first steps to halting gum disease.

If you’re concerned about sensitivity or pain, you can also use an over-the-counter pain reliever before the procedure. I prefer a natural option when possible, such as CBD oil, but you may also take ibuprofen (Motrin) the night before and morning of your procedure to get ahead of the inflammation.

What to Expect During SRP

A deep teeth cleaning should take between 1-4 hours.

First, your hygienist will numb you by injecting a local anesthetic.

Sometimes, the hygienist will need one hour per quadrant to do the proper scaling and root planing of all the root surfaces in one quadrant.

Typically, one side of the mouth is done per one-hour session. For instance, the right side will be done in one hour (both quadrants) and then the two left quadrants will be done a week or two later.

Your dentist, hygienist, or periodontist will use tools such as a dental scaler or an ultrasonic device with a vibrating tip to clear plaque and calculus from above and below the gum line. It’s often described as a “rubbing” motion that’s used to polish and smooth out rough spots on teeth.

Does a deep teeth cleaning hurt?

In order to prevent pain during the procedure, your dentist will usually apply a local anesthetic to numb your gums.

Typically, a patient will feel only a little sensitivity after SRP, though some throbbing and achiness may occur. Keep in mind, even regular teeth cleanings can cause a bit of pain.

If sensitivity occurs, it is for one of two reasons: One is related to the gum, and the other is related to a very clean root surface.

First of all, the gums being manipulated by the dental hygienist may leave you with soreness or throbbing for a brief period of time.

Then, the root surface being so much cleaner may cause sensitivity. All the tartar and calculus on the root surface acts as a sort of thermal barrier, so a very clean surface may be temperature sensitive for a few weeks, at worst.

After a root planing is the best time to be brushing with a nano-hydroxyapatite toothpaste, like Boka, to prevent prolonged sensitivity.

How to Take Care of Your Teeth and Gums Afterwards

After you’ve had your root planing done, there are some habits that are helpful in helping you recover.

  1. Stay away from acidic drinks and foods for 2-3 days.
  2. Make sure you have plenty of saliva in your mouth — that’s how the root surfaces will be remineralized and strengthened. If you are a mouth breather at night, try mouth taping to prevent dry mouth.
  3. Brush with nano-hydroxyapatite (nHa) toothpaste.
  4. Consider switching to a sonic toothbrush, which can gently help to break up plaque before it hardens into tartar buildup. (The Boka kit includes both a sonic toothbrush and nHa toothpaste.)

Many dentists will prescribe a course of antibiotics after SRP in order to prevent infection from the increased bacterial load. This seems to produce good treatment outcomes, according to a 2010 study.

How much does a dental scaling and root planing cost?

While a typical cleaning is around $100-150, depending on where you live, an SRP treatment will range from $150-250 per quadrant. This means your deep teeth cleaning can range from $600-1,000 per treatment, and more if upgraded numbing agents are used (which is an optional service some dentists offer).

This is almost always covered by dental insurance at 80% once every 36 months. In general, dental insurance will then cover 4 normal cleanings each year, known as “perio maintenance.”

What happens if you don’t get SRP when your dentist recommends it?

It’s vital to address periodontitis as soon as your dentist points it out — which is just one reason that getting a regular cleaning every 6 months is important for everyone’s dental health.

While it’s not possible to reverse gum disease after it starts, you can often stop it in its tracks. Since 47-70% of adults over 30 have some form of gum disease, it’s not a problem to ignore!

The impact of ignoring gum disease may include:

  • Tooth loss from advancing tooth decay (it’s harder to treat cavities without healthy gums to protect the tooth roots)
  • Alveolar bone loss
  • Painful receding gums
  • Loose teeth that are more likely to fall out

Key Takeaways: Deep Cleaning for Teeth

A deep dental cleaning may not sound like fun, but it’s a necessity to stop periodontal disease. Most often called SRP, this procedure goes beyond a standard cleaning to smooth and clean the surface of the roots beneath inflamed gums with a pocket depth beyond 3 mm.

This type of cleaning appointment takes 1-4 hours and is frequently broken into two visits.

The roots of your teeth may be more sensitive after the procedure, but this shouldn’t last a long time and can be countered with a strong nano-hydroxyapatite (nHa) toothpaste.

SRP is covered by most dental insurance policies.

Read Next: Does a teeth cleaning hurt? What should you expect?

2 References

  1. Smiley, C. J., Tracy, S. L., Abt, E., Michalowicz, B. S., John, M. T., Gunsolley, J., … & Hujoel, P. P. (2015). Systematic review and meta-analysis on the nonsurgical treatment of chronic periodontitis by means of scaling and root planing with or without adjuncts. The Journal of the American Dental Association, 146(7), 508-524. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/26113099
  2. Cionca, N., Giannopoulou, C., Ugolotti, G., & Mombelli, A. (2010). Microbiologic testing and outcomes of full‐mouth scaling and root planing with or without amoxicillin/metronidazole in chronic periodontitis. Journal of periodontology, 81(1), 15-23. Abstract: https://www.ncbi.nlm.nih.gov/pubmed/20059413