Treatment of periodontitis may include several steps, the first of which often requires the removal of the local causative factors in order to create a biologically compatible environment between the tooth and the surrounding periodontal tissues, the gums and underlying bone.
Left untreated, chronic inflammation of the gums and supporting tissue can raise a person's risk of heart disease.

Prior to beginning these procedures, the patient is generally numbed in the area intended for instrumentation.
Because of the deeper nature of periodontal scaling and root planing, either one half or one quarter of the mouth is generally cleaned during one appointment.
This allows the patient to be entirely numbed in the necessary area during treatment.
It is usually not recommended to have the entire mouth scaled at one appointment because of the potential inconveniences and complications of numbing the entire mouth- i.e., inability to eat or drink, likelihood of self injury by biting, etc.

Generally, the first step is the removal of dental plaque, the microbial biofilm, from the tooth, a procedure called scaling.
Root planing involves smoothing the tooth's root.
These procedures may be referred to as scaling and root planing, periodontal cleaning, or deep cleaning.
These names all refer to the same procedure.
The term "deep cleaning" originates from the fact that pockets in patients with periodontal disease are literally deeper than those found in individuals with healthy periodontia.
Such scaling and root planing may be performed using a number of dental tools, including ultrasonic instruments and hand instruments, such as periodontal scalers and curettes.

The objective for periodontal scaling and root planing is to remove dental plaque and calculus (tartar), which house bacteria that release toxins which cause inflammation to the gum tissue and surrounding bone.
Planing often removes some of the cementum or dentine from the tooth.

Removal of adherent plaque and calculus with hand instruments can also be performed prophylactically on patients without periodontal disease.
A prophylaxis refers to scaling and polishing of the teeth in order to prevent oral diseases.
Polishing does not remove calculus, but only some plaque and stains, and should therefore be done only in conjunction with scaling.

Often, an electric device, known as an ultrasonic scaler, sonic scaler, or power scaler may be used during scaling and root planing.
Ultrasonic scalers vibrate at a high frequency to help with removing stain, plaque and calculus.
In addition, ultrasonic scalers create tiny air bubbles through a process known as cavitation.
These bubbles serve an important function for periodontal cleanings.
 Since the bacteria living in periodontically involved pockets are anaerobic, meaning unable to survive in the presence of oxygen, these bubbles help to destroy them.
 The oxygen helps to break down bacterial cell membranes and causes them to lyse, or burst.

Since it is of the utmost importance to remove the entirety of the deposit in each periodontal pocket, attention to detail during this procedure is crucial.
Therefore, depending on the depth of the pocket and amount of calculus deposit versus soft biofilm deposit, hand instruments may be used to complete the fine hand scaling that removes anything the ultrasonic scaler left behind.
Alternatively, power scalers may be used following hand scaling in order to dispel deposits that have been removed from the tooth or root structure, but remain within the periodontal pocket.

Sonic and ultrasonic scalers are powered by a system that causes the tip to vibrate.
Sonic scalers are powered by an air-driven turbine.
Ultrasonic scalers use either magnetostrictive or piezoelectric systems to create vibration.
Magnetostrictive scalers use a stack of metal plates bonded to the tool tip.
The stack is induced to vibrate by an external coil connected to an AC source.
Ultrasonic scalers also include a liquid output or lavage, which aids in cooling the tool during use, as well as rinsing all the unwanted materials from the tee
Treatment of periodontitis may include several steps, the first of which often requires the removal of the local causative factors in order to create a biologically compatible environment between the tooth and the surrounding periodontal tissues, the gums and underlying bone. Left untreated, chronic inflammation of the gums and supporting tissue can raise a person's risk of heart disease.
Prior to beginning these procedures, the patient is generally numbed in the area intended for instrumentation. Because of the deeper nature of periodontal scaling and root planing, either one half or one quarter of the mouth is generally cleaned during one appointment. This allows the patient to be entirely numbed in the necessary area during treatment. It is usually not recommended to have the entire mouth scaled at one appointment because of the potential inconveniences and complications of numbing the entire mouth- i.e., inability to eat or drink, likelihood of self injury by biting, etc.
Generally, the first step is the removal of dental plaque, the microbial biofilm, from the tooth, a procedure called scaling. Root planing involves smoothing the tooth's root. These procedures may be referred to as scaling and root planing, periodontal cleaning, or deep cleaning. These names all refer to the same procedure. The term "deep cleaning" originates from the fact that pockets in patients with periodontal disease are literally deeper than those found in individuals with healthy periodontia. Such scaling and root planing may be performed using a number of dental tools, including ultrasonic instruments and hand instruments, such as periodontal scalers and curettes.
The objective for periodontal scaling and root planing is to remove dental plaque and calculus (tartar), which house bacteria that release toxins which cause inflammation to the gum tissue and surrounding bone. Planing often removes some of the cementum or dentine from the tooth.
Removal of adherent plaque and calculus with hand instruments can also be performed prophylactically on patients without periodontal disease. A prophylaxis refers to scaling and polishing of the teeth in order to prevent oral diseases. Polishing does not remove calculus, but only some plaque and stains, and should therefore be done only in conjunction with scaling.
Often, an electric device, known as an ultrasonic scaler, sonic scaler, or power scaler may be used during scaling and root planing. Ultrasonic scalers vibrate at a high frequency to help with removing stain, plaque and calculus. In addition, ultrasonic scalers create tiny air bubbles through a process known as cavitation. These bubbles serve an important function for periodontal cleanings.  Since the bacteria living in periodontically involved pockets are anaerobic, meaning unable to survive in the presence of oxygen, these bubbles help to destroy them.  The oxygen helps to break down bacterial cell membranes and causes them to lyse, or burst.
Since it is of the utmost importance to remove the entirety of the deposit in each periodontal pocket, attention to detail during this procedure is crucial. Therefore, depending on the depth of the pocket and amount of calculus deposit versus soft biofilm deposit, hand instruments may be used to complete the fine hand scaling that removes anything the ultrasonic scaler left behind. Alternatively, power scalers may be used following hand scaling in order to dispel deposits that have been removed from the tooth or root structure, but remain within the periodontal pocket.
Sonic and ultrasonic scalers are powered by a system that causes the tip to vibrate. Sonic scalers are powered by an air-driven turbine. Ultrasonic scalers use either magnetostrictive or piezoelectric systems to create vibration. Magnetostrictive scalers use a stack of metal plates bonded to the tool tip. The stack is induced to vibrate by an external coil connected to an AC source. Ultrasonic scalers also include a liquid output or lavage, which aids in cooling the tool during use, as well as rinsing all the unwanted materials from the tee
Scaling and root planing