The objective of scaling and root planing, otherwise known as conventional periodontal therapy, non-surgical periodontal therapy, or deep cleaning, is to remove or eliminate the etiologic agents which cause inflammation: dental plaque, its products, and calculus, thus helping to establish a periodontium that is free of disease.
Plaque is a soft, sticky mixture of bacteria, waste products from bacteria, and some food debris. It irritates the gums, or gingiva, and causes inflammation over time: gingivitis. The longer plaque is left on the teeth, the harder it gets. After 24 hours, some plaque hardens into calculus, otherwise known as tartar.
Calculus is mineralized plaque and does not come off with the brush and floss anymore. The bacteria in plaque and calculus cause an ongoing state of inflammation called gingivitis. If left untreated, gingivitis can progress to a more serious disease called periodontitis.
The most common treatment for periodontitis is scaling and root planing.
Removal of adherent plaque and calculus with hand instruments can also be performed prophylactically on patients without periodontal disease. 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 periodically 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.