Scaling and root planing, explained properly

A routine cleaning works on the crown of the tooth and just under the gum margin. A deep cleaning goes further down — along the root surface inside the pocket, where hardened deposits sit against the root and keep the inflammation going.

Root planing then smooths that root surface, because a rough root holds bacteria and a smooth one lets the gum tissue reattach to it. That reattachment is the actual goal. Removing the deposit is only half of it.

Because it works below the gumline, you are numbed for it, and it is usually done a quadrant or a half-mouth at a time rather than all at once.

This is one of the most commonly over-recommended procedures in dentistry, and patients are right to be wary. So here is the standard we hold ourselves to: we will show you the actual numbers, tooth by tooth, and the x-rays showing whether bone has been lost.

Pockets of four millimeters and above with bleeding and visible deposit is a genuine indication. Three millimeters everywhere with a bit of staining is not — that is a regular cleaning, and we will book you a regular cleaning.

If you have been quoted this elsewhere and it did not sit right, bring the treatment plan in. We will look at it with you honestly, including when we think they were right.

We pass a diode laser through the pockets alongside the scaling. It targets bacteria in the soft tissue lining of the pocket — the part instruments cannot physically reach — and it seals small vessels as it goes.

In practice patients notice two things: less bleeding during the appointment, and less soreness that evening. It adds a few minutes and no discomfort.

It is not a substitute for the mechanical cleaning. Anyone offering laser treatment instead of scaling is overselling it.