Procedures

Scaling & root planing

Disadvantages & risks

Scaling & root planing usually requires local anesthetic to be performed comfortably. Although not feeling the procedure is an advantage, local anesthesia has risks and disadvantages of its own, with which patients should be familiar. Local anesthetic is generally not billed as a separate procedure, however.
Learn more: Procedures › Local anesthetic

Causes a temporary rise in the number of bacteria borne by the blood ("bacteremia"). In patients with a suppressed immune system, this may cause septicemia, which is toxicity due to high levels of bacteria and their byproducts in the blood. In patients with certain heart conditions, bacteremia could cause endocarditis. Typically heart patients and immunosuppressed patients are aware of their condition, and the increased risks, and are pre-medicated with antibiotics for the procedure.

Many studies show that SRP alone is not completely effective at removing calculus and diseased cementum from the roots of affected teeth. Success may depend on many factors, including the skill and diligence of the operator, whether sharp instruments were used, whether appropriate instruments for the shape of the root being instrumented were used, the length of time the calculus has been present on the root surface, and the mineral density of the calculus.

May cause the teeth to be sensitive for a period of time. This is because plaque and calculus can act as an insulating layer on the roots of teeth. This does not mean that plaque and calculus are in any way beneficial to the teeth, gums or bone. Moreover, desensitizing gels and varnishes are available which can diminish the duration and amount of sensitivity following the procedure.

SRP is often misunderstood by the patient to be "a deep cleaning", and is even referred to as such by some dental professionals. This is unfortunate, because SRP is actually NOT a preventive procedure. It is a non-surgical method of treating an active disease process.

If SRP is perceived as "a deep cleaning", patients can be frustrated with the cost and time required to complete the procedure. For a patient with generalized periodontal disease, it may take up to four hours (normally over two to four appointments) to have SRP done.

As with any dental procedure, it is possible that you may develop chapping or cracking of the lips, and/or cold sores following treatment. These risks can be minimized by rinsing with antiseptic rinse before the procedure, and frequent application of lip balm or vaseline during the procedure.

Since periodontal disease is not curable, SRP is only a means of helping a patient manage the disease more effectively. There are periodontal treatment regimens available which offer up cures for the disease. These involve laser debridement (cleaning) of infected gum pockets, and nutrition supplements which are sold as "cures". Unfortunately, these programs have not withstood the test of time. It may be best to approach these "magic bullet" periodontal therapies with healthy skepticism and to continue to maintain excellent oral hygiene until better long-term data are available to validate their claims of a cure.

It has been said that control over periodontal disease is 25% up to the dental professionals managing the problem, and 75% up to the patient. Although SRP can help a patient retain their teeth long-term, if a patient is not motivated to keep the teeth, and cannot commit to the practice of effective daily oral hygiene, treatment is unlikely to succeed.

Once you have been diagnosed with, and treated for periodontal disease, you should be evaluated more frequently than usual to be sure the condition is under control. Most commonly, periodontal patients are seen three to four times per year for "Periodontal Maintenance" procedures. Maintenance involves a thorough periodontal assessment and appropriate disease management procedures to prevent progression of periodontitis.

The gingiva may recede enough following SRP to make the root surfaces of the teeth visible. While this has the advantage of making the teeth easier to clean, it may be of cosmetic concern to the patient. It is best to know ahead of time what the likelihood of this outcome is, so be sure and discuss it with your dental professional. There may be little choice if a patient wants to maintain healthy gums and bone around the teeth.