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Procedures

Scaling & root planing

Procedure overview

Learn about the dental procedure, when it is generally prescribed, and other information which can increase your knowledge of the topic.

Scaling & root planing (SRP) are terms most often used together to describe a non-surgical periodontal procedure for the treatment of early to moderate periodontal disease ("periodontitis"), sometimes referred to by the antiquated term, "pyorrhea".
Learn more: Diagnoses › Periodontitis

SRP is a procedure in which dentists or dental hygienists use sharp, specialized hand instruments known as "curettes" to scrape mineralized calculus deposits from the cementum surface of tooth roots, into which the attachment fibers of the gums and periodontal ligament previously inserted (Figure 1a and Figure 1b). When the deposits are removed (referred to in general medical terms as "debridement"), the cementum surface is planed smooth to make it less supportive to bacterial colony formation.

If a diagnosis of generalized periodontal disease has been made, SRP may be needed on most or all of the teeth. If the diagnosis is localized periodontal disease, only the affected teeth are treated.

Scaling and root planing for periodontal disease can help avoid systemic illness

Figure 1a: Scaling & root planing procedures are performed below the gum level on the root surfaces of the teeth, where the damaged gingival and periodontal ligament fibers once attached to the tooth roots. Specially shaped "curettes" are used to remove the diseased cementum and calculus deposits, which support bacterial colonization.

Scaling and root planing improves dental health and helps avoid heart disease & strokes

Figure 1b: Note that the bone level has receded, allowing the "furcation" area to be visible (where the tooth divides into separate roots). Normally, the furcation would be submerged in bone, and inaccessible to bacteria. Periodontal disease has caused the bone to "dissolve" away in the acidic environment created by bacteria and chemical agents of the body's immune system.

Scaling & root planing is recommended for early active periodontitis when there is inflammation (bleeding and gum enlargement), a periodontal pocket of 4 to 6 millimeters in depth, and a detectable amount of mineralized calculus deposits on the teeth (Figure 2). Probings of 4 to 6 millimeters without detectable deposits on the teeth or inflammation does not necessarily indicate SRP.

Early periodontal disease typified by incipient bone loss and radiographic calculus

Figure 2: Early Periodontal Disease. Heavy subgingival deposits of mineralized plaque known as calculus ("C"), and early bone loss ("P") are among the indications for treatment by scaling & root planing.