Q.  I have not been to the dentist in a long time and finally decided that I should go because my gums were bleeding every time I brushed my teeth for the last few weeks and have been sore.  The dentist said that I have gum pockets that are deeper than normal and that I need something called “scaling & root planing”.  What exactly is this procedure?  Will it cure my gum problems?

 

A.  The condition that you are describing is known as periodontitis.  Simply stated, this is an infection involving the gums and the tooth-supporting bone.  This is the number one cause of adult tooth loss in the United States.

 

When your dental office did the examination, they most likely used a measuring probe and measured the depth of the periodontal pockets around each tooth.  The pockets are measured from the height of the gum to the attachment of the gum to the root of the tooth.  I call this “popcorn space” because it makes it easier for the average patient to understand.  Normal pocket depths range from 1 – 3 millimeters in depth.  Pocket depths deeper than that indicate infection is present.  If the gum itself is inflamed, this can result in a deeper- than- normal reading.  Also, if there is loss of attachment of the gum to the root of the tooth (recession), this will result in higher readings.

 

Scaling & root planing is sometimes called "deep cleaning."  When performing scaling and root planing a local anesthetic is generally used since the gums are oftentimes very tender and all of the irritants that are deep in the pockets must be removed for proper healing to occur.  Most always, 3 to 4 weeks after the deep cleaning, the pockets are measured again hopefully showing great improvement.  Proper oral hygiene (brushing and flossing as directed) is essential during this healing phase to facilitate good results.  If deep pockets remain in some areas, this usually indicates that the attachment to the tooth has been destroyed from the disease process and further treatment, oftentimes surgery, is necessary to reduce the pocket depth so that the area is once again cleansable.  Today it is often possible to regenerate (regrow) bone and lost tissue back in areas where it was destroyed.  Your general dentist may refer you to a periodontist (gum specialist) if they feel you would be better served under his/her care.