Regular oral hygiene, including brushing and flossing, cleans only the surface and a very small portion of the teeth beneath the gums. Deep cleaning, which is usually performed by a dentist or periodontist, gets below the gum line to remove plaque and bacteria that have formed there. Deep cleaning is generally performed only when a person has symptoms of gum disease.
Deep cleanings are needed to allow the gums and other tissues in the mouth heal. They also reduce the need for more drastic procedures by halting and sometimes reversing the damages caused by gum disease.
Gum Disease
Gum disease, also called periodontitis, is primarily caused by bacteria on and below the gums. Over time, plaque can build up below the gums due to bacteria.
Gum disease causes many symptoms that compromise the health and functioning of the teeth in addition to their appearance. Swollen, bleeding gums are often one of the first signs that bacteria are present beneath the gum line. Either recessed pockets or bulging protrusions can form on the gums, and they are usually filled with pus. Over time, the presence of the bacteria destroys the connective properties of the gums, which causes them to recede from the teeth. That makes the situation worse because food particles and bacteria can more easily get between the teeth and gums, which only exacerbates the gum disease symptoms.
Teeth can eventually shift out of alignment or even fall out from the damages caused by gum disease. The teeth also loosen due to the loss of jaw bone mass that the bacteria can cause over prolonged periods of time.
Tobacco
Tobacco users are at higher risk of developing gum disease. Tobacco and other ingredients often included in tobacco products produce inflammation in the gums. They also promote the growth of bacteria in the mouth.
The more bacteria that are present, the more likely the gums will develop gum disease. According to information from the Mayo Clinic, "The sugar and irritants in chewing tobacco and other forms of smokeless tobacco can cause your gums to pull away from your teeth in the area of your mouth where you place the chew. Over time, you can develop gum disease."
Root Planing
Root planing is one form of deep cleaning. It is often used to try to reduce the damage caused by gum disease and to allow the tissue to heal.
Root planing is a procedure that removes spots of plaque or bacteria from below the gum line. Dan Peterson, D.D.S., of Nebraska, who has been a practicing dentist for more than 30 years, describes root planing as a procedure that, "...involves smoothing the root surfaces of your teeth with thin curettes so gum tissue can more firmly reattach to roots that are clean and smooth to prevent tooth loss and sensitivity problems. The procedure makes it more difficult for plaque to accumulate along the root surfaces." If that procedure isn't enough to heal the gums, it is sometimes combined with another procedure, called scaling.
Scaling
According to Jeffrey Wissot, D.D.S., of California, and director of dental operations at dentistry.com, "One-fourth or half of the mouth is anesthetized so that the hygienist can comfortably scrape below the gums. This is called scaling and it's similar to removing the scales from a fish. The procedure may be performed by a dentist, hygienist or periodontist [gum specialist], using hand instruments or ultrasonic vibrating instruments to blast deposits off the teeth." This procedure doesn't result in a smooth tooth surface, so it is often paired with root planing. Gums adhere more readily to a smooth surface. Also, a smooth surface makes it more difficult for plaque to stick.
Recovery
After root planing or scaling, the mouth still needs to heal. The teeth may be sensitive to hot and cold for a while. The bleeding and swelling of the gums may remain until the tissue has time to fully repair itself. Once it has healed, it can begin adhering to the teeth again. With a clean area below the gums and a tighter seal at the gum line, bacteria can't cause damage as effectively. However, proper oral hygiene is still imperative to keep the condition from developing again.
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