When is deep cleaning recommended?
Scaling takes hardened tartar and plaque off the teeth above and below the gumline.
Root planing smooths the root surfaces. A smooth root gives the gum a chance to reattach and gives bacteria fewer places to collect.
Gum pockets deeper than healthy gums have
Tartar stuck to the roots
Bone loss around the teeth on X-rays
A diagnosis of periodontitis
Bleeding gums on their own do not mean you need a deep cleaning. The American Dental Association says a professional cleaning should do when gum disease is caught before it damages the structures below the gumline.
Routine cleaning versus scaling and root planing: what is the difference?
A routine cleaning works at the gum edge of healthy gums, and scaling and root planing works deep inside gum pockets. Our dental checkup and cleaning page covers the routine visit.
| Routine cleaning | Scaling and root planing | |
|---|---|---|
| Where it cleans | At and just under the gum edge | Roots deep inside gum pockets |
| Who it is for | Healthy gums or early gingivitis | Periodontitis with pockets |
| Freezing | Not usually needed | Depends on pocket depth and sensitivity |
| Wrong choice when | Pockets and root tartar are present | Gums are healthy or mildly inflamed |
How is the need for root planing diagnosed?
The need for root planing is diagnosed from pocket measurements. A thin measuring probe goes into the space beside each tooth, and the readings go on a chart. The dentist also checks bleeding, gum recession, loose teeth and tartar below the gumline. Dental X-rays are taken when the dentist decides you need them after your history and exam.
What happens during scaling and root planing?
1. The treatment area is planned
The team maps which teeth need deep cleaning. Treatment can cover one area, half the mouth or one quadrant (a quarter of the mouth) at a time. Tell the team about every health condition you have and every medicine you take, including anything that affects bleeding.
2. The area is numbed
Local anaesthetic (freezing) numbs the gums and roots being cleaned. Whether you need it depends on pocket depth, tooth sensitivity and how much tartar there is.
If you feel anxious, ask the team whether nitrous oxide sedation suits you. Nitrous oxide wears off faster than other sedation, but the team will tell you when it is safe to drive. Any sedation can cause drowsiness and, in rare cases, breathing problems, so the team reviews your health first.
3. Scaling removes the tartar
Ultrasonic instruments, hand instruments or both remove plaque and tartar down to the bottom of each pocket.
4. Root planing smooths the roots
Root planing smooths the cleaned roots so the gum can heal against them.
5. You get home-care instructions
Before you leave, the team shows you how to clean around the treated teeth as they heal.
How painful is scaling and root planing?
Scaling and root planing should not hurt during treatment, because the area is numbed first. You will feel pressure and some scraping. Tell the dentist or hygienist straight away if anything hurts so they can stop and check.
Once the freezing wears off, expect soreness. The American Dental Association puts the pain at a day or two and tooth sensitivity at up to a week.
How many appointments are needed?
A deep cleaning takes one to two hours in total, according to Cleveland Clinic. It is done in one visit or split across two or more. The split depends on how many teeth need treatment, how deep the pockets are, your comfort and your insurance or CDCP limits. The dentist recommends what comes next after each visit.
What to expect after deep cleaning
After deep cleaning, expect tender, slightly swollen gums and some sensitivity to cold. These effects usually settle within a week. Cleveland Clinic notes that sensitivity to hot and cold can take a month or two to fade.
Call us at (905) 581-2228 right away for swelling that grows, bleeding that will not stop or pain that is not getting better. Mild sensitivity to cold can last longer and should fade over time. Emergency same-day care when available.
- Brush gently with a soft brush and clean between your teeth as shown
- Stay away from smoking and vaping as your gums heal
- Use a rinse or medicine only as your dentist, pharmacist or doctor directs
Call 911 or go to the nearest hospital emergency department if you have trouble breathing or swallowing, swelling that spreads toward your eye or neck, fever with facial swelling, or bleeding that will not stop.
What happens at the re-check and periodontal maintenance?
A re-check after your gums have had time to heal shows how well scaling and root planing worked. The American Dental Association says the dentist measures your pockets again at that visit. The next step depends on what it shows:
- Periodontal maintenance, a schedule of deep gum cleanings set for you
- More scaling in areas that have not healed
- Gum surgery for pockets that stay deep
- A referral for further gum care when the disease is advanced
Periodontal maintenance has no fixed interval for everyone. The dentist sets yours from your pocket depths, your home care and how your gums respond.
Is scaling and root planing good for your teeth?
Scaling and root planing is good for teeth with gum disease because it removes the deposits that keep the gums inflamed. A 2015 review of 72 clinical trials by an American Dental Association panel found an average gain of about half a millimetre in gum attachment. The aim is to stop the damage, not to rebuild what is gone.
The treatment aims to reduce bleeding and swelling, make the roots easier to keep clean and slow periodontitis. Results depend on how advanced the disease is, smoking, diabetes and how well you keep up home care.
What are the limits and risks of scaling and root planing?
The main risks of scaling and root planing are tooth sensitivity and gum shrinkage. Swollen gums tighten as they heal, so more of the tooth root can show and teeth can look longer. The gums can bleed for a short time after treatment, and newly exposed roots can feel sensitive to cold. Cleveland Clinic says complications such as infection are rare.
- It does not cure periodontitis. Control depends on home care and maintenance visits
- It cannot promise you will keep every tooth
- Very deep pockets may need gum surgery afterwards
How much does scaling and root planing cost in Vaughan?
Published prices at other Toronto-area clinics put scaling and root planing (deep cleaning) at about $200 to $450 per quadrant. Your own cost comes in a written estimate after an exam. What changes the cost:
- How many quadrants need treatment
- Time spent, since scaling and root planing are billed in units of time
- Local anaesthetic, and X-rays when the dentist decides you need them
- Re-check and maintenance visits
Does insurance cover scaling and root planing?
Private dental plans can pay a share of scaling and root planing, up to each plan's limits. My City Dental offers direct insurance billing. Ask for a predetermination before treatment. It is an estimate from your plan, not a promise of payment.
Does CDCP cover scaling and root planing?
The Canadian Dental Care Plan pays for scaling and root planing up to set limits for each age group. Under the CDCP Dental Benefits Guide, adults 17 and over get 4 units of scaling and root planing combined in any 12 months. Teens 12 to 16 get 1 unit of scaling and children 11 and under half a unit. More units need preauthorization, backed by a periodontal chart from the last 12 months with six measurements per tooth.
My City Dental accepts the Canadian Dental Care Plan (CDCP). Coverage depends on the service and your eligibility, and some services need preauthorization.
Frequently Asked Questions
Is scaling and root planing a big deal?
Scaling and root planing is a common non-surgical treatment, not an operation. There are no cuts or stitches, and Cleveland Clinic says most people return to their normal routine after the visit. It still matters, because it treats an infection that can cost you teeth.
What is the 2 2 2 rule for teeth?
The 2 2 2 rule is a memory aid: brush twice a day for two minutes and see the dentist twice a year. The Canadian Dental Association advises brushing with fluoride toothpaste twice a day, two minutes each time. After scaling and root planing, your dentist sets your maintenance cleanings and checkups to suit your gums.
Does root planing make gums grow back?
Root planing does not make lost gum or bone grow back. Once the swelling goes down, the gums can fit more snugly and the pockets can get shallower. Gum that has already receded stays where it is. For roots that stay exposed, the dentist talks with you about gum surgery.
Can teeth become loose after deep cleaning?
Teeth can feel a little loose right after a deep cleaning. Cleveland Clinic expects this feeling to fade as the gums tighten back up. Call us if a tooth stays loose, feels looser over the following weeks or hurts when you bite.
Can I eat after scaling and root planing?
You can eat once the freezing has worn off. Eating when your mouth is still numb makes it easy to bite your lip, cheek or tongue. Pick softer foods for a day or two if your gums feel tender, and skip very hot or cold food if your teeth feel sensitive.
Book an Assessment for Scaling and Root Planing in Vaughan
Bleeding gums, deep gum pockets or tartar below the gumline? Book a gum-health assessment at My City Dental to find out whether a routine cleaning, deep cleaning or maintenance suits your gums.