When a regular cleaning is what you need
A regular cleaning, also known as prophylaxis, is for when there is no periodontal attachment loss from periodontitis and no sign of active periodontitis. Periodontal attachment loss means the gum and supporting tissue have lost some of their normal connection to the tooth. There is plaque and calculus, mostly on the tooth surfaces we can reach. Gingivitis may be present, but there is no periodontitis.
The purpose is to remove plaque, calculus and stains to maintain oral health.
When you need a deep cleaning
A deep cleaning, also known as scaling and root planing, is appropriate when there is periodontal attachment loss from periodontitis.
The clinical findings support periodontal disease. That can include deeper pockets, bleeding and some calculus under the gum. Pocket depth is how far your gum tissue extends down alongside your tooth when you measure it with a periodontal probe. X-rays may show bone loss that fits the clinical diagnosis.
The purpose of scaling and root planing is to remove deposits under the gum and treat the periodontal infection and inflammation.
What we look at to decide
- Periodontal probing depths
- Bleeding on probing
- Clinical attachment levels, and recession where relevant
- Bone levels and findings on X-rays
- Plaque, calculus and deposits under the gum
How these parameters above affect our decision
- One to three millimeter pockets with no attachment loss: a regular cleaning is recommended.
- Bleeding gums with no attachment loss or bone loss: usually a regular cleaning with appropriate gingivitis management.
- Isolated four millimeter pockets: these need further evaluation. They do not automatically qualify for scaling and root planing.
- Four to five millimeter pockets with clinical attachment loss: these need to be assessed for periodontitis. Further treatment, possibly scaling and root planing, is needed.
- Five to six millimeter pockets with attachment loss, bleeding and calculus under the gum: scaling and root planing is needed.