A regular dental cleaning, also known as prophylaxis, is a routine preventative procedure performed on patients who have generally healthy gums and only exhibit plaque and tartar above the gum line. It is designed to maintain health and prevent disease. In contrast, a deep cleaning, or scaling and root planning (SRP), is a therapeutic procedure necessary to treat periodontal (gum) disease. It is performed when the patient has pockets of infection where the gums have pulled away from the teeth, and tartar has built up below the gum line along the tooth roots. Regular cleaning maintains health, while deep cleaning is required to treat active disease and prevent bone loss.

Scaling and root planing (SRP) is a two-part, non-surgical procedure used to treat chronic gum disease. Scaling involves meticulously removing all the hardened plaque (calculus or tartar) from the tooth surface, both above and, crucially, below the gum line and down to the bottom of the periodontal pocket. Root planing is the process of smoothing the tooth roots to remove bacteria, toxins, and rough spots where plaque can easily collect. It is considered a deep cleaning because it targets the root surfaces inside the periodontal pockets, which can be several millimeters deep, making it a more involved procedure than simply cleaning the visible part of the tooth.

The primary indicator that you need a deep cleaning is the measurement of your periodontal pockets and signs of active gum disease, which is determined during a routine dental exam. If your dentist measures pocket depths greater than 3 or 4 millimeters and observes bleeding, inflammation, and visible bone loss on X-rays, they will recommend scaling and root planing. These deep pockets indicate that the connective tissue and bone supporting the tooth have been damaged by bacterial infection. A regular cleaning is sufficient if your pocket depths are consistently shallow (2–3 mm) and your gums are pink and firm without bleeding.

Since scaling and root planning involves working below the gum line, often on root surfaces that have become sensitive, it is common for dentists to use local anesthesia to ensure the patient remains comfortable throughout the procedure. The anesthesia is administered to numb the gums and the underlying tissues in the section of the mouth being treated. Patients typically feel pressure or vibration during the cleaning but should not feel sharp pain. Any discomfort after the anesthesia wears off is generally mild and can be managed with over-the-counter pain relievers, making the discomfort significantly less severe than the consequences of untreated gum disease.

A deep cleaning (scaling and root planning) is typically not done in a single appointment across the entire mouth. It is usually divided into two or four separate appointments, treating one or two quadrants of the mouth at a time. This approach allows the dentist to use enough local anesthesia to ensure comfort in the area being treated and gives the practitioner ample time for the detailed, thorough cleaning required for successful root planning. Each appointment usually lasts between 45 minutes to an hour and a half, depending on the severity of the tartar buildup and the depth of the pockets.

Gum recession is the process where the gum tissue pulls back from the tooth, exposing the root surface. Dental cleanings and scaling and root planning do not cause gum recession; rather, they can expose recession that was previously obscured by swelling and inflammation caused by gum disease. When the deep-seated tartar and infection are removed during SRP, the inflamed gum tissue shrinks back down, sometimes exposing more of the root than before. This is not a side effect, but a sign of healing, as the gums return to a healthy, firm state. The true cause of the recession is almost always the underlying gum disease or aggressive toothbrushing.

Following scaling and root planning, the recovery period is generally short, but you should expect some temporary symptoms for a few days. The most common issues are mild gum soreness, tenderness, and increased tooth sensitivity to hot and cold temperatures, especially after the local anesthesia wears off. Your dentist will typically advise you to take over-the-counter pain relievers and to stick to a soft diet for the first 24 to 48 hours to avoid irritating the healing gums. You should continue to brush gently, and your dentist may recommend rinsing with warm salt water to help reduce swelling and promote healing.

The primary goal of root planning is to create a clean, smooth, and biologically compatible root surface that encourages the gums to heal and reattach tightly to the tooth. When gum disease is present, the exposed tooth roots become rough, creating a perfect harbor for bacteria and their toxins. Root planning physically removes this toxic layer and the cementum, creating a smooth surface that makes it difficult for bacteria to re-adhere. This clean, smooth surface reduces inflammation and is critical for shrinking the periodontal pockets, thereby stabilizing the tooth and halting the progression of bone-destroying periodontal disease.

Yes, follow-up care is absolutely critical after a deep cleaning because scaling and root planning is only the first step in managing chronic gum disease. You will typically have a re-evaluation appointment a few weeks after the SRP is completed to check the pocket depths and ensure the gums have healed and tightened. After successful deep cleaning, patients are usually moved from a standard six-month cleaning schedule to a periodontal maintenance schedule, which requires cleanings every three to four months. These more frequent visits are necessary because individuals with a history of gum disease are prone to relapse and require more intense, frequent cleaning to prevent the disease from becoming active again.

Deep cleaning (scaling and root planning) is the standard and most effective non-surgical treatment for halting the progression of gum disease (periodontitis). While it cannot regenerate the bone that has already been lost, it can drastically reduce the inflammation, shrink the periodontal pockets, and eliminate the active bacterial infection that causes bone loss. By removing the source of the infection, SRP significantly stabilizes the teeth and dramatically increases the patient’s chance of preventing future tooth loss. The treatment’s long-term success, however, depends entirely on the patient’s commitment to meticulous daily oral hygiene and strict adherence to the required three-to-four-month periodontal maintenance cleanings.