Deep cleaning is the term most patients hear; scaling and root planing is what dentists actually call it. The two procedures are usually done together, and they form the standard non-surgical treatment for periodontitis.
If your dentist has mentioned it, the gum disease has probably progressed beyond what a routine scale and polish can manage. The good news is that this treatment for gum disease works extremely well in most cases, particularly if it’s done early and followed up with proper maintenance. Patients across Essex come to us for this every week, and the outcomes are generally far better than the term “deep cleaning” suggests.
Most patients are surprised how manageable it is.
The difference between a scale and polish and a deep clean
A standard scale and polish removes plaque and calculus (tartar) from the surfaces of the teeth above the gumline, and a small distance below it. It’s appropriate for healthy mouths, mild gingivitis, and routine maintenance. The instrument used is usually an ultrasonic scaler, which vibrates calculus off the tooth surface using high-frequency sound waves and water.
Scaling and root planing goes deeper, literally. The dentist or hygienist works below the gumline, into the periodontal pockets where the gum has detached from the tooth. The aim is twofold: remove the calculus and biofilm that’s adhering to the root surface, and smooth the root itself so the gum can reattach more easily afterwards. “Planing” simply means making the surface smoother.
Worth knowing: the procedure is almost always done under local anaesthetic, because working below the gumline on inflamed tissue is uncomfortable otherwise.
Who actually needs it
The decision is driven by pocket depth and bone levels, not by how the gums look from outside. We measure pockets at every check-up using a calibrated probe. Pockets of 4mm or more typically indicate periodontitis, and pockets of 5mm or more are where scaling and root planing is usually indicated. Anything 7mm and above sometimes needs surgical input as well.
X-rays tell us how much bone has been lost, which informs the prognosis for each tooth.
The patients who benefit most are those who’ve noticed:
- Persistent bleeding when brushing or flossing
- Bad breath that doesn’t resolve with normal cleaning
- Receding gums or teeth looking longer than they used to
- A loose tooth, or a tooth that’s drifted
- A bad taste, particularly in the morning
- Pus around a tooth or gum, which is less common but does happen
Not all of these need deep cleaning. Some need different treatment entirely. The point of the assessment is to work out which.
What the appointment looks like
Scaling and root planing is usually delivered across one to four visits, depending on how much of the mouth is affected and how the patient tolerates each session. Single-quadrant treatment (one quarter of the mouth at a time) is the most common pattern in our clinic, partly because it keeps the anaesthetic localised and partly because it spreads recovery.
Local anaesthetic is given first. Once the area is numb, we use a combination of ultrasonic scalers (for bulk calculus removal) and hand instruments called curettes (for fine detail and root smoothing). The session typically runs forty-five minutes to an hour per quadrant. Patients usually feel pressure and vibration but no pain.
Afterwards, the gums are tender for a day or two. Most people manage on paracetamol or ibuprofen if needed. We’ll provide aftercare instructions, including a saltwater rinse for the first few days and any prescribed mouthwash.
Standard scale and polish vs scaling and root planing
| Aspect | Scale and polish | Scaling and root planing |
|---|---|---|
| Where it cleans | Above and just below gumline | Deep into periodontal pockets |
| Anaesthetic | Not usually needed | Local anaesthetic, almost always |
| Number of visits | One | Typically two to four |
| Suitable for | Healthy gums, mild gingivitis | Periodontitis with 4mm+ pockets |
| Typical duration | 20 to 30 minutes | 45 to 60 minutes per quadrant |
| Recovery | None to speak of | 1 to 3 days of mild tenderness |
| NHS band (currently) | Band 1: £27.90 | Band 2: £76.60 (sometimes more) |
Recovery and what to expect afterwards
The first 24 hours are the most uncomfortable, and even then “uncomfortable” rather than “painful” is usually the right word. Cold drinks may sting briefly. The gums look slightly redder than normal because the inflammation hasn’t fully resolved yet, and small amounts of blood when you brush are normal for a few days.
Sensitivity to cold is the most common surprise. The reason is that the root surface, which had been hidden under inflamed gum and calculus, is now exposed. As the gum reattaches and tightens against the tooth, this usually settles within a few weeks. We sometimes recommend a sensitivity toothpaste in the meantime.
Actually, that’s the question patients ask most often, so it’s worth saying clearly: the sensitivity isn’t damage. It’s the gum healing into a tighter position than it was before treatment.
By six to eight weeks, the gums should look pinker, feel firmer, and bleed considerably less. We re-measure pockets at this stage to check that depths have reduced. Most patients see improvements of 1 to 3mm at the affected sites, sometimes more.
What happens if you don’t have it done
Untreated periodontitis is one of the leading causes of tooth loss in adults in the UK. The bone supporting the teeth gradually resorbs, the gum recedes further, and at some point teeth become mobile enough that they need to be extracted. The British Society of Periodontology has long highlighted that early intervention is far more effective than salvage work later. The NHS overview of gum disease covers the basics if you’d like to read more.
The progression is usually slow, often years rather than months, but it’s also one-way without intervention. That’s why we treat early.
If you’re in Essex and you’ve been told you need scaling and root planing, or you’re not sure whether your gum disease has progressed that far, our team at Westcliff Dental Practice can assess your gums properly and explain your options. We can usually book an initial appointment within a week or two. Call us on 01702 344 500 to arrange a consultation.
