Scaling and root planing, more commonly referred to as a deep cleaning, is a more extensive cleaning below the gum line that is performed to treat periodontal disease. When professional cleanings are not performed every six months, plaque accumulates at the gum line and extends below the level of the gums onto the roots of the teeth. This causes inflammation of the gums (gingivitis) and gradual loss of the bone that supports the teeth (periodontitis), creating deeper gum pockets between the teeth and gums where harmful bacteria can thrive. If left untreated, this can lead to tooth loss.
In order to properly diagnose what you need, radiographs and an examination are done. X-ray images show the tartar build up below the gums as well as the level of the bone. The below image shows plaque build-up (red circles) and bone levels (yellow lines), with angulation of the bone level highlighting bone loss.
During a deep cleaning, the plaque and bacteria are removed above and more importantly, below the gum line in order to reduce inflammation and prevent further bone loss. This requires local anesthetic for comfort. Deep cleanings generally are broken up into two appointments due to the amount of time and anesthetic required to clean half the mouth.
Since the lost bone cannot regenerate, these deep gum pockets will remain even after completion of the deep cleaning. To keep up with the pace of bacterial growth in these deep gum pockets, periodontal maintenance cleanings usually take place every 3-4 months after a deep cleaning. No anesthetic is used and the entire mouth is done in one visit for these cleanings.