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Scaling and Prophylaxis

Did you know that there a different types of cleanings? There are three kinds: Prophylaxis, Scaling Root Planing (SRPs), Periodontal Maintenance.

Prophylaxis

This is the cleaning that most patients ask for when they schedule an appointment. This is the standard 6-month recall that people follow. A Prophylaxis is indicated for patients who have a HEALTHY periodontal state. This is important because during this cleaning, only the areas above the gum-line are cleaned. The gum tissue should be tight and heathy, to not allow debris to form any lower within the 6-month interval. Plaque and calculus debris are removed by the hygienist. After this treatment is complete, polishing is performed to remove any remaining surface stain. The appointment concludes with flossing and an exam from the doctor. Patients usually will schedule there next 6-month recall.

Why are any other cleanings necessary? Well, have you ever missed your 6-month cleaning? Were you one month overdue? 6 months overdue? One year or more overdue? For many reasons, patients may fall off of the recommended interval. When this happens, a “regular” cleaning may not be enough to maintain a HEATHY periodontal state.

Scaling and Root Planing

A Scaling Root Planing (SRP) appointment is needed for people who have some form of periodontal disease and need specific treatment to return to a stable state. Even though this cleaning is usually indicated for patients who are overdue for a cleaning, a patient who has always maintained their 6-month cleanings may require periodontal therapy if that 6-month interval is no longer adequate to keep the debris above the gum-line. This cleaning is designed to remove plaque and calculus that have migrated below the gum level. This is the area that cannot be cleaned with a toothbrush at home. Indications for this type of cleaning are calculus and bone loss on x-rays, 5mm probing depths (indicating bone loss), and easily bleeding gums.

SRPs can be completed on localized areas of 1-3 teeth or on an entire quadrant. Regardless of the amount of areas needing treatment, the procedure is consistent. The areas are numbed with either a topical anesthetic or with the use of a local anesthetic. The areas are then thoroughly cleaned beneath the gum level to remove bacteria and debris. With the bacteria causing periodontal disease removed, the gum tissue will shrink to a more manageable state. With proper maintenance, this procedure can be avoided in the future. This leads into the 3rd type of cleaning: Periodontal Maintenance.

Periodontal Maintenance

Periodontal Maintenance cleanings are performed on patients who have completed periodontal therapy through SRPs. A periodontal maintenance cleaning is usually completed every 3-4 months, depending on the patient’s specific needs after treatment. While a prophylaxis cleaning indicates cleaning above the gum-line, a periodontal maintenance indicates cleaning below the gum-line if necessary. Since periodontal disease needs to be closely monitored, cleaning solely above the gum level could allow for bacteria to migrate below the gums again and start causing deterioration of bone again. Periodontal Maintenance cleanings are the protocol of managing periodontal disease after therapy was completed.

Role of Professional Applications of Fluoride

Fluoride applications are performed on children as a form of preventing cavities. On adults, this procedure is oftentimes overlooked since many patients pay for fluoride treatments out of pocket. However, there are benefits to applying fluoride treatments on adults. The elderly population and patients with dry mouth are particularly recommended to receive fluoride since they are at a higher risk of developing decay. This simple procedure can prevent decay from forming and causing a larger problem. Pt’s who have periodontal disease also benefit from fluoride treatments. When the gum tissue heals after treatment, sometimes the root surface of the teeth are revealed. These areas are at a higher risk of developing decay. By simply applying fluoride to these areas, decay can be prevented. Even if a patient does not fit into any of these categories, fluoride treatments are still a positive way to maintain healthy teeth for the long term.