How To Srp Dental – Periodontal disease (gum disease) is a bacterial infection of the gums around the teeth, if left untreated it will spread to other teeth and eventually lead to tooth loss. When periodontal disease is detected, Dr. Prieto may recommend a scaling and root planing procedure.
Root scaling and planing (sometimes called deep cleaning or non-surgical periodontal therapy) is usually the first step in the ongoing process to stop the destruction of periodontal disease and keep the disease under control.
How To Srp Dental
Scaling and root planing is the process of smoothing the root surfaces of the teeth by removing hard calculus and debris from under the gums.
Common Services — Dr. Jerry H Ter Avest Dds
The time required to complete the SRP procedure depends on the severity of the disease, the number of teeth involved, the depth of the pocket and the amount of calculus present. Traditionally, when the whole mouth needs SRP, we finish one side at a time. For most patients, SRP is performed in two visits, each lasting about an hour.
The dentist may recommend taking further action immediately after the deep cleaning is completed. He may recommend putting antibiotics directly into deeper pockets (placed by your dentist or hygienist), or an antibacterial mouthwash used at home.
The dentist will determine when you should return to periodontal maintenance therapy. Typically, the first maintenance visit will be somewhere between 2-4 months after scaling and root planing. Deep cleaning, or scaling and root planing (SRP), is the same thing. Although SRP is a technical term, many dentists have referred to it as “gum therapy,” “gingival bacterial control,” or “subgingival therapy” due to the growing public resistance to deep cleaning.
If you have multiple probing depths >4mm — you know that series of numbers your dentist or hygienist calls during your exam — and you have bone loss, yes, you would benefit from an SRP. No, regular cleaning is not enough here. The scientific literature is convincing about the benefits and effectiveness of the procedure.
All On 4
SRP is essentially scraping tartar from the roots of your teeth, below the gum line, with either a metal scaler or an ultrasonic scaler. Tartar is formed from hardened plaque, which is naturally produced from food and saliva over time, and must be mechanically removed from the tooth.
As periodontal disease progresses, the natural pockets between the gum tissue and the tooth grow deeper, allowing tartar to form further into the root of the tooth. Over time, this further exacerbates the problem and leads to inflammation, bone loss and eventually infection and tooth loss.
The goal of SRP is to remove this tartar, allowing the pockets to tighten around the tooth. The picture below is a person with a severe disease state, which we are trying to avoid with treatment.
There is a vast body of evidence detailing the effectiveness of the procedure ( source ) and the success of the procedure being tied to the skill of the individual service provider. (Source) In other words, the better your dentist or hygienist, the better the potential outcome.
General Preventative Care — Dr. Susan King & Dr. Sherief Hussein
However, SRP in itself is not a magic bullet, (Source) and the necessity of SRP is a clear indication that there is active periodontal disease, which requires regular periodontal maintenance (usually every three months) to keep the disease at bay; (Source) think of something between deep cleaning and regular cleaning. With shallow probing depths (eg, pockets smaller than 4 mm), there is less measurable benefit from the procedure and it is considered unjustified. However, the greater the initial probing depth, the more benefits the procedure provides. (Source) Smoking also negatively affects the success of deep cleaning (Source) and, overall, worsens periodontal disease.
Probably, but the degree to which they work is not fully established and treatments are usually expensive. (Source) For this reason, these are popular sales. If you want to get everything you can out of your deep clean, it probably won’t hurt, but it also might not offer as many benefits as you’d like. Various additional therapies would be a separate article to do them justice. As it stands, there is no definitive ‘yes’ or ‘no’ to this question.
The term ‘deep cleaning’ is a bit of a disservice because it compares SRP to regular cleaning, also called prophylaxis. Deep cleaning is much more involved and used in far more specific situations than a typical teeth cleaning.
Deep cleanings are coded and billed by quadrant of the mouth—basically, divide the mouth into four even sections—and typically cost $200-$300 per quadrant. Typically, one to two quadrants will be treated at a time, which involves numbing the area being worked on, similar to a filling, and takes about forty-five minutes per quadrant to properly clean. Apart from mechanical descaling, the two have little in common.
Full Mouth Debridement
Every list on the Internet of “what to look out for at the dentist” calls out deep cleanings as something to be wary of. It only takes a few minutes on Google to leave you thinking your dentist is trying to scam you. That said, yes, SRPs have historically been overused. We know they are, and it’s an extremely unfortunate situation.
There are clear diagnostic standards based on decades of research that guide the use of treatments, and it is extremely frustrating when these are not followed. SRPs have unfortunately become a staple of unscrupulous and large corporate dental practices that advertise a $39 exam, cleaning, and a series of full-mouth x-rays. We’ve written about this specific scenario before, and to warn our readers once again, you will almost always be taken advantage of if you try to participate in these ‘deals’.
Probably the biggest reason is that many insurance companies, in their never-ending quest to save dollars, do everything in their power to deny coverage. By denying coverage for some arbitrary reason, the burden of cost is placed on their customer, the patient.
When confronted, the insurance company will state that the procedure was not necessary despite never seeing the patient, while simultaneously trying to blame the dentist for allegedly performing unnecessary work. This scenario can be mitigated with excellent documentation and x-rays from your dentist, but it’s still an unfortunate reality.
How To Know You Need A Deep Cleaning
The easiest way to avoid this situation is to never need it through proper oral hygiene. I know, I know, that’s not what you’re reading this for. Well, unfortunately, there is no really easy way for you as a patient to know when you do or don’t need a deep cleaning. If you’re ever in doubt, get a second opinion. I am always happy to offer patients a free second opinion, and I am never offended if my patient seeks it elsewhere.
As mentioned earlier, I’d recommend avoiding shopping at the dentist like you do a couples massage or a whale-watching trip on Groupon, as you’ll inevitably save yourself a lot in the long run. Once those two are covered, your dentist should explain your probing depths and x-rays. (If your dentist or hygienist didn’t do a depth probe or x-rays, your dentist absolutely should not be looking for SRP, so that should be a clear sign) Your dentist should also be able to show you bone loss on an x-ray .
The x-ray below was of a patient of mine many years ago and is truly an ideal example of when SRP is needed. Although not always visible on an x-ray, in this example you can see tartar (circled in red) on the teeth below the gum line, as well as bone loss (the yellow lines show where the bone level is currently). The bone level angle further indicates that bone loss has occurred. Bone loss should always be present before SRP is performed. Removing hard deposits (calculus or tartar) from the root surface of your teeth is known as root scaling and planing, sometimes called a “deep cleaning.” This treatment can be completed in one or more appointments depending on your unique needs.
After this therapy, you will begin to notice your gum tissue change from unhealthy (swollen, red) to healthy (firm and pink) as you continue to be seen regularly for maintenance visits. When we see this change in your gums, we will know that the infection is under control and your gums are healthier.
Scaling And Root Planing
Your toothbrush and floss can only clean so far below the gum line. When plaque and calculus (bacterial colonies) are on the gums and roots of your teeth, inflammation occurs. This inflammation and the bacteria that cause it release toxins that can cause gingivitis and bleeding gums. If left untreated, gum disease can lead to:
This type of gum disease is called periodontal disease. Dr. Lepore can diagnose the need for scaling and root planing (SRP) to remove hard plaque from your teeth.
Periodontal disease (gums) can be treated, but not cured. After scaling and root planing is completed, patients are usually placed on periodontal maintenance
