​If you have periodontal disease which has resulted in bone loss,

 gum “pockets” deeper than 4 millimeters, bleeding gums, exposed

 root surfaces, or if you have had periodontal surgery or root planning

 to treat periodontal surgery or root planning to treat periodontal

 disease, a regular cleaning is not appropriate.

 Periodontal Maintenance Scaling is needed to maintain gum and bone

 health. This procedure includes removal of plaque and tartar from above

 and below the gumline, all the way down the length of each tooth to

 where the root, gum and bone meet. Rough areas of the roots are

 smoothed if needed, pocket depths are carefully monitored, and inflamed  pockets may be irrigated with  antibacterial medicines if  necessary. Periodontal  

 Maintenance is considered a basic service by your insurance carrier, and may be  subject to a yearly deductible.  PM is usually  performed 3 to 4 times a year,  depending on several factors: how quickly the plaque and tartar  accumulate, how  much bleeding or  inflammation is present, how stable the present condition is,  how well you  are able to maintain your teeth at home on a daily basis,  any health  risk factors you may have.

 We know that there is a relationship between chronic inflammation in the gums  and overall health, especially  heart disease and  diabetes. Keeping the gums and  the bone surrounding your teeth as healthy as possible is an  important part of  your regular dental  visits or hygienist.

 A debridement is a procedure to remove thick or dense deposits on the teeth. It is required when tooth structures are so  deeply  covered with plaque and calculus that the dentist and staff cannot check for decay, infections or gum disease. A  debridement  is  not the same as a regular cleaning. It is usually a preliminary treatment when a person has very heavy plaque or calculus.​

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 A regular cleaning is a prophylaxis in dental terms. It is the removal of plaque, calculus, and stains from the tooth structures. A  prophylaxis is accomplished by using dental instruments that scrape away deposits from the teeth. An electric device, called an  ultra-sonic or sonic scaler, may be used. This deposit removal is performed on tooth structures that have not been affected by  bone loss, periodontal disease or infection, typically the crowns of the teeth. A regular cleaning is recommended for persons who  do not have dense deposits.

 A debridement is recommended for persons who do have dense deposits. It is described by the ADA as the removal of heavy  plaque and calculus that interferes with the ability of the dentist to perform a comprehensive oral evaluation, a preliminary  procedure that does not rule out the need for additional procedures. Simply put, a debridement is necessary when dense plaque  or  calculus is present. Dental instruments and electric devices may be used, but the amount of time needed to complete the  procedure, as well as the difficulty and extent of the procedure, are different.

If you've been diagnosed with gum disease, there are a variety of treatment options depending on the details of your situation and the severity of the problem. We always start with the least invasive options, which are non-surgical. However, in more serious cases, surgery may be necessary.

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 The first line of defense against gum disease is a unique type of  cleaning  called “scaling and root planing.” In this procedure, an  ultrasonic cleaning  device is used to remove plaque and tartar from  your teeth where regular  cleaning devices can't reach: under  the gum  line, on the tooth, and around  the root. Then, the rough surface of the  tooth and the root are smoothed out  (planed).  This provides a  healthy, clean surface that makes it easier for the  gum tissue to  reattach to the tooth.

 If you address your gum disease before it becomes severe, scaling and  root  planing may be the only treatment you need.  However, as with  any dental  procedure, after-care is vital. In order to keep your teeth in  good shape and  resist future occurrences  of gum disease, you must  brush and floss daily,  eat a healthy diet, avoid tobacco use, and have  regular dental checkups.

 Even  after a successful scaling and root planing, if you don't attend to  your  teeth properly, it's quite likely that you'll develop gum  disease  again.