You go to a dental office for X-rays and an examination. You know you haven’t been in a while and your gums aren’t in the best of shape. You walk out of the office with a treatment plan (cost estimate and course of action) for a couple fillings and four quadrants of root planing. You really just want your teeth cleaned but they can’t do it because you have a disease and it needs to be treated first. You have never been told this before and aren’t quite sure what to think. I’m going to try my best to educate you about root planing and why you might be a candidate.
If you aren’t aware of the different types of cleaning a dental hygienist can provide, click here when you get a chance.
What is Root Planing?
Root planing, otherwise known as deep scaling, is a procedure performed to treat periodontal disease. Tartar and bacteria have caused your gums to become infected and the bone holding your teeth is in now in jeopardy. Root planing is where a hygienist (usually) carefully removes the toxins and tartar buildup from below the gum line so that the tissue can shrink back to a healthy state. They will use ultrasonic scalers, hand instrumentation and even antibacterials to treat the infection. Often times, a local anesthetic is used to keep you comfortable.
Why Would You Need It?
According to the CDC, “47.2% of adults aged 30 years and older have some form of periodontal disease”. And as age goes up, those statistics rise as well. When a dental provider is screening you for periodontal disease, they look at your X-rays and your mouth to determine if you have bone loss. Using a periodontal probe (a tiny measuring device), they will measure the bone that holds your teeth in. Imagine a little castle with a circular mote surrounding it. This little “mote” is the space we are measuring. A range of 1-3 mm is considered normal because that’s about how far your toothbrush and floss can reach. Anything above the 5mm range is a big red flag. Either your bone has dropped to a dangerous level or your tissue is very inflamed. Either way, if the dentist and hygienist feel like the disease can’t be treated by a simple cleaning, you’re a candidate for root planing.
How Long Does it Take?
The number of appointments and how much time is needed for each will be determined by the dental team. It all depends on how many teeth are involved, the level of infection, and how difficult the tartar is to remove. Usually each quadrant of your mouth will take anywhere from 30-60 minutes on average. Again, there shouldn’t be any cookie cutter rules because we are dealing with a few factors and human beings. I truly believe your appointment should be catered to your individual needs.
How Much Will This Cost?
The cost will be all over the place. It depends on where you live and what kind on insurance you have. I recommend getting a preauthorization if the dental office isn’t quite sure what your copay will be. It’s much better to plan accordingly so that you can get all of your mouth treated in the quickest time frame possible. Because we are dealing with live bacteria, we don’t want the germs from one side of your mouth re infecting the other because you have to space your appointments far apart.
What Questions Should I Ask?
I want everyone who needs treatment for periodontal disease to know why THEY need root planing. Sometimes it’s a straightforward bacterial infection. Sometimes you can actually see the heavy tartar buildup on the X-rays. Often times, it’s lack of going to the dentist for regular cleanings or a misunderstanding on how to take care of your mouth. Medications and their underlying conditions you are treating most certainly comes into play. You should feel comfortable asking to see the periodontal charting and images. If they have an intra oral camera, they can show you the tartar and where you need to spend more time with your brushing and flossing efforts. If you feel in your gut that you need a second opinion, go get it.
Let me tell you I LOVE destroying tartar and I love doing root planing because it’s instant gratification and I know this procedure helps my patients get healthy and stay healthy. BUT I get angry about offices that over treatment plan. If someone can’t take the time to hep you understand why you need treatment, maybe you would feel more comfortable somewhere else. You cannot trust everyone so I made a video about just that:
Root planing is a scam!
I see my dentist every 6 months to have my teeth cleaned and have been doing it for years. No problem. However, the insurance,Cigna, reduced the payout to the Dentist for only the patients who had an independent policy. Sounds like discrimination to me..so i was forced to find another dentist that was in network.
So I went to this new dentist and xrays were taken. They went over them with me and basically, tgere was nothing I didnt already know but they tefused to clean mt teeth without having to do a $1200. root planing procedure. There were only about 3-4 teeth that were in the 5-6 range…one was a 7. Therefore, they refused to clean my teeth…I usually steer flear of dental office who pull the root planing card but I didnt know this was one if them. I am furious that they refused my cleaning because it is their policy.
I can understand your frustration but I also know that 5-6 mm pockets are not healthy, tend to trap a lot of plaque and usualy get worse.. Over the years, root planing procedures were often the only way we could treat a patient’s periodontal disease and get them to a much healthier place…. however SOME type of treatment would be better than none in my honest opinion.
I do wish that hygienists were compensated by insurance companies by the TIME they need to spend treating a patient correctly and not so much the procedure or insurance codes that are used. The current system gives the insurance companies too much control over what a patient can or can’t have done.
I wish you all the luck finding a dental home you feel comfortable with.
I went to the Dentist for cleaning and evaluation and the Hygienist measured my gums mostly at 3’s and 4’s with two teeth at 5 and 6. I do not smoke and there was no mention of tarter. I am 72 years old. The dentist recommended root planing on all 4 quads with a quote of what the insurance would pay and would I would pay. Is the recommendation of root planing on all 4 quads over kill?
Can you please answer these questions for me.
To have scaling and root planing done is it better to go to a periodontist or can a dental hygienist do the job just as good as the periodontist?
Does scaling and root planing cause receding gums?
How long does it take to have the gums healed after scaling and root planing?
Thankyou.
I responded to this question via email since it was a rather lengthy answer 🙂