If your dentist or hygienist has recommended a “deep cleaning,” you may be wondering how it differs from a regular cleaning, whether you really need it, and what recovery is like. The formal name for the procedure is scaling and root planing. It is a non-surgical treatment for gum disease, and for many people it is the main step in getting gum health back on track. This guide explains what it is, why it is recommended, what to expect during and after, and the questions worth asking.
Why a deep cleaning is recommended
Gum disease starts with plaque, the sticky film of bacteria that is always forming on teeth. The ADA explains that when plaque is not cleaned away well, the bacteria inflame the gums. The gums then pull away from the teeth and form spaces called pockets. Plaque gets trapped in those pockets, where a toothbrush cannot reach, and if the disease is not treated it can lead to bone and tooth loss (ADA MouthHealthy: Scaling and Root Planing).
The National Institute of Dental and Craniofacial Research (NIDCR) describes gum disease as an infection that inflames the tissues holding teeth in place. It starts with red, swollen gums that bleed, and if it is not treated it can spread to the bone supporting the teeth; in the worst cases teeth may loosen or need to be removed. NIDCR explains that dentists measure the spaces around teeth with a small ruler called a probe, and that in a healthy mouth these pockets are usually between 1 and 3 millimeters deep. Deeper pockets can be a sign of periodontal disease (NIDCR: Periodontal (Gum) Disease).
According to the ADA, if gum disease is caught early and has not damaged the structures below the gumline, a regular professional cleaning should be enough. When the pockets are too deep, scaling and root planing may be needed. Our article on signs of gum disease covers the symptoms to watch for.
Regular cleaning vs deep cleaning
| Routine cleaning | Scaling and root planing | |
|---|---|---|
| Purpose | Prevention and maintenance for healthy gums | Treatment of gum disease with deeper pockets |
| Where it cleans | Mainly the tooth surfaces and just at or slightly below the gumline | Down to the bottom of the pockets, along the root surfaces |
| Numbing | Usually not needed | Local anesthetic is often used |
| Visits | Usually one | May take more than one visit, often by section of the mouth |
| Follow-up | Next routine checkup | A re-evaluation visit to measure healing |
What happens during the procedure
The ADA describes the deep cleaning in two parts:
- Scaling. Plaque and tartar (hardened plaque) are removed from above and below the gumline, all the way to the bottom of each pocket.
- Root planing. The root surfaces are smoothed so the gums can reattach to the teeth. The American Academy of Periodontology adds that smoothing the roots helps prevent plaque and bacterial toxins from sticking to them again (American Academy of Periodontology: Non-Surgical Treatments).
The ADA notes that scaling and root planing may take more than one visit and may require a local anesthetic. Many offices treat one or two quarters of the mouth per appointment, though the approach varies.
Before the procedure
You will usually have a periodontal exam first, in which the hygienist or dentist gently measures the depth of the space between each tooth and the gum, often along with X-rays to look at the bone. Those measurements are what drive the recommendation, so it is fair to ask to see them. Tell the office about your medical history and medications, especially if you have diabetes, a heart condition or take blood thinners.
Recovery and aftercare
The ADA says that after a deep cleaning you may have pain for a day or two and tooth sensitivity for up to a week. Your gums may be swollen, tender and bleed. Practical tips:
- Wait for numbness to wear off before eating, so you do not bite your cheek or tongue.
- Choose soft foods for a day or so and avoid very hot or very cold items if your teeth are sensitive.
- Keep brushing gently with a soft brush. Cleaning the area is part of healing, even if it is tender.
- Use any rinse or medicine your dentist prescribes exactly as directed. The ADA notes that a pill or mouth rinse may be prescribed to prevent infection, control pain or help healing, and that medication may sometimes be placed directly into a cleaned pocket.
- Call the office if pain, swelling or bleeding gets worse instead of better, or if you develop a fever.
The re-evaluation visit and long-term maintenance
According to the ADA, your dentist will schedule another visit to see how your gums have healed and measure your pockets again. If they have gotten deeper, more treatment may be needed. The American Academy of Periodontology says many patients do not need additional treatment after scaling and root planing, but most will need ongoing maintenance therapy to keep gums healthy. If non-surgical treatment does not achieve the hoped-for result, a periodontist may recommend gum surgery.
Maintenance cleanings are often scheduled more frequently than standard checkups after gum disease treatment. Ask your dentist what interval they recommend for you and why. If your case is complex, you may be referred to a periodontist, a dentist who specializes in the gums and supporting bone.
What about lasers and other options?
Some offices offer laser treatment for gum disease. The American Academy of Periodontology says controlled studies have found results similar to certain other non-surgical treatments, including scaling and root planing alone, and warns that using a laser with the wrong wavelength or power can damage tissues. It also notes that FDA clearance of tray-based medication delivery systems did not establish that any specific medication delivered by tray is a proven treatment for gum disease. If you are offered an add-on, ask what it adds compared with standard scaling and root planing.
Cost and insurance
We do not publish prices, because the total depends on how many areas of the mouth need treatment, whether anesthetic or medication is used, your location and your plan. Dental plans often treat scaling and root planing differently from a routine cleaning, so ask for a written estimate and a pre-treatment check of your benefits. Our guides to dental cleaning costs, reading a dental treatment plan and dental insurance terms can help.
Keeping gum disease from coming back
The ADA’s home-care advice after a deep cleaning is straightforward: brush twice a day with a soft brush, clean between your teeth daily, eat a balanced diet, avoid tobacco and see your dentist regularly. NIDCR also notes that smoking or using tobacco is the most significant risk factor for gum disease, and that tobacco can delay healing and make treatment less successful.
Questions to ask your dentist
- What are my pocket measurements, and which areas need treatment?
- Why is a deep cleaning recommended instead of a regular cleaning?
- How many visits will it take, and will I be numbed?
- When will you re-check my gums, and what happens if pockets are still deep?
- How often should I come in for maintenance afterward?
- What will my insurance cover, and can you send a pre-treatment estimate?
Frequently asked questions
Is scaling and root planing painful?
It is usually done with local anesthetic when needed. Afterward, the ADA says some pain for a day or two and sensitivity for up to a week are common.
Is a deep cleaning the same as gum surgery?
No. Scaling and root planing is a non-surgical treatment. Surgery may be considered if non-surgical treatment does not achieve healthy gums.
Will I need it again?
Many people do not need a repeat deep cleaning if they keep up with maintenance visits and home care, but gum disease can return. Your follow-up measurements will guide what comes next.
Sources
- ADA MouthHealthy – Scaling and Root Planing
- NIDCR – Periodontal (Gum) Disease
- American Academy of Periodontology – Non-Surgical Treatments
By the Dentist Review Editorial Team.
This article is for general information only and is not medical advice. Talk to a licensed dentist about your own situation. See our disclaimer.
Featured image: “Interdental Brush BW 2012-04-03 19-13-45” by Berthold Werner, via Wikimedia Commons, licensed CC BY-SA 3.0. Resized and compressed for the web.
Our guides are written and reviewed by the Dentist Review editorial team. We research each topic using public, authoritative sources such as the CDC, the National Institutes of Health (NIH/NIDCR), the American Dental Association (ADA) and CMS, and we update guides when guidance changes. Guides are for general information only and are not dental or medical advice; please read our disclaimer and learn more about us.