Patient Guide for Scaling and Root Planing (Deep Cleaning)

Q: Why are my teeth so sensitive now? They weren't this sensitive before.

The tartar that was built up on the roots of your teeth was acting as a thick, insulating blanket. The deep cleaning removed this harmful layer, exposing the clean (but sensitive) root surface to the mouth for the first time. This sensitivity is a sign that the teeth are clean and will gradually improve over the next few weeks.

Q: Does this deep cleaning "cure" my gum disease?

Periodontal disease is a chronic condition that cannot be “cured,” but it can be controlled. This deep cleaning is the first and most critical step to get the active infection under control. At your follow-up visit, we will assess how your gums have healed and determine if any further treatment is needed to achieve long-term stability.

Q: If my gums are stable, why do I have to come back every 3-4 months?

This is the most important part of your long-term health. The aggressive bacteria that cause periodontal disease can grow back to harmful levels in about 90 days. The 3-4 month maintenance schedule is the proven, scientific standard for disrupting these bacteria before they can cause more bone loss. It is the only way to prevent the need for another deep cleaning and to keep your teeth for life.

Surgical Care Instructions

Pain Management

It is normal for your gums to be tender and your teeth to be sensitive for several days after this procedure. Here is how to manage both effectively.

For Gum Tenderness:

Why it’s Sore: A deep cleaning is a therapeutic procedure where we clean the root surfaces deep below your gum line. The tenderness you feel is a sign that your gums are beginning to heal from an active infection.
Medication: For the first 1-2 days, we recommend a scheduled regimen of 600mg of Ibuprofen AND 500mg of Tylenol (Acetaminophen) taken together every 6 hours to manage inflammation.

For Tooth Sensitivity (CRITICAL):

It is very common for teeth to become sensitive to cold after a deep cleaning. To manage this effectively, we recommend the following protocol:

Use a Desensitizing Toothpaste: Brush with a toothpaste containing potassium nitrate, such as Sensodyne®. This calms the nerve inside the tooth.
Add a Special Mouth Rinse: For added relief, use a mouth rinse containing potassium oxalate, such as Listerine® Clinical Solutions for Sensitive Teeth. This creates a protective barrier over the sensitive root surfaces.
AVOID Whitening Toothpastes: It is critical that you do not use any whitening toothpastes. They are highly abrasive and will significantly worsen your sensitivity.

Bleeding Control

It is normal and expected to see some minor bleeding when you brush and floss for the first few days. This is a sign of your gums healing. As the inflammation resolves, the bleeding will stop completely.

Swelling Management

Significant swelling of your gums or face is not expected after this procedure. Your gums may feel slightly puffy or tender, but you should not experience noticeable swelling. If you do, please contact our office.

Oral Hygiene/Site Care

The scaling and root planing procedure is the first and most important step—it hits the “reset button” on your gum disease. The long-term success of this treatment is now a partnership between you and our clinical team.

Phase 1: Your Role (Excellent Home Care)

Brush gently but thoroughly twice a day with a soft-bristled toothbrush.
Floss daily. This is absolutely essential to prevent new plaque from forming under the gums.

Phase 2: Our Role (Re-Evaluation & The Long-Term Plan)

About 4-6 weeks after your deep cleaning is complete, we will have you back for a critical appointment called a periodontal re-evaluation. This is where we measure the pockets around your teeth again to see how well your gums have healed and responded to the initial therapy.

The Goal: The ideal outcome is for the deep pockets to become shallow and healthy, in a range that you can effectively clean at home (typically 3mm or less).
If Pockets Remain: In some cases, even after excellent initial therapy, deep pockets may remain. These “residual pockets” are impossible for you to clean at home and will continue to harbor bacteria, leading to further bone loss. If this is the case, we may recommend additional treatment to create a stable, long-term result. This could include:
- Corrective Procedures (Osseous Surgery): A minor surgical procedure to reshape the bone around the teeth, eliminating the deep “craters” where bacteria hide and creating a healthier, more cleanable gum architecture.
- Regenerative Procedures (GTR): In specific situations, a procedure to regenerate or “add back” bone that has been lost.

We will discuss the findings of your re-evaluation with you in detail and create a personalized plan together. The goal is always to achieve true periodontal stability and improve the long-term prognosis of your teeth.

Phase 3: Lifelong Care (Periodontal Maintenance)

Once your gums are stable, you will be on a Periodontal Maintenance schedule, with professional cleanings every 3 to 4 months. This is the evidence-based standard of care to prevent the disease from recurring and to protect your investment in your health.

Dietary Recommendations

Stick to a soft diet for the first day or two while your gums are tender.
Avoid very hot or very cold foods if your teeth are sensitive.
Try to avoid foods with small, hard pieces (like popcorn kernels or chips) that can get lodged under your healing gums.