Bleeding gums, persistent bad breath, gum recession, and tenderness around the teeth can be signs that plaque and tartar have collected below the gumline. When routine cleaning is no longer enough, scaling and root planing may be recommended to control the infection and protect the tissues supporting your teeth.
Dr. John Savukinas has completed more than 1,500 periodontal therapy and gum disease cases. He evaluates the depth of the gum pockets, the condition of the tooth roots, and the health of the surrounding bone before recommending treatment.
Concerned about gum disease in Rockville, MD?
Call 301-738-1155 or request a periodontal evaluation online.
Why a Regular Dental Cleaning May Not Be Enough
A routine cleaning removes plaque and tartar from the visible surfaces of the teeth and around the gumline. Gum disease creates deeper spaces, called periodontal pockets, between the teeth and gums. Bacteria and hardened deposits can collect inside these pockets where brushing, flossing, and routine cleaning cannot reach effectively.
Scaling and root planing is a nonsurgical periodontal treatment that cleans beneath the gumline. The purpose is to reduce bacterial buildup, remove hardened deposits, and create a cleaner surface against which the gum tissue can heal.
This treatment may be recommended when an examination shows:
- Periodontal pockets that are deeper than healthy gum measurements
- Bleeding during brushing, flossing, or examination
- Tartar deposits below the gumline
- Swollen, tender, or receding gums
- Persistent bad breath or an unpleasant taste
- Changes in the bone supporting the teeth
- Loose teeth or changes in the bite
What Happens During Scaling and Root Planing?
The treatment has two related parts. Both focus on removing the deposits and bacterial irritants associated with periodontal disease.
Scaling Below the Gumline
Scaling removes plaque, tartar, and bacterial deposits from the surfaces of the teeth and roots. Special dental instruments are used to reach beneath the gums and clean areas inside periodontal pockets.
The goal is to remove the hardened buildup that cannot be eliminated with a toothbrush or floss.
Smoothing the Root Surfaces
Root planing cleans and smooths areas of the tooth roots affected by bacterial deposits and toxins. A smoother root surface is easier to keep clean and may allow inflamed gum tissue to heal more closely against the tooth.
Root planing does not regenerate all tissue or bone already lost to advanced periodontal disease. However, it may help control infection and slow further damage when combined with effective home care and ongoing professional maintenance.
How Gum Disease Develops
Gum disease often begins when plaque remains around the teeth and gumline. The bacteria in plaque can irritate the gums, leading to redness, swelling, and bleeding.
In its earliest stage, gum inflammation may be reversible with improved home care and professional cleaning. When infection progresses beneath the gumline and begins affecting the supporting tissues, the condition is known as periodontitis.
Without treatment, periodontitis may contribute to:
- Deeper periodontal pockets
- Gum recession
- Loss of bone around the teeth
- Tooth movement or looseness
- Changes in the way the teeth fit together
- Eventual tooth loss
Because gum disease may advance without significant pain, regular examinations are important even when your teeth feel comfortable.
Signs You May Need a Periodontal Evaluation
Bleeding gums are common, but they should not be considered normal. They may indicate inflammation caused by plaque, tartar, or gum disease.
Schedule an evaluation if you notice:
- Gums that bleed regularly
- Red, swollen, or tender gum tissue
- Gums pulling away from the teeth
- Teeth appearing longer than before
- Ongoing bad breath
- Pus between the teeth and gums
- Sensitivity near exposed tooth roots
- Loose or shifting teeth
- Changes in the fit of a partial denture
These symptoms do not confirm the severity of gum disease on their own. Dr. Savukinas will examine the tissues and determine whether scaling and root planing, routine preventive care, or another form of periodontal treatment is appropriate.
What to Expect at Your Evaluation
Before recommending treatment, Dr. Savukinas will assess the gums and supporting structures around your teeth.
The evaluation may include:
- Measuring the spaces between the teeth and gums
- Checking for bleeding and inflammation
- Identifying tartar above and below the gumline
- Reviewing areas of gum recession
- Evaluating tooth mobility
- Reviewing dental images for signs of bone loss
- Discussing tobacco use, medications, and health conditions
- Reviewing your current brushing and flossing routine
These findings help determine which areas require treatment and whether the procedure should be completed in one visit or divided into sections.
Will Scaling and Root Planing Hurt?
The teeth and gums may be sensitive when inflammation or deep deposits are present. Local anesthesia can be used to numb the treatment area and improve comfort.
Scaling and root planing is often completed one section of the mouth at a time. Dividing treatment into appointments may allow the team to clean each area thoroughly while helping the patient remain comfortable.
After treatment, you may notice temporary:
- Gum tenderness
- Minor bleeding
- Sensitivity to hot or cold temperatures
- Spaces between teeth becoming more noticeable as swelling decreases
Dr. Savukinas will provide instructions based on the extent of your treatment and the condition of your gums.
Healing After a Deep Dental Cleaning
As inflammation decreases, the gums may become firmer and less likely to bleed. They may also fit more closely against the cleaned tooth surfaces.
Healing varies based on the severity of the disease, the depth of the periodontal pockets, tobacco use, medical conditions, and the quality of daily plaque control.
Following treatment, you may be advised to:
- Brush gently but thoroughly
- Clean between the teeth every day
- Use any recommended rinse as directed
- Avoid tobacco products
- Follow dietary instructions if the gums are tender
- Attend the recommended follow-up examination
Do not stop cleaning an area simply because it feels tender. Plaque control remains important during healing, although you should follow the specific instructions provided by our team.
Reevaluating Your Gum Health
Scaling and root planing is not complete without follow-up. After the gums have had time to respond, Dr. Savukinas may remeasure the periodontal pockets and check for bleeding, inflammation, and remaining deposits.
The reevaluation helps determine whether:
- The gums are responding as expected
- Periodontal pockets have become easier to maintain
- Additional localized treatment is appropriate
- More frequent periodontal maintenance is needed
- Referral for advanced periodontal care should be considered
Some areas respond well to nonsurgical treatment, while deeper or more advanced areas may require additional care.
Periodontal Maintenance After Treatment
Scaling and root planing controls existing bacterial buildup, but it does not permanently eliminate the risk of gum disease. Plaque begins forming again each day.
Patients with a history of periodontitis may need periodontal maintenance more frequently than patients receiving standard preventive cleanings. The recommended interval depends on how quickly deposits return, the depth of remaining pockets, and individual risk factors.
Periodontal maintenance may include:
- Cleaning above and below the gumline
- Monitoring periodontal pocket depths
- Checking for bleeding or inflammation
- Reviewing home-care techniques
- Evaluating tooth mobility and gum recession
- Monitoring the supporting bone when indicated
Learn more about oral hygiene and dental cleanings and exams.
Factors That Can Affect Gum Health
Plaque is the primary cause of gum disease, but several factors may affect how the condition develops or responds to treatment.
These may include:
- Smoking or other tobacco use
- Diabetes and blood sugar control
- Certain medications
- Dry mouth
- Genetic susceptibility
- Changes in hormone levels
- Crowded teeth or difficult-to-clean dental work
- Inconsistent brushing and interdental cleaning
Share your medical history and current medications with Dr. Savukinas. This information may influence treatment planning and the frequency of ongoing periodontal care.
Experience Treating Gum Disease
Periodontal treatment requires careful assessment, thorough cleaning, and long-term monitoring. Dr. Savukinas has completed more than 1,500 periodontal therapy and gum disease cases during his career.
His broader clinical background includes 34 years of dental experience and more than 3,000 fillings and restorative cases. This experience helps him evaluate how gum health affects the stability, comfort, and long-term outlook of the teeth and existing restorations.
Dr. Savukinas is also a Fellow of the Academy of General Dentistry and has served as a faculty member at the University of Maryland School of Dentistry since 1994.
Frequently Asked Questions About Scaling and Root Planing
What is scaling and root planing?
Scaling and root planing is a nonsurgical treatment for gum disease. Scaling removes plaque and tartar from above and below the gumline, while root planing cleans and smooths affected root surfaces.
How is a deep cleaning different from a regular cleaning?
A regular cleaning focuses mainly on deposits above and around the gumline. A deep cleaning treats areas below the gumline and inside periodontal pockets where bacteria and tartar have collected around the tooth roots.
How many appointments will I need?
The number of visits depends on how many areas require treatment, the depth of the deposits, and your comfort needs. Treatment may be completed in sections so each area can be cleaned thoroughly.
Does scaling and root planing cure gum disease?
It can help control periodontal infection and reduce inflammation, but periodontitis requires ongoing management. Daily home care, follow-up evaluation, and periodontal maintenance are important for limiting recurrence or progression.
Will my gums grow back after treatment?
Inflamed gums may become firmer and fit more closely around the teeth as they heal. However, gum tissue and bone already lost to advanced disease do not always regenerate after nonsurgical treatment.
Why do my teeth look longer after a deep cleaning?
As swelling decreases, the natural contours of the gums and any existing recession may become more visible. This can make the teeth appear longer even though the treatment did not remove healthy gum tissue.
Can gum disease return after scaling and root planing?
Yes. Bacterial plaque continues to form every day. Without effective home care and professional maintenance, inflammation and deeper deposits can return.
How often will I need periodontal maintenance?
The interval is based on the severity of your gum disease, remaining pocket depths, plaque buildup, health history, and response to treatment. Dr. Savukinas will recommend a schedule after reevaluating your gums.
What areas do you serve?
Dr. Savukinas provides scaling and root planing in Rockville, Maryland, and serves patients from Gaithersburg, Germantown, North Potomac, Potomac, and nearby communities.
Schedule a Gum Disease Evaluation in Rockville, Maryland
Bleeding, swelling, recession, and persistent bad breath may indicate that your gums need more than a routine cleaning. An evaluation can determine whether scaling and root planing or another form of periodontal care is appropriate.
Call 301-738-1155 or schedule your periodontal evaluation online.