Being told you need a deep cleaning probably isn’t the highlight of your dental visit. But the procedure itself is much less mysterious once you know what happens.
A deep teeth cleaning, also called scaling and root planing, is a nonsurgical treatment that removes plaque and hardened tartar from above and below the gumline and cleans the roots of your teeth. Dentists use it to treat periodontitis and help your gums heal around your teeth.
Here’s what to expect before, during, and after a dental deep cleaning.
What Is Deep Cleaning Teeth?
Deep cleaning teeth, also called scaling and root planing, is a non-surgical treatment for gum disease. Your dentist or hygienist removes plaque and tartar from the tooth surfaces above and below the gumline, then smooths the tooth roots so your gums can heal and reattach to your teeth.
It isn’t just a longer version of a routine cleaning. A regular cleaning is preventive and focuses on your teeth at and above the gumline. A dental deep cleaning is a treatment: it targets the pockets that form between your gums and teeth once gum disease takes hold.
Periodontitis is common. A CDC-led analysis of U.S. survey data from 2009-2014 estimated that 42% of adults ages 30 and older had periodontitis, including 7.8% with severe periodontitis. Left untreated, the infection can damage the gums and bone that hold your teeth in place. For most patients, our gum disease treatment starts with a deep cleaning.
Scaling vs. Root Planing: Two Steps, One Treatment
- Scaling removes plaque and tartar (hardened plaque) from your teeth, above the gumline and down into the pockets below it.
- Root planing smooths the surfaces of your tooth roots. Smoother roots give bacteria fewer places to cling to and help your gums reattach.
How Your Dentist Decides You Need a Deep Cleaning
Not everyone with bleeding gums or tartar needs scaling and root planing. Your dentist evaluates the overall health of your gums before recommending treatment.
That evaluation may include measuring the spaces between your teeth and gums with a periodontal probe, checking for bleeding and inflammation, looking for tartar below the gumline, and reviewing X-rays for signs of bone loss. The ADA specifically distinguishes scaling and root planing from treatments used for patients who have inflammation without periodontal attachment or bone loss.
This is why pocket depth alone shouldn’t be used to decide whether you need a deep cleaning. Your dentist considers the full clinical picture.
If you’re wondering how this differs from the cleaning you normally receive at a checkup, see our guide to deep cleaning vs. regular cleaning.
What Happens During a Deep Cleaning: Step by Step
Every mouth is different, but most deep cleanings follow the same six steps.
Step 1: Exam and Gum Measurements
Before treatment starts, your dentist reviews your X-rays and gum measurements to confirm which areas need a deep cleaning. Not every tooth always does. Sometimes only one section of the mouth needs treatment.
Step 2: Numbing the Area
Your dentist numbs your gums with a local anesthetic. The area is usually treated one section at a time, so only the part being cleaned is numb.
Step 3: Scaling
Using hand scalers or an ultrasonic instrument, your dentist or hygienist removes plaque and tartar from your teeth, working down to the bottom of each gum pocket.
Step 4: Root Planing
Next, the tooth roots are smoothed. Rough root surfaces collect bacteria easily, and smooth ones give your gums a better chance to heal and reattach to the teeth.
Step 5: Antibiotic Treatment, If Needed
Some pockets may need additional treatment. When appropriate, your dentist may place an antibiotic directly into deeper periodontal pockets. At our office, this can include Arestin (minocycline microspheres), which the FDA approved as an add-on to scaling and root planing to reduce pocket depth in adults with periodontitis. It’s placed as a powder at the base of the pocket and dissolves on its own, so there’s nothing to remove later.
Step 6: The Follow-Up Visit
A few weeks later, your dentist may re-measure your gums and evaluate how they’ve responded to treatment. The exact timing depends on your treatment plan and periodontal health.
How Long Does a Deep Cleaning Take?
A deep dental cleaning usually takes one to two hours. Depending on how many areas need treatment, it’s done in one of two ways:
- One visit: everything is treated in a single, longer appointment.
- Two visits: half of your mouth is treated at the first appointment and the other half at the second.
Your dentist will recommend the approach that fits how much treatment you need and how comfortable you’d like to be. Most people can return to their normal routine the same day.
Does Deep Cleaning Teeth Hurt?
With the area numbed, scaling and root planing shouldn’t be painful. Local anesthesia can be used to numb the area during scaling and root planing. You may still notice pressure, movement, or vibration while your teeth are being cleaned.
Once the anesthetic wears off, some tenderness is normal. The ADA notes that patients may have discomfort for a day or two and tooth sensitivity for up to a week. Gums may also temporarily feel swollen or tender or bleed slightly.
If the procedure itself isn’t what worries you but the idea of sitting in the dental chair does, you’re definitely not alone. Woodbridge Comfort Dental Care offers nitrous oxide and oral sedation options for appropriate patients who experience dental anxiety.
Your dentist can discuss whether sedation is appropriate for your particular treatment.
Healing After a Deep Cleaning: What the First Few Weeks Look Like
Healing is gradual, and most of it happens without you noticing much.
- The same day: most people go back to work or their usual routine. Wait until the numbness wears off before eating so you don’t bite your cheek.
- The first day or two: some soreness, swelling or light bleeding is normal. Brush gently and keep cleaning between your teeth.
- The first week: tenderness fades and sensitivity usually settles.
- The following weeks: as inflammation decreases and the tissues heal, your gums may fit more snugly around your teeth. At your follow-up, your dentist can recheck pocket depths and decide whether additional periodontal care is needed.
Call your dentist if pain gets worse instead of better, bleeding doesn’t stop, or you notice swelling or signs of infection. Your dentist will give you specific aftercare instructions, including what to eat in the first few days.
Keeping Gum Disease Away After Your Deep Cleaning
A deep cleaning treats gum disease, but it doesn’t make you immune to it. Ideally, you’ll only need scaling and root planing once, as long as regular dental visits and good home care keep the bacteria in check.
After scaling and root planing, your dentist may recommend periodontal maintenance rather than routine preventive cleanings. These visits are often scheduled every three to four months, although the right interval depends on your gum health and risk factors.
They go further than a regular dental cleaning: your gums are re-measured and cleaned below the gumline where needed, so any problem is caught early.
At home, the basics matter most: brush twice a day, clean between your teeth every day and keep your dental appointments.
Does Insurance Cover a Deep Cleaning?
Dental insurance may cover some of the cost of scaling and root planing when the treatment meets the plan’s clinical requirements, but coverage varies by insurer and individual plan. Insurers may require documentation such as periodontal measurements and X-rays when reviewing claims for scaling and root planing.
Woodbridge Comfort Dental Care is in-network with most PPO insurance plans and provides upfront estimates before treatment. The practice also offers an in-office discount plan for patients without insurance.
Because benefits differ between policies, the best way to know what you’ll pay is to have your individual benefits verified before treatment.
Ready to Get Your Gums Back on Track?
Bleeding when you brush, gums that look red or puffy, or bad breath that won’t go away are all worth a closer look. The earlier gum disease is caught, the simpler it is to treat.
Our Woodbridge office is at 14605 Potomac Branch Dr., Suite 120, with evening hours on Mondays and Wednesdays and appointments on the first and third Saturday of each month. Book online or call (703) 580-8181.
Frequently Asked Questions
What does a deep cleaning consist of at the dentist?
A deep cleaning has two main parts. Scaling removes plaque and tartar above and below the gumline, and root planing smooths the tooth roots. The area is numbed first, and your dentist may add an antibiotic to deeper pockets. A follow-up visit a few weeks later checks how your gums have healed.
Do gums reattach after a deep cleaning?
Helping your gums reattach to your teeth is one of the main goals of root planing. As the inflammation settles over the following weeks, your gums tighten around your teeth and the pockets often get shallower. How much they improve depends on how advanced the gum disease was.
How often do you need a deep cleaning?
Most people don’t need deep cleanings on a regular schedule. If your gums respond well, one treatment may be enough. Afterward, your dentist monitors your gums and may recommend periodontal maintenance visits, often more frequent than routine cleanings. If gum disease returns or some areas don’t heal as expected, additional treatment may be needed.
Can gum disease come back after a deep cleaning?
Yes. If plaque builds up again, the infection can return. The earliest stage, gingivitis, is reversible, but bone that has already been lost to gum disease doesn’t grow back on its own. Regular maintenance visits and daily brushing and cleaning between your teeth are the best protection.
Can I go back to work after a deep cleaning?
Most people can return to their normal routine the same day. Your mouth may stay numb for a few hours, so plan meals and meetings with that in mind.