Without proper cleaning and dental visits plaque and tartar build up in the mouth and collect at an area just below the gum line called the sulcus. Eventually this buildup will cause the gums to move away from the teeth forming pockets in the mouth. These pockets fill with even more plaque. This buildup can lead to periodontal or gum disease. In severe cases a dentist may have to perform gum surgery such as a gingivectomy (removal of gum tissue) or periodontal flap surgery (removal of gum tissue and underlying bone). More routine cases can be treated through scaling the removal of tartar and plaque from the tooth especially below the gum line along the root surface.
Before he or she begins the scaling process your dentist might first remove larger chunks of tartar with a device called a cavitron an ultrasonic scaler that uses high frequency sound vibration to blast away tartar. This method can remove up to fifty percent of existing tartar. (Note though that this step must be skipped if the patient has a pacemaker as the vibrations caused by the cavitron can interfere with the pacemaker.) In scaling the dentist deep-cleans your tooth using hand-held instruments called scalers and curettes above and below the gum line to remove plaque and calculus. He or she then planes the root until it is smooth. The purpose of root planing is threefold: first it removes rough calculus deposits on the root that can attract and collect bacteria; second it buffs out any scratches the scaling process may have caused; and third a smooth surface is much better for the gum ligaments to reattach. When the ligaments reattach the pocket of space between the tooth and gums is much smaller than before. The breeding ground for bacteria has been destroyed.
The amount of times you will need to return to your dentist depends on how widespread your case of periodontis or gum disease is. Localized cases can be treated in a single scaling and root planing session. Cases spread throughout the mouth however are often treated one quarter of the mouth at a time. Such cases then require four visits to your dentist.
Your dentist will likely send you home with prescriptions for antibiotics to combat any leftover bacteria and for chlorexidine an antibacterial mouth rinse. Expect a follow-up appointment with your dentist in four to six weeks. Often scaling and root planing will eliminate the need for surgical treatment.