Name of the Procedure:

Periodontal Scaling and Root Planing - Four or More Teeth per Quadrant (D4341)

Summary

Periodontal scaling and root planing is a deep cleaning procedure that targets gum disease. It involves cleaning the teeth and their roots to remove plaque, tartar, and bacteria to improve gum health and prevent further destruction of the supporting structures of the teeth.

Purpose

This procedure addresses chronic periodontal disease. The goals are to remove bacterial deposits from below the gum line, reduce gum inflammation, and promote healing of the affected tissues to prevent tooth loss.

Indications

• Bleeding gums
• Swollen or inflamed gums
• Deep periodontal pockets (spaces between the teeth and gums)
• Bad breath that does not resolve with brushing and flossing
• Bone loss visible on dental X-rays

Preparation

• No fasting required.
• Patients should inform their dental provider of any medications or medical conditions.
• A thorough dental examination and X-rays are typically performed to assess the extent of the gum disease.

Procedure Description

1. Local anesthesia is administered to numb the affected area.
2. Dental instruments, such as ultrasonic scalers and hand-held curettes, are used to remove plaque and tartar from the tooth surfaces and roots below the gum line.
3. The roots are then smoothed to eliminate rough areas where bacteria can reattach.
4. The dentist may apply an antimicrobial agent to help control bacterial growth and facilitate healing.

Duration

The procedure typically takes 1 to 2 hours, depending on the severity of the gum disease and the number of quadrants being treated.

Setting

Periodontal scaling and root planing is generally performed in a dental office or outpatient clinic.

Personnel

• Dentist or periodontist (gum specialist)
• Dental hygienist or assistant may also be involved in the procedure

Risks and Complications

• Discomfort or mild pain during and after the procedure
• Temporary sensitivity to hot and cold
• Slight bleeding or swelling of the gums
• Rarely, infection or gum recession

Benefits

• Reduction in gum inflammation and bleeding
• Decreased depth of periodontal pockets
• Improved gum health and prevention of tooth loss
• Enhanced overall oral hygiene

Recovery

• Patients may experience minor discomfort and sensitivity, which usually resolves in a few days.
• Pain relievers or a prescribed mouth rinse may be used to alleviate symptoms.
• Good oral hygiene practices, including brushing and flossing, are crucial.
• Follow-up appointments may be necessary to monitor the healing process and assess gum health.

Alternatives

• Regular dental cleanings (not effective for advanced periodontal disease)
• Antimicrobial treatments or mouth rinses
• Surgical options like flap surgery or bone grafting for severe cases
• Pros and cons: Regular cleanings are less invasive but may not address deep-seated disease; surgical options are more invasive with longer recovery times but may be necessary for advanced cases.

Patient Experience

• During the procedure, patients will likely feel pressure but should not experience significant pain due to the local anesthesia.
• After the procedure, patients might feel sensitivity and tenderness in the treated areas.
• Pain management options include over-the-counter pain relievers and prescribed mouth rinses to enhance comfort during recovery.