Dr. Jessica Scully, DDS

Great question! On a technical level, scaling is the removal of calculus (also known as tartar), plaque, and stain from your teeth. Root planing is the removal of the bacteria and their toxins that has attached to and embedded in the root surface. This leaves the root surface clean and ready for the gum tissue to heal back to it. In practice, if you have deep pockets, both scaling and root planing are needed to help your gum tissue heal to a level that you can keep them clean at home.

Great question! The need for a deep cleaning (or 'scaling and root planing') will depend on how deep the gum tissue pockets are around your teeth. The gum tissue is almost like a turtleneck around your tooth that attaches further on the root of the tooth than what you see in your mouth. The pocket is measured from where you gum tissue attaches to the tooth to the top of the gum tissue you see. With pockets of 1-3 mm, you can typically be effective cleaning them with your toothbrush and floss at home and seeing your dentist regularly. Once the pocket gets deeper, it becomes very hard or impossible for your toothbrush and floss to physically reach down that far to clean the bacteria out of the pocket. As that bacteria sits, it is able to team up with other bacteria and worse bacteria can thrive, leading to gum and bone loss.

Depending on where your pocket depths start, you may be able to have a deep cleaning/scaling and root planing to help heal those pockets to all 2-3 mm. Oftentimes, if pockets were deeper to start with, there will still be areas with pockets greater than 3 mm because some bacteria and calculus (tartar) may be left deeper than even the deep cleaning could reach. At
this point, you may need to be referred to a periodontist to see what else can be done to help return those pockets to a healthier level. This could be moving forward to treatment where we can actually see the root surface and bone we are trying to clean, or additional deep cleanings.

So, ideally, one deep cleaning (with possible further treatment) with regular follow up care will be able to get and keep you healthy. Periodontal disease is an ongoing disease, though, so some areas may need to have additional SRPs if the deep pockets recur.

Healing will vary based on your overall health and the specifics of the implant surgery, so talking to your dental surgeon would be the best way to get a more precise answer. In general, you can expect to be sore for a few days, and start to feel better after that. Some patients report very little soreness at all even! Your bone will take longer to heal, anywhere from 3-6 months, or sometimes even longer depending on underlying conditions you may have. The good news, though, is that you will not notice all of this healing, and typically feel back to normal within a week or two (if not sooner)!

Congratulations on taking a step towards oral health with a gum graft! The most important thing to do is follow the post-operative instructions given by your surgeon because they know your case the best. In general, you want to let your body heal by staying away from the area, not pulling on your lip or cheek, not eating on that side, and taking any medication as
prescribed by your surgeon. Gum grafts are typically very successful, and the body has great healing potential, so just let it heal!

Great question! Before you get braces is a wonderful time to start thinking about the health of your teeth. I would recommend going to a general dentist or a periodontist to make sure your teeth, gums, and bone are healthy enough for safe tooth movement. Any cavities or gum/bone problems can get worse while you are in braces if not addressed first. You can also get a professional cleaning to make sure everything is in top shape. Building good habits now is another great idea - make sure you are brushing at least 2 times per day for 2 minutes each time with a fluoride toothpaste (to help keep away cavities), and flossing regularly. Brushing and flossing can be harder once you have braces on, so having good practices beforehand can go a long way! You can also look into an electric toothbrush, Waterpik, or even proxabrushes/go-betweens that will help you keep your teeth and gums healthy while you have braces.
Congratulations on deciding to get braces and good luck with your treatment!

Hello!

Typically, I recommend my patient brush and floss all teeth except for those directly in the surgical site until I see them for a follow-up visit. During this time, they use a prescription mouthwash to help keep the area clean. At the follow-up, we determine when they are ready to start brushing. If you want a more specific answer to your exact situation, I am sure the surgeon's office would be happy to answer if you called them.
Good luck healing!