Periodontitis is an infection and inflammation of the soft tissues and bone surrounding the teeth, caused by an accumulation of bacterial plaque and the ensuing inflammatory response. According to the Canadian Dental Association, periodontal disease is common, affecting up to 70% of Canadians at some point in their lifetimes. If left untreated, periodontitis can progress to connective tissue destruction and alveolar bone loss, causing teeth to fall out. Therefore, prevention of periodontitis is very important, and preventative measures provided by oral health care professionals include offering oral hygiene instructions (encouraging patients to brush teeth and floss regularly), and performing routine dental cleaning. Dental cleaning includes scaling, which is the mechanical removal of plaque and calculus from the teeth around the gum line. For patients who develop periodontitis, a more extensive procedure called scaling and root planing (SRP) is performed. This involves mechanical debridement of plaque and calculus down to the root of the affected teeth, and is considered the “gold standard” initial treatment for periodontitis. However, the optimal frequency of regular preventative scaling or therapeutic SRP, and the usual length of time (or number of units; one unit is defined as 15 minutes of service) to perform each procedure, is unclear. The purpose of this report is to review the evidence regarding the clinical and cost-effectiveness of scaling with or without root planing, as well as evidence-based guidelines for their use.
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