Periodontal curettage, or scraping and planing the roots inside the pocket created by inflammation of the periodontium, is the first technique used to treat periodontitis. This unaggressive treatment is generally highly effective. It is carried out once the patient has perfected the technique of periodontal cleaning with interdental brushes and is using the appropriate toothpaste and mouthwash.
Objective of Curettage
Curettage is complementary to the oral hygiene or dental cleaning applied to the majority of patients yearly at our surgery. It achieves deeper cleaning than the regular procedure and therefore requires anaesthetic. It is a surgical procedure thanks to which we can achieve in-depth cleaning of the surface of the roots and of the gum.
The objective is to disinfect the tissues and close the periodontal pockets, encouraging the gum to reattach to the tooth surface. However, if the curettage applied to all teeth fails to stabilise the periodontitis, we will have to turn to other techniques, above all surgical, such as cleaning flaps.
Having applied anaesthetic, we remove the tartar and the bacteria which have accumulated inside the periodontal pocket and on the root surface. This is done with specific instruments for the task, called curettes, which are a sort of long, slender metal scoops used to empty the periodontal pocket.
We also use low-revolution drills similar to those used for regular tooth cleaning.
To intensify the disinfection procedure beneath the gums, we irrigate the pockets with an antiseptic such as chlorhexidine.
The number of curettage sessions depends on the extent of the periodontitis and the number of teeth affected. It is normally applied to half of your mouth at a time, and will only require two sessions: in one session we work on the two quarters on the left-hand side, top and bottom, and in the following session on those on the other side. Normally we leave two or three days of rest between the two sessions. All of this is combined with a 7 to 10 day antibiotic treatment.
For a week after the curettage, you will be prescribed a soft diet (pasta, vegetables, pulses, fish), avoiding hard food like nuts, apples or chocolate.
The consequences of curettage
The main consequence is deactivation of the periodontitis which, when combined with careful tooth brushing, is highly unlikely to return.
Sometimes the curettage is followed by a slight recession of the gums. This is because, when the inflamation and the infection have disappeared and your gums start to heal, the swelling goes down and the gum settles into its proper position. This may mean that you can see more of the tooth roots, making some of your teeth look longer. However, now that your gum has been cured, it will remain stable and shouldn’t suffer further recession.
You must remember that, without the curettage, your diseased gums will continue to recede, and that the later you have treatment, the further they will recede. Treatment will always be necessary, and the sooner you have it done the better.
Sometimes receding gums are associated with a passing sensitivity to hot and cold; however, we can solve this problem by using a gel, mouthwash or toothpaste specifically designed for sensitive teeth.