Often the dentist may identify ongoing gum (periodontal) problems and plan with the hygienist thorough scaling appointments, often coinciding with visits for dental restorations, and so making use of the existing local anaesthesia. Predominantly, gum disease is the result of accumulating deposits of calculus: mineral deposits settling from the saliva. Once formed, calculus is too hard for a toothbrush to remove.
Much scaling is performed using an ultrasonic scaler. The instrument tip vibrates at high frequencies under a spray of coolant water and this dislodges the calculus from the tooth or root surface. We may also complete calculus removal with fine hand scalers. We may suggest charting the depths of the pockets around the teeth. This gives a record of how much attachment or support has been lost. In the following months and years we then re measure the pocket depths to see if the situation is stable, or where there is ongoing loss of support we may advise a consultation with a specialist periodontist.