Deep Cleaning: Scaling and Root Planing

Deep cleaning, properly called scaling and root planing, cleans below the gumline where a normal scale and polish cannot reach. It is the standard treatment for gum disease that has started destroying the attachment around your teeth, and it is what stops teeth becoming loose.

Deep Cleaning Is Not a Scale and Polish

These get confused constantly, and they are different treatments for different problems.

A scale and polish cleans the visible surfaces of your teeth and just under the gum margin. It is preventive maintenance, takes about half an hour, and needs no anaesthetic. Everyone should have one regularly.

Scaling and root planing goes deep into the pockets that form between gum and root once gum disease has taken hold. It removes hardened deposits from the root surface itself, then smooths that surface so bacteria have nothing to grip. It takes 60 to 90 minutes per section of mouth and is usually done under local anaesthetic.

The distinction matters because a scale and polish on established gum disease is essentially ineffective. It cleans what you can see while the actual problem, several millimetres down, is untouched.

Why It Becomes Necessary

Gum disease works in a specific sequence, and understanding it explains why deep cleaning is the treatment.

Plaque hardens into tartar at the gum margin. The gum becomes inflamed and starts to detach from the tooth, creating a pocket. That pocket is deeper than a toothbrush can reach, so it collects more bacteria, which pushes the gum further away. Bone around the root begins to resorb.

Once a pocket forms, no amount of home cleaning reaches the bottom of it. That is the point where you need someone to clean inside the pocket mechanically. Left alone, the bone loss continues, and bone is what holds teeth in.

This is the mechanism behind most adult tooth loss. If you have noticed a tooth beginning to move, our guide to loose teeth in adults explains how far that process can be reversed. Our gum disease page covers the earlier stages.

Signs you may need it

• Gums that bleed when you brush or floss
• Persistent bad taste or bad breath
• Gums that look receded, or teeth that look longer than they used to
• A tooth that feels slightly mobile
• Gaps opening up between teeth that were not there before
• Dull soreness or itching in the gums

Bleeding is the one people dismiss. Healthy gums do not bleed when cleaned, in the same way healthy skin does not bleed when washed.

What Happens in the Appointment

Assessment first. Before any treatment, we measure the depth of the pockets around each tooth and usually take X-rays to see the bone level. That gives a baseline, and it means we can measure afterwards whether the treatment worked rather than guessing.

Local anaesthetic for the area being treated. Root surfaces are sensitive and the instruments go several millimetres below the gum, so this is not a treatment to attempt without numbing.

Cleaning the pocket. Hardened deposits are removed from the root surface using fine hand instruments, ultrasonic tips, or both. The root is then smoothed, which is the “planing” part, so there is no rough surface for bacteria to recolonise.

Section by section. The mouth is usually divided into quadrants and treated across separate appointments, because doing it properly takes time and because numbing your whole mouth at once is unpleasant.

Review, typically six to eight weeks later. The pockets are re-measured. That comparison tells us whether it has worked, which areas need more, and whether anything needs referring.

How many appointments?

Two to four sessions is typical for a full mouth, depending on how many pockets there are and how deep. Mild, localised disease might need one. Advanced disease across the whole mouth needs four, sometimes spread over a couple of months.

Does It Hurt?

During the appointment, no. The area is numbed properly.

Afterwards, expect some tenderness for a few days, and gums that feel bruised. That settles.

The part people are not warned about is sensitivity afterwards. Cleaning out a pocket removes deposits that were, in effect, insulating the root. The root surface underneath is exposed and often reacts to cold for a few weeks. It is normal, it improves, and desensitising treatment helps. Our page on sudden tooth sensitivity covers what to do about it.

You may also notice small gaps appearing between teeth as inflammation reduces and swollen gum tissue shrinks back to its actual level. That can be disconcerting. It is the gum revealing where the bone level truly is, not the treatment causing damage.

What It Costs

UK market rates for private root planing generally run £200 to £400 per quadrant, with a full mouth typically falling between £400 and £1,040 depending on severity and how many sessions are needed.

On the NHS it falls under Band 2, a single charge covering the course of treatment. Band charges are set nationally and change each April, so check the current rate on the NHS website.

Our current fees are on our fees page, and you will be given a written plan with the number of sessions and total cost after the assessment, before treatment starts.

Ongoing maintenance is the part to budget for. After successful treatment, most people move to appointments every three to four months rather than every six, because pockets recolonise. Market rates for maintenance visits run around £80 to £150 each. That is a real ongoing commitment, and it is what keeps the result.

Does It Work?

For most people, yes, and the measurements at review show it objectively.

Pockets shrink as inflammation resolves and the gum reattaches. Bleeding stops. The progression of bone loss halts.

What it does not do is regrow bone that has already gone, or bring back gum that has receded. This is why timing matters so much: treatment stops the damage, it does not reverse it. Someone treated early keeps far more than someone treated after five more years.

If it does not fully work, which happens with deep pockets or where disease is aggressive, the next steps are referral to a periodontist, surgical access to clean deeper pockets, or in some cases accepting that a particular tooth cannot be saved.

Two things determine the outcome more than anything we do: how well you clean between your teeth daily, and whether you smoke. Smoking substantially reduces the success rate of gum treatment, because it restricts the blood supply the gum needs to heal.

Frequently Asked Questions

What is the difference between a scale and polish and deep cleaning?

A scale and polish cleans visible surfaces and just below the gum margin, takes about 30 minutes, and needs no anaesthetic. Deep cleaning goes several millimetres into pockets to clean the root surface, takes 60 to 90 minutes per section, and is done under local anaesthetic.

How much does deep cleaning cost in the UK?

Private rates typically run £200 to £400 per quadrant, or £400 to £1,040 for a full mouth. On the NHS it is a Band 2 charge. Our fees are listed on our fees page and confirmed in writing before treatment.

How many appointments will I need?

Usually two to four for a full mouth, plus a review six to eight weeks later. Localised disease may need only one.

Is deep cleaning painful?

Not during, because the area is anaesthetised. Expect tender, bruised-feeling gums for a few days afterwards, and cold sensitivity for a few weeks.

Why are my teeth sensitive after deep cleaning?

The deposits removed were insulating the root surface. Once cleaned, that surface is exposed and reacts to cold until it settles. It normally improves over a few weeks and desensitising treatment speeds it up.

Will my gums grow back after deep cleaning?

No. Treatment stops further loss and lets inflamed tissue return to health, but gum that has receded and bone that has been lost do not regenerate. That is why treating early matters.

Why do I have gaps between my teeth now?

Swollen gum tissue was filling spaces where bone had already been lost. As the swelling resolves the gum sits at its true level, revealing the gaps. It is a sign of healing rather than harm, though it can look alarming.

How often will I need it repeated?

Full root planing is not usually repeated indefinitely. After successful treatment most people move to maintenance appointments every three to four months, which prevent pockets redeveloping.

Can I just brush and floss more instead?

Not once pockets have formed. Home cleaning cannot reach the bottom of a pocket, which is exactly why the treatment exists. Good home care is essential to keep the result, but it cannot achieve it.

Book a Gum Assessment in Elephant & Castle

If your gums bleed when you brush, the useful first step is having the pocket depths measured. That takes one appointment and tells you whether you need deep cleaning or just a regular hygiene visit.

Call 020 7928 4474 or book online. We are in Elephant and Castle, minutes from Waterloo, Borough, London Bridge and Southwark.

Market pricing figures are indicative UK ranges from published 2026 guides. NHS band charges change each April. Our own fees are confirmed in writing after assessment. This page is general information, not a diagnosis. Last reviewed August 2026.