Dental curettage is a dental procedure that involves deep cleaning of the gums and the area surrounding the teeth, especially in cases where periodontal disease (gum disease) is present. This procedure is performed to remove bacterial plaque and tartar accumulated below the gum line, in what are called periodontal pockets.
What is a dental curettage?
Curettage is a deeper and more detailed cleaning than the usual dental cleaning. It is done with special instruments called curettes, which allow scraping and cleaning both the tooth surface and the roots and damaged gingival tissue.
The objective is:
- Remove tartar (calcified plaque) from periodontal pockets.
- Reduce gum inflammation.
- Facilitate healing of the gingival tissue.
- Prevent the progression of periodontal disease, which could lead to tooth loss.
Difference between dental curettage and dental cleaning
The difference between curettage and dental cleaning lies mainly in the depth of treatment and the type of problems addressed by each procedure.
Dental cleaning or prophylaxis is a preventive and superficial procedure performed to remove bacterial plaque and tartar accumulated on the surface of the teeth and gum line. It is an essential part of routine oral care and is recommended at least once or twice a year, depending on the patient’s needs.
Dental curettage or RAR (scaling and root planing) is a more in-depth procedure performed when periodontal disease (periodontitis) is present and the gums show signs of infection. Its goal is to clean the areas below the gums (subgingival) where bacteria and tartar have formed periodontal pockets that cannot be removed by normal cleaning.
Dental cleaning is a preventive procedure to maintain overall oral health, while dental scaling is a more in-depth treatment for people with advanced periodontal disease. Both procedures are essential for oral health, but curettage is reserved for cases where there is more severe periodontal damage.
When to perform curettage treatment
Curettage is indicated when there is periodontal disease at a more advanced stage than simple gingivitis, which means that there is tartar accumulation under the gum. Some situations in which it is performed are:
- Periodontal disease (periodontitis): This is the most common reason. If gingivitis is not treated in time, it can progress to periodontitis, where tartar and bacteria accumulate under the gum line, forming periodontal pockets.
- Presence of periodontal pockets: When gum pockets are more than 3-4 mm deep, they become a space where daily cleaning with toothbrush and dental floss is not effective, and curettage is required to clean them.
- Persistent bleeding and inflammation: If the gums bleed easily when brushing or flossing, and there is constant inflammation, it could be a sign that plaque and tartar are affecting the periodontal tissue.
- Tooth mobility: In more advanced cases of periodontitis, teeth may begin to move due to loss of bone support. Curettage may be part of the treatment to slow the progression of the disease.
Curettage procedure
Dental curettage can be performed in one or several sessions, depending on the severity of the case and how many areas of the mouth are affected.
- Local anesthesia: To minimize discomfort, local anesthesia is usually applied to the area to be treated.
- Subgingival cleaning: With curettes or ultrasonic instruments, the dentist removes tartar and plaque from under the gums and cleans the root surfaces of the teeth so that gum tissue can reattach.
- Root softening (root scaling): Often, after removing calculus, the dentist softens the root of the tooth to prevent bacteria from easily reattaching.
Does dental curettage hurt?
Dental curettage may generate some discomfort, but in general, it should not be a painful procedure due to the use of local anesthesia. However, the experience may vary depending on the individual and the degree of periodontal disease.
Recommendations after dental curettage
- Tooth sensitivity: It is normal for the teeth and gums to be somewhat sensitive after the procedure. This discomfort decreases with time.
- Oral hygiene: Maintaining excellent oral hygiene is essential to prevent future infections. Your dentist may recommend an antibacterial mouthwash.
- Regular dental visits: After curettage, follow-up visits are recommended to ensure that periodontitis is under control.
Advantages of dental curettage
- Reduces gum inflammation and bleeding.
- Reduces the risk of tooth loss.
- Improves overall oral health.
- Prevents the progression of periodontal disease.
If signs of periodontitis or advanced gingival problems are detected, curettage can be an effective solution to restore gum and tooth health.
Contraindications to curettage
Absolute contraindications
- Uncontrolled heart disease: Patients with severe heart conditions such as bacterial endocarditis or those who have recently had heart surgery require special precautions due to the risk of infection.
- Severe immunosuppression: Patients with compromised immune systems, either by disease or medication (such as transplant recipients or people with uncontrolled HIV), are at increased risk of infections.
- Uncontrolled bleeding disorders: In people with blood coagulation problems (such as hemophilia or uncontrolled use of anticoagulants), curettage may increase the risk of excessive bleeding.
- Acute infections: If there is an untreated acute infection in the area where curettage is planned, it is best to postpone the procedure until the infection has been controlled.
Relative contraindications
- Uncontrolled diabetes: Patients with poorly controlled diabetes may have difficulty healing and be at increased risk for infections.
- Pregnancy: Although dental curettage can be performed during pregnancy, it is advisable to postpone non-urgent procedures until after the first trimester or consult with the obstetrician to assess the appropriate time.
- Autoimmune diseases: Some conditions, such as lupus or rheumatoid arthritis, require special precautions due to systemic inflammation that can be exacerbated.
- Patients with oncological treatments: People undergoing radiotherapy or chemotherapy may have a higher risk of infection or healing complications.
Before performing a dental curettage, it is important that the dentist evaluates the patient’s general health, medical history, and that preventive measures are taken in case any of these contraindications are present.
Are there alternatives to curettage?
Yes, there are several alternatives to dental curettage to treat periodontal or gum problems, depending on the severity of the condition and the individual characteristics of the patient. These alternatives can be more conservative or advanced depending on the case. We can find among them dental prophylaxis, antiseptics and mouthwashes, local and systemic antibiotics, periodontal surgery, etc.
Each alternative has its indications and advantages depending on the degree of periodontal disease. It is important that the dentist performs a complete evaluation and proposes the most appropriate treatment for each case.
