can i afford a scaling and root planing

Can I Afford a Deep Cleaning?

A deep cleaning—also called a periodontal scaling and root planing or “SCRP” for short—is a special type of dental cleaning that’s used for people with active gum disease. An SCRP is recommended for anyone who fits the symptoms of periodontal infection, where a prevention-based “six month” cleaning would not be appropriate.


Unfortunately, deep cleanings are not covered at 100% by your insurance the same way a routine dental cleaning is. That’s why a lot of people want to know how much a deep cleaning costs and if they can afford it. The truth is, you can’t afford not to have a scaling and root planing if your mouth is truly infected.



Symptoms of Periodontal Disease


Deep cleanings are for situations where a person has an active periodontal infection in their mouth, as well as heavy tartar buildup and pockets that cannot be cleaned during a “preventative” cleaning.


Some of the most common warning signs of periodontitis include:


  • Gum recession (“long teeth”)
  • Spaces between teeth
  • Bad breath
  • Loose or missing teeth
  • Shifting and leaning teeth
  • Visible tartar buildup
  • Bleeding gums when you brush or floss
  • Deep “pockets” around your teeth
  • Swollen, tender gum tissues


During your dental exam, our dentist or hygienist will measure the attachment levels where your gums meet the roots of your teeth. It’s normal for a 2-3mm pocket to exist around each tooth, but anything deeper than that indicates active or previous disease. We’ll also check for bleeding and tartar buildup. Even if the buildup is not visible during your exam, we will be able to see it across the roots of your teeth on your dental X-rays.



Deep Cleanings vs. Preventative Cleanings


Typically, if your mouth is healthy and you don’t have a lot of buildup, a preventative (prophylaxis) cleaning is recommended every six months. But a “prophy” is only for maintaining already-healthy mouths. These routine checkups allow for maintenance and touch-ups twice a year, giving you a blank slate to work with once you return home. While mild buildup is removed during a preventative cleaning, it’s restricted to certain areas of your mouth. Your gums could have minor gingivitis here and there, but overall, your mouth is considered healthy.


Deep cleanings are different. At a certain point, gum pockets and tartar buildup become too excessive to remove during a “routine” dental cleaning. Especially if there is heavy bleeding, excessive tartar along the roots of the teeth, or pockets are deeper than 4-5mm.


To ensure your comfort, most deep cleanings are completed with local anesthetic or another temporary numbing gel. That way our hygienist can gently clean below the gumlines in each of the deep pockets to remove the calcified buildup. Instead of a full-mouth cleaning being completed in about an hour, we’re spending 1-1.5 hours on one side of your mouth at a time.


As you might guess, deep cleanings cost more than a routine six-month dental cleaning does. Since it is not a preventative process and is a therapeutic one, much more time and technology goes into performing the scaling and root planing process.



Why You Shouldn’t Avoid a Deep Cleaning


If you need a deep cleaning, it’s important to schedule it at your earliest convenience. Most chronic oral infections are the result of accumulating buildup and a lack of preventative care. Allowing tartar and plaque to stay put under your gumlines—against the roots of your teeth—will allow further gum deterioration and bone loss. Without a series of deep cleanings, it’s only a matter of time before chronic gum disease results in tooth mobility and complete tooth loss.


There is no way to maintain your mouth as-is if you have periodontal disease, the way you would if you stayed up to date with routine dental cleanings. Flossing does not physically reach 4-5mm or deeper under gums where bacteria are thriving, nor can it physically remove tartar buildup. Special tools must be used to remove these areas of bacterial accumulation to halt the disease process.


Without a deep cleaning, periodontal infections continue in a downward spiral toward tooth and bone loss. It is not a matter of maintenance with good home care. So even if you don’t physically see the infection when you’re smiling in the mirror, it’s still there lurking below the gumlines.


Some people ask if they can have a “regular cleaning” instead of a deep cleaning and just focus on what’s visible when they smile. Unfortunately, no. It would be like cleaning the surface of a wound on your arm, without addressing the broken bone underneath. It is essentially neglectful on our part to offer a superficial cleaning when active disease lies just below the gums.



Long-term Maintenance


After you schedule a deep cleaning, you will want to book a series of periodontal maintenance cleanings to help prevent relapse. The cost of a periodontal maintenance visit may not be completely covered at 100% by your dental insurance, so it’s important to know there may be extra costs incurred throughout the future of your smile’s health.  Typically these cleanings are scheduled at 3-4 month intervals, depending on the oral health status of your tissues.



Cost of Deep Cleanings with Dental Insurance


Dental insurance plans tend to be prevention-based. That is, they cover and pay more on services that are preventative in nature, encouraging their enrollees to take advantage of preventative services before problems strike. For instance, six-month prophylactic cleanings are usually covered at 100% twice a year, making it “free” for you to visit our Raleigh dentist for checkups every six months.


If you have dental insurance that you’re using toward the cost of your deep cleaning, it probably will not cover your scaling and root planing at 100%. Deep cleanings (scaling and root planing) are typically categorized as a basic dental procedure, similar to dental fillings. As such, the tier of coverage for a deep cleaning typically drops to around 60-80%, depending on your unique insurance plan details.


Keep in mind that if you have a deductible or co-pay to meet, that amount will need to be paid before the insurance benefits “kick in” on the remaining portion of the deep cleaning. Our insurance coordinators will run the math for you, so that you have an estimate on what the total price will be before you schedule treatment.



Cost of Deep Cleanings without Insurance


The price of deep cleanings in Raleigh is based on a few factors. One, how many quadrants of your mouth need to be deep cleaned. And two, the number of teeth per quadrant. As you might guess, we’ll have to perform a thorough exam of your mouth before knowing what the total fee for a deep cleaning will be.



“Can I Finance a Deep Cleaning?”


Absolutely. Our treatment coordinators at Raleigh Dental Arts will work with you to tabulate your insurance coverage (if applicable) and then review which payment plan options are available. Since deep cleanings do cost more than preventative checkups, it’s normal for our patients without dental insurance to ask about breaking the payment up into smaller portions. Perhaps you prefer to pay 50% when you schedule, then the other 50% at the time of the service. Or you can always utilize a 0% interest option like CareCredit to make low monthly payments for a few months until the balance is paid off. When you use a financing option, you also have the choice to add additional treatment—such as fillings, crowns, implants, etc.—to your balance as needed.



The Cost to Your Health


Untreated gum disease places a scientifically proven strain on your immune system and co-existing medical conditions. With active periodontal infection, the oral bacteria can spread straight into your bloodstream, becoming lodged throughout the body. We know from research that an untreated periodontal infection will raise your risk of stroke, heart attack, stillbirth, erectile dysfunction, pneumonia, and abnormal blood glucose levels (even with medication.)


If you’re battling co-existing medical problems but ignoring your mouth because it’s not a priority, it’s time to take a different approach. Co-treating your oral disease as well as your other health conditions will provide a boost to your immune system. Most people see health improvements within just a few months of their deep cleaning. Your body can’t afford for you to skip this essential treatment.



Your Smile Depends on It


Periodontal therapy is a crucial step in preventing tooth loss caused by gum disease. If you’ve seen “gum disease run in your family” you might be at a greater risk for tooth loss than someone who never had dental issues growing up. But if you fit certain risk factors—like you don’t floss on a regular basis or you smoke—your smile is still at serious risk of gum infection.


Deep cleanings are an essential part of halting gum disease and preventing additional bone and gum deterioration. Without them, it’s usually a matter of time for someone with infected gums to eventually suffer tooth loss.


If you think you have periodontal disease or you know you need a deep cleaning, contact Raleigh Dental Arts today. We’ll work with you to develop a prevention-based plan and discuss the financial options available, to make sure you can afford a deep cleaning before it’s too late. Call now to get started.



Tarun Agarwal

Dr. Tarun Agarwal, DDS is considered one of the top dentists in the country. He is a recognized speaker, author, and dental leader. He has been featured on CBS, NBC, ABC, FOX, and News 14 Carolina. Dr. Agarwal has been awarded '40 under 40' Business Leaders by the Triangle Business Journal. He is regularly invited to teach other dentists around the world and recently built a training center within the practice dedicated to sharing his expertise. Most importantly he is a loving husband and dedicated father of three wonderful children. His biggest accolade was being voted 'Best Dad in the World' by 2 of his 3 kids.