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Dental Scaling and Root Planing for Periodontal Health: A Review of the Clinical Effectiveness, Cost-effectiveness, and Guidelines

Last updated: October 17, 2016
Project Number: RC0813-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness of scaling with or without root planing for periodontal health?
  2. What is the clinical effectiveness of different frequencies or number of units of scaling with or without root planing?
  3. What is the cost-effectiveness of scaling with or without root planing for periodontal health?
  4. What are the evidence-based guidelines regarding scaling with or without root planing?

Key Message

Evidence from two systematic reviews, 12 randomized-controlled trials, and one non-randomized controlled clinical trial showed that scaling with or without root planing, provided with or without oral hygiene instructions, were associated with improvements in periodontal outcomes across a variety of adult patient populations within three months of treatment. Exceptions to this trend were noted in patients with less severe periodontal disease at baseline and in one study of pregnant women. Three evidence-based guidelines were identified that recommend SRP for the treatment of chronic periodontitis, including specific subtypes of periodontitis. One evidence-based guideline regarding the prevention of periodontitis was identified that recommends professional mechanical plaque removal to support self-performed oral health care. Limited evidence was identified regarding the clinical effectiveness of varying frequencies or units of scaling (not including root planing) that showed no significant differences between any evaluated frequencies. Long-term studies were not identified, which makes it difficult to conclude how long the positive effects of SRP may be maintained. One evidence-based guideline was identified that recommends supportive periodontal therapy every three to six months for patients with chronic periodontitis. No evidence was identified to address the cost-effectiveness question.