Dental curettage is a procedure in which diseased tissue is removed from the mouth and gums. At one time, dental curettage was a common technique used to manage periodontal disease, but the practice has become much less common, and is viewed as controversial by some dental practitioners. In preference to curettage, some dentists prefer to do perform what is known as a “deep cleaning,” otherwise known as a scaling and root planing.
In curettage procedures, instruments are used to cut away dead tissue. The idea is that such tissue can contribute to inflammation, infection, and bad odors, and that removal of the damaged tissue will promote the development of healthy tissue. There are several different types of dental curettage, including ultrasonic curettage, which uses an ultrasonic dental instrument, and surgical curettage, in which a flap of gum is cut and rotated away so that a pocket of infected tissue can be cleaned out before the flap is rotated back and fixed in place.
In basic dental curettage, a sharp cutting instrument is run into gingival pockets in front of the teeth to remove dead tissue, and dead or infected tissue will be removed from the gums. Local anesthetic is often used to make the patient more comfortable, and the mouth is frequently flushed with a sterile solution to sweep out the debris. This procedure is usually provided to people with advanced gum disease as a tool for managing the problem, and it may be required on multiple occasions.
Studies have suggested that scaling and root planing may be just as effective, especially when it is done at an early stage. In this procedure, built-up calculus is removed from the teeth with hand-held instruments, and the roots of the teeth are smoothed so that they do not provide a surface for plaque to build up on. Several sessions are often required, and patients may be given anesthetic so that they feel more comfortable, since the procedure can be mildly painful.
If a dentist recommends dental curettage, patients should not be afraid to ask specifically why curettage is being recommended, as opposed to more modern treatments. It may not be a bad idea to solicit a second opinion to confirm that this treatment is appropriate. Patients should also consult their insurance companies to confirm that curettage is covered, as they may be required to pay for the procedure if an insurance company decides that it is not medically necessary, or that there is an alternative treatment available.