Short answer: In dentistry, curettage is the procedure of cleaning tartar and bacterial plaque that have built up on the root surface inside the gum pocket with special instruments, and smoothing the root surface. It is performed when gum disease has affected the tissues that support the tooth and the gum pockets have deepened. It is usually done under local anesthesia and should be supported by good home care and regular check-ups.
Bleeding gums, swollen gums, bad breath and teeth that look longer are symptoms that are often ignored but can be signs of gum disease. As gum disease progresses, bacterial plaque and tartar reach below the gum line, down to the root surface. At this point, a superficial scaling alone may not be enough. Curettage is a gum treatment method in which these deposits below the gum are cleaned and the root surface is smoothed. In this article we explain what curettage is, how it differs from scaling, the concept of debridement, how the procedure is done and what to pay attention to afterward.
What is curettage?
In dentistry, curettage is the procedure of removing tartar and bacterial plaque attached to the root surface inside the gum pocket and making the root surface smooth and clean. In current terminology, this procedure is mostly called "subgingival cleaning" or "root planing" (scaling and root planing).
In healthy gums, there is only a shallow groove of a few millimeters between the tooth and the gum. When gum disease (periodontitis) develops, inflammation caused by bacteria affects the connective tissue and bone surrounding the tooth; this groove deepens and becomes a "gum pocket" (periodontal pocket). Because the tartar and bacteria that build up in these pockets are at a depth that a toothbrush and floss cannot reach, they keep the inflammation going and cause bone loss to progress. The aim of curettage is to clean this environment so that the inflammation subsides and the gums heal.
How does it differ from scaling?
Scaling is mostly the removal of tartar above and just below the gum line; curettage, on the other hand, goes down into the deeper gum pockets and includes cleaning the root surface. The two procedures complement each other, but their aims and scope are different.
- Scaling (tartar removal): Usually performed on people who are healthy or who have only gum inflammation (gingivitis). Visible tartar and stains on the tooth surface are cleaned. In most cases, it does not require anesthesia.
- Curettage (root planing): Performed in cases of periodontitis, where the gum pockets have deepened and the tissues supporting the tooth are affected. Hardened deposits and the bacterial layer on the root surface are cleaned. It is mostly done under local anesthesia.
Gingivitis, the early stage of gum disease, can be reversed with good oral care and professional cleaning. Periodontitis, however, is a stage in which lost bone does not grow back on its own; so the aim of treatment is to stop the disease from progressing and to preserve the remaining tissues.
What is debridement?
Debridement is a general term for removing bacterial plaque and tartar from the tooth surface and below the gum while causing as little damage to the tissues as possible. In the current approach to gum treatment, the aim is to reduce the bacterial load without removing more tissue from the root surface than necessary.
In practice, you may come across the term debridement in two different senses:
- Initial debridement: When tartar is so heavy that it even prevents the gum pockets from being measured, the coarse deposits are cleaned before a detailed examination. After this cleaning, the gums are re-evaluated and a treatment plan is created.
- Subgingival debridement: Similar in meaning to curettage and root planing, it is the removal of bacterial buildup inside the pockets.
Whichever term is used, the common goal is to create a clean environment in which the gums can heal.
How is the curettage procedure done?
Curettage begins with a detailed gum examination; it is then usually done under local anesthesia, either by dividing the mouth into sections or all at once, using ultrasonic devices and hand instruments. The process generally consists of these stages:
- Examination and measurement: The gum pocket depths around each tooth are measured with a thin probe, and bleeding, gum recession and tooth mobility are recorded.
- X-ray evaluation: The amount and distribution of bone loss are examined with X-rays.
- Oral care instruction: Home care is very important for the success of treatment; brushing technique and interdental cleaning are explained to you individually at this stage.
- Local anesthesia: The area to be treated is numbed.
- Cleaning: Tartar and bacterial plaque inside the pocket are cleaned with ultrasonic tips and hand instruments called curettes, and the root surface is smoothed. The areas are rinsed to remove debris.
- Re-evaluation: A few weeks after the procedure, the gums are measured again; if healing is sufficient, you move on to the maintenance phase, and if deep pockets persist, additional treatment options are considered.
In some cases, the dentist may recommend a mouthwash or medication to support treatment; this decision is individual, and the recommended use should be followed. In advanced cases or deep pockets that do not respond to curettage, gum surgery options may be considered by a periodontist.
General health conditions that affect curettage
Diabetes and smoking are the main factors that negatively affect the course of gum disease and the response to treatment. Uncontrolled diabetes can make healing more difficult; gum inflammation can also make blood sugar harder to control. For this reason, you should always tell your dentist about your general health and the medications you take. Quitting smoking contributes significantly to the success of gum treatment.
What should care and follow-up look like after curettage?
Sensitivity and slight bleeding for a few days after curettage are normal; long-term success, however, depends on good home care and regular check-ups. In the period after the procedure, it is recommended to pay attention to the following points:
- Not eating until the anesthesia wears off, and being careful not to bite your lips or cheeks,
- Avoiding very hot, very spicy and hard foods in the first days,
- Continuing to brush gently with a soft brush rather than stopping,
- Cleaning between your teeth with the interdental brush or floss your dentist recommends,
- Using a desensitizing toothpaste if you have temporary sensitivity to hot and cold.
As the inflammation subsides, the swelling in the gums goes down. As a result, your teeth may look a little longer after treatment, or you may notice more visible gaps between your teeth. This is a natural result of healing and comes from the gums returning to their healthy position.
For people treated for periodontitis, regular maintenance check-ups are very important to prevent the disease from coming back. The frequency of these check-ups is determined by the severity of the disease and the person's risk level; they are often scheduled more frequently than general check-ups. For other questions about gum treatment and oral care, take a look at our frequently asked questions page.
When should you seek care for gum problems in Ankara?
If your gums often bleed when you brush, or if you notice persistent bad breath, swollen gums, loose teeth or new gaps between your teeth, a gum evaluation is recommended. For adults considering orthodontic treatment, it is also important to have gum health checked beforehand. At our polyclinic in Oran, Çankaya, after your gum pockets and bone condition are evaluated, a treatment and care plan suited to you is created.
Frequently asked questions
Does curettage hurt?
Because curettage is usually done under local anesthesia, you do not feel significant pain during the procedure. There may be sensitivity and mild discomfort for a few days afterward. In most cases, these complaints ease within a short time.
Why do the gums look receded after curettage?
Gums that were inflamed and swollen before treatment shrink back to their healthy position as the inflammation subsides. As a result, the teeth may look a little longer. This is generally a natural result of healing.
How many sessions does curettage take?
The mouth is usually divided into sections and treated over several sessions, or in suitable cases it can be completed in a shorter time. The number of sessions is determined by the dentist based on the extent of the gum disease and the person's condition.
Does gum disease come back after curettage?
If home care is insufficient and regular check-ups are skipped, the disease can come back. Effective brushing, interdental cleaning, avoiding smoking and maintenance check-ups at the intervals your dentist recommends reduce the risk of recurrence.
