SRP stands for scaling and root planing, a deep cleaning procedure used to treat gum disease. Unlike a routine dental cleaning that focuses on the visible surfaces of your teeth, SRP goes beneath the gumline to remove hardened buildup (tartar) from tooth roots and smooth them so gums can reattach. It’s one of the most common non-surgical treatments for periodontitis, and it’s typically recommended when gum pockets measure 4 millimeters or deeper.
How SRP Differs From a Regular Cleaning
A standard cleaning, called a prophylaxis, removes plaque and tartar from the surfaces of your teeth above the gumline. It’s preventive care for healthy gums. SRP is a therapeutic procedure, meaning it’s done to treat an existing problem. When bacteria-laden tartar builds up below the gumline, it creates pockets between the gum tissue and the tooth root. These pockets trap more bacteria, leading to inflammation, bone loss, and eventually loose teeth if left untreated.
SRP addresses this in two steps. The scaling portion removes plaque and tartar from both above and below the gumline. The root planing portion smooths the rough surfaces of the tooth roots, which eliminates tiny ridges where bacteria like to collect and gives the gum tissue a clean surface to heal against.
When Dentists Recommend SRP
Your dentist measures gum pockets using a small probe during routine exams. Healthy pockets are 1 to 3 millimeters deep. Once pockets reach 4 millimeters or more, with signs like bleeding during probing and bone loss visible on X-rays, SRP becomes the standard first-line treatment. Most dental insurance policies require documented pocket depths of at least 4 mm on multiple teeth before they’ll cover the procedure.
SRP is also used for recurrent or resistant gum disease that hasn’t responded to earlier treatment, and for periodontal abscesses. If your pockets are in the 4 to 6 mm range, SRP alone is often enough to bring things under control. Deeper pockets (7 mm and above) may still benefit, but additional treatment like surgery could be necessary.
What Happens During the Procedure
SRP is usually done one or two quadrants at a time (your mouth is divided into four quadrants), so most people need two to four appointments to complete the full treatment. Each visit typically takes 45 minutes to an hour.
Your dentist or hygienist will numb the area with local anesthesia before starting. Research comparing injectable anesthetic to topical numbing gel found that injections provide better pain control and reduce the need for additional anesthesia during the procedure, though both approaches are used in practice. Once you’re numb, the provider uses hand scalers, ultrasonic instruments, or a combination of both to clean below the gumline and smooth the root surfaces. Ultrasonic instruments vibrate at high frequency to break up tartar and flush the pockets with water. A systematic review and meta-analysis found no significant difference in clinical outcomes between ultrasonic and manual instruments at six months, so both approaches work equally well.
What Results to Expect
SRP doesn’t regrow lost bone, but it stops the progression of gum disease and allows gum tissue to heal and tighten around the teeth. In pockets measuring 4 to 6 mm, studies show an average reduction of about 1 mm in pocket depth after treatment. About half of that reduction comes from the gums shrinking back (recession) as swelling resolves, and the other half comes from the gum tissue reattaching more firmly to the tooth root.
Deeper pockets tend to see greater improvement. Research has shown pockets in the 7 to 12 mm range can shrink by about 2 mm after SRP. The type of bone loss matters too. Teeth with horizontal bone loss (a broad, even pattern) typically see about 1.1 mm of pocket depth reduction, while teeth with vertical bone loss (a more localized, angular pattern) see closer to 0.7 mm.
Recovery and Aftercare
Most people experience mild soreness and minor bleeding for a few days after treatment. Sensitivity to hot and cold is also common as the gums recede slightly during healing, exposing parts of the root that were previously covered.
For the first 24 to 48 hours, stick to soft foods like yogurt, scrambled eggs, mashed potatoes, and soup. Avoid crunchy, hard, or spicy foods that could irritate the treated areas, and skip using a straw for the first day since the suction can dislodge blood clots that help with healing. Brush gently with a soft-bristled toothbrush, and continue flossing but be careful not to snap the floss against your gums. Starting the day after your procedure, rinse two to three times daily with warm salt water (one teaspoon of salt in eight ounces of water) to keep the area clean and reduce inflammation.
Cost and Insurance Coverage
SRP is typically billed per quadrant. The average cost runs around $175 per quadrant, so a full-mouth treatment across all four quadrants would come to roughly $700 before insurance. Most dental insurance plans cover SRP as a medically necessary procedure when documentation supports the diagnosis of periodontal disease, though they often require specific evidence: pocket depths of 4 mm or greater, bleeding on probing, radiographic bone loss, and calculus on the root surfaces.
Follow-Up and Long-Term Care
After completing SRP, you won’t go back to standard twice-yearly cleanings right away. Your dentist will schedule a re-evaluation, usually four to six weeks after your last appointment, to check how your gums have responded. From there, most periodontitis patients are placed on a periodontal maintenance schedule, with cleanings every three to four months rather than every six. These maintenance visits involve measuring your pocket depths, cleaning below the gumline, and watching for signs of disease recurrence.
Periodontal disease is a chronic condition. SRP can bring it under control, but without consistent maintenance and good home care, pockets can deepen again and bone loss can resume. The combination of professional maintenance visits and thorough daily brushing and flossing gives the best long-term outcome.