Root Surface Debridement
Root Surface debridement (RSD) is the careful cleaning of the root surface of the tooth until all deposits have been removed.
If gum disease becomes established deep pockets of 5mm or more may develop and become an ideal environment for bacteria and act as a reservoir of infective organisms. Calcified deposits (calculus) in these pockets make the tooth surface rough so it is harder to keep clean and bacteria collect more readily.
A toothbrush can only clean effectively to a depth of 3mm so that bacteria will be left in deeper pockets causing bleeding, soreness and further deepening of the pocket. If these pockets are left untreated the resulting loss of supporting bone will result in tooth loss. Often there is little awareness that gum disease is present. Bleeding and a bad taste or bad breath (halitosis) are signs of gum disease but give no indication of the extent of the loss of attachment of the gum to the tooth and the amount of pocketing. A detailed pocket chart that indicates the depth of the pocket at either 4 or 6 points together with a note of areas where plaque and bleeding are present is first undertaken. Prior to root surface debridement it is essential that oral hygiene at home is meticulous so that bacteria above the gum (supragingival) don’t re-infect the pockets (subgingival areas).
RSD requires a much longer appointment especially if there are a number of deep pockets and it is often necessary to organise a sequence of appointments so that all the pockets can be cleaned. This prevents re-infection from pockets that have yet to be treated. The aim of the treatment is reattachment of the gum to the tooth so that the pocket will be no more than 3mm. If this can be achieved on all teeth the gum health can be considered stable.