Scaling is a mechanical procedure used to remove plaque and calculus (tartar) from tooth surfaces and below the gingival margin. It is a fundamental component of periodontal therapy, particularly for gingivitis and as an initial step in preventing progression to periodontitis. Following scaling, gingival tissues enter a healing phase, making post-therapy gingival care critically important to reduce inflammation, promote tissue regeneration, and restore oral microbiota balance.
A study conducted by FKG UGM student Monica Agnesia M, under the supervision of Dr. drg. Archadian Nuryanti, M.Kes., and drg. Ruslin, M.Kes., Ph.D., investigated the use of nano-extract of Patikan Kerbau (Euphorbia hirta) as a coolant agent during ultrasonic scaling and its effect on lymphocyte count (an immune system component) in rat gingiva after therapy. This research provides biological evidence that adjunct materials used during scaling can influence post-therapy tissue responses.
Summary of Key Research Findings
- The study utilized 45 Wistar rats induced with gingivitis. Ultrasonic scaling was performed using various concentrations of Patikan Kerbau nano-extract as a coolant agent (25%, 30%, and 35%). Control groups used 0.1% ethanol and 2% iodine glycerin.
- Observations were conducted on days 3, 5, and 7 post-scaling. Gingival tissues were examined histologically, and lymphocyte counts were measured to evaluate local immune responses.
- Results showed a significant effect of both time and nano-extract concentration on lymphocyte count (p < 0.05), indicating that the use of Patikan Kerbau nano-extract as a coolant influences gingival immune responses after therapy.
These findings demonstrate that modifying components used during scaling, such as coolant agents, can affect inflammation and gingival tissue healing phases.
The Role of Scaling in Gingival Care
Scaling serves as the primary mechanical therapy to reduce microbial load, eliminate local irritants, and initiate tissue healing. Its key roles include:
- Decreasing bleeding and edema, as removal of irritants leads to reduced bleeding on probing (BOP) and tissue swelling.
- Decreasing bleeding and edema, as removal of irritants leads to reduced bleeding on probing (BOP) and tissue swelling.
- Stimulating tissue healing, allowing gingival tissues to undergo regeneration, including fibroblast activity, new collagen formation, angiogenesis, and epithelial remodeling.
- Providing an opportunity for adjunctive agents, such as antimicrobial or herbal coolants, to modulate tissue response and accelerate gingival healing.
Post-Scaling Gingival Care Strategies
To optimize scaling outcomes and ensure proper gingival recovery, the following clinical strategies may be applied:
- Selection of biocompatible coolants or adjunct agents Herbal nano-extracts, such as Patikan Kerbau, may be considered as alternative coolants during scaling to reduce irritation and modulate immune responses. Research indicates that concentration and observation time influence lymphocyte levels in tissue.
- Intensive oral hygiene instructions Patients should be guided to maintain meticulous oral hygiene after scaling, including proper brushing techniques, flossing, and mouth rinses when necessary, to minimize plaque re-accumulation.
- Regular gingival tissue monitoring Gingival conditions (color, texture, bleeding, sulcus depth) should be reassessed in the following days (e.g., day 3, day 7, or week 2) to ensure proper healing.
- Control of local and systemic risk factors Factors such as smoking habits, blood glucose control in diabetic patients, stress, and oral habits should be managed to avoid interference with healing.
- Additional interventions when necessary If inflammation or high microbial levels persist, additional measures such as light re-scaling, local antimicrobial gel application, or supportive therapy may be considered.
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Scaling is a fundamental step in gingivitis therapy and early periodontal care. However, the medium- and long-term success of this therapy depends heavily on post-procedural gingival care, including proper oral hygiene, risk factor control, and potentially the use of biocompatible adjunct agents.
The referenced study indicates that modifying materials used during scaling—specifically herbal nano-extracts—can influence local immune responses, as reflected by lymphocyte counts in gingival tissue after therapy.
References
MONICA AGNESIA M, Dr. drg. Archadian Nuryanti, M.Kes., drg. Ruslin, M.Kes., Ph.D., Pengaruh Waktu dan Konsentrasi Nanoekstrak Patikan Kerbau (Euphorbia Hirta) sebagai Herbal Coolant Agent Ultrasonic Scaler terhadap Jumlah Limfosit pada Perawatan Gingivitis Tikus Wistar, https://etd.repository.ugm.ac.id/home/detail_pencarian_downloadfiles/666484
Author: Rizky B. Hendrawan | Photo: Freepik
