The proper use of periodontal instrumentation is the ability to adequately remove calculus and arrest or recover a patient’s periodontal disease and is an essential function of a dental hygienist. There is an increasing variety of instrument types available for dental hygienists to perform this task. These instruments range from traditional manual hand scaling, ultrasonic scalers, air polishers, and more. The studies found show that different calculus removal instruments available to dental hygienists today are effective in the removal of calculus. The question that is being left asking is after removing the calculus, what is the condition of the surface of the root? When the surface of a tooth’s root is smooth, there is less surface area in order for bacteria to adhere to. Rougher root surface can increase the rate of periodontal disease and calculus build-up. Looking at these studies does one instrument produce less damaging outcomes to the tooth surface? Review of Literature Scaling and root planing, also known as traditional periodontal therapy, constitutes the removal of dental plaque and calculus and then the smoothing, or planing, of the surfaces of the roots, in turn removing cementum or dentin. In the treatment of periodontal disease, A variety of instruments are available to Dental Hygienists today to aid in the removal of these agents that contribute to the disease process. These instruments include manual hand scalers and curettes, ultrasonic scalers, air polishers, planing burs, and laser therapy as well. Competently performed scaling and root planing can achieve superior outcomes utilizing the least damaging choice of instrumentation. Existing studies assessing the fluctuations in the extent of root surface changes created by manual, and ultrasonic instruments is lacking (Walmsley et al., 2008; Oda et al., 2004; Kocher et al., 2002). While some studies report manual scalers as removing more root substance (Jacobson et al., 1994), other conflicting studies report statistically significant differences with the ultrasonic scaler being more damaging overall (Oda et al., 2004). Another study set out to evaluate the root surface roughness after SRP with erbium, yttrium aluminum garnet (er.YAG) laser, in comparison to ultrasonic and hand instruments (Attaei, E.; Birang, E.; Birang, R.; Nachsh, N.; Yaghini, J., 2015). During scaling and root planing procedures with ultrasonic instruments, the wrong application of the tip to the tooth surface or unintentional over-instrumentation of calculus-free subgingival root areas may cause surface alterations including scratches, gouges, and nicks on the tooth. There is a considerable amount of published literature on the comparativ>