The complete removal of accretions during closed scaling and root planing in moderate-deep pockets is difficult, presumably due to inadequate mechanical and visual access. The purpose of this study was to evaluate the effect of minimal papilla reflection and illumination with a prototype fiber optic unit on root planing efficiency. Nonmolar teeth with moderate-deep interproximal pockets (greater than 3 mm) in four patients scheduled to receive immediate complete dentures were randomly divided into groups for treatment: Group I--interproximal root planing augmented by papilla reflection and fiber optic illumination (n = 26 surfaces); Group II--interproximal root planing with papilla reflection only (n = 24); Group III--untreated controls (n = 23). Immediately after treatment, the experimental teeth were extracted, stained with toluidine blue and interproximal areas were evaluated for remaining accretions with a microscope-digitizing pad-computer system. Significantly less (P less than 0.01) root surface was covered by deposits in Group I than Group II (0.57 +/- 0.29% vs. 2.42 +/- 0.63%), and both treatment groups had fewer (P less than 0.0005) accretions than untreated controls (57.72 +/- 3.40%). These results suggest that root planing with papilla reflection produces an interproximal surface with few remaining deposits, and fiber optic illumination and transillumination further enhance this effect.