Purpose of Dental Cleanings
Dental cleanings are performed by our Registered Dental Hygienists to keep our patients’ oral cavity in good health. Specifically, cleanings are performed to prevent the onset of gum disease, treat existing gum disease, and prevent the progression of gum disease. In order to maintain gum health, dental cleanings must be completed routinely and home care implemented consistently.
Cleanings involve the thorough removal of plaque and calculus on the teeth which cause harmful inflammation. This inflammation is the beginning of gum disease. If left untreated, gum disease progresses to the loss of gum tissue and bone. With bone loss, the teeth become mobile, shift, and eventually fall out.
Plaque is a sticky, invisible film that forms on the teeth. It consists of a growing colony of bacteria, food debris, and saliva. The bacteria in plaque produce toxins that inflame the gums. Calculus, sometimes also called tartar, is yellow/brown debris formed when plaque has been left on the tooth surface and hardens. Since calculus firmly attaches to teeth, unlike plaque it cannot be removed by brushing or flossing and must be removed with special dental instruments.
Types of Dental Cleanings
The type of cleaning you will need depends on the condition of your gum health. During your initial exam, your gums are comprehensively evaluated. This involves assessing the visual appearance of the gums for signs of inflammation and disease, evaluating x-rays for bone loss, and performing periodontal charting where measurements of gum pockets, tooth mobility, and other conditions are recorded. After all information is gathered, the gum health is identified any gum disease is diagnosed by the doctor. Based on this, the appropriate type of cleaning is recommended. Gum health is re-evaluated at each subsequent cleaning. There are two types of dental cleanings:
- A dental prophylaxis is a basic cleaning performed on patients with healthy gums as well as patients with gingivitis (reversible early stage gum disease). If left untreated, gingivitis advances to periodontitis.
- A periodontal scaling & root planing (SRP) is an advanced cleaning performed on patients with periodontitis (gum disease that has progressed past gingivitis).
Prophylaxis (Basic Cleaning)
For those with healthy gums or reversible early stage gum disease, known as gingivitis, prophylaxis cleanings are recommended. It is typically recommended that patients maintain their prophylaxis cleanings twice a year. Maintaining routine cleanings is vital because if prolonged, gingivitis advances to periodontitis (irreversible gum disease). These basic cleanings involve the removal of plaque and calculus from exposed tooth surfaces.
The process of removing plaque and calculus from the tooth surface using dental instruments is called scaling. Our dental hygienists use a combination of hand scaling (the use of manual scaling instruments) and ultrasonic scaling (the use of a scaling tool which gently vibrates and irrigates) to thoroughly remove plaque and calculus. This process is typically very comfortable for patients and does not require the use of local anesthetic (numbing). At the end of the cleaning, the teeth are polished with flavored pumice. Polishing the teeth removes any residual plaque and stains (from things like coffee, tea, and wine) and leaves the teeth looking shiny and feeling smooth.
Periodontal Scaling & Root Planing (Advanced Cleaning)
For those diagnosed with gum disease that has advanced past gingivitis (periodontitis), periodontal scaling and root planning (SRP) is recommended. This type of cleaning is also sometimes referred to as a deep cleaning. Periodontitis is caused by plaque and calculus that has been allowed to accumulate near the gumline. As the gum disease advances, connective tissue and bone is irreversibly lost, forming pockets under the gumline. If further left untreated, these pockets harbor even more plaque and calculus, causing connective tissue and bone loss to progress further down the root of the teeth. Early detection and treatment of periodiotitis is vital, as the further the disease progresses, the harder it is to reach into the pockets and remove the disease causing agents, forming a vicious cycle.
While scaling is the process of removing plaque and calculus from the tooth surface, root planning is the process of removing them from the root while smoothing the root surface. During SRP, our dental hygienists use a combination of hand scaling and ultrasonic scaling. Since this involves cleaning underneath the gumline, our hygienists recommend administering local anesthetic (numbing) to ensure our patients remain comfortable. Patients are given post-operative instructions as some tenderness after the appointment can be expected.
Depending on how widespread the periodontitis is (localized in a few areas or generalized throughout the mouth), these cleanings can be separated into multiple appointments. After scaling and root planning is complete, patients return for their maintenance cleanings, known as periodontal maintenance. Periodontal maintenance appointments are recommended at either 3 month, 4 month, or 6 month intervals, depending on each individual patient’s progress. In cases where periodontitis is severe or bone loss is significant, we may refer patients to a periodontist (dentist who specializes in gum therapy and surgery).
*Please note the people depicted in the photographs are models and not real patients.*