When you have your teeth cleaned, what do you remember most about the process? For most people, what they remember is the rubber cup polishing with the dental prophy paste, but that really isn’t the “cleaning”. Let’s look at what your dental cleaning consists of:
If you’ve ever looked at your insurance company paperwork or dentist statement, your dental cleaning is called a prophylaxis (pro-phil-axe-us). The American Dental Association (ADA) defines this as “removal of plaque, calculus and stains from the tooth structures” and state “it is intended to control local irritational factors”.
Plaque is the soft, sticky buildup that forms when food, your saliva, and bacteria mix. It sticks to your teeth, but because it is soft, it can be moved around by your toothbrush or dental floss (or by the dentist’s dental instruments and/or polishing cup and paste). Because it contains bacteria, plaque is one of the “local irritational factors” mentioned above. The bacteria irritate your gums and make them redder, more swollen, and more likely to bleed.
Calculus, also called tartar, is hardened plaque. If plaque is not removed or moved around on your tooth or teeth, it attaches to the tooth. Minerals, which are dissolved in your saliva, harden the plaque and cement it to your tooth or teeth. Once calculus has formed, it needs to be removed by a dental professional (dentist, dental hygienist, or dental specialist such as a periodontist). You might think of this removal as the “scraping” that the dental professional does at your appointment. Calculus also contains bacteria. It is also rough, so it tends to catch the sticky plaque. So calculus is also one of the “irritational factors” mentioned in the definition above. Dental professionals use ultrasonic machines and hand instruments to remove plaque. The polishing cup or dental paste will not remove calculus from your teeth (nor will your toothbrush, toothpaste or dental floss take it off.)
The stains discussed in the definition refer to surface stains on the teeth. These usually come from food, beverages or habits. Coffee, tea, and smoking are the three most common surface stain causers, but there are other ones. Surface stains can be loosened with dental instruments and then polished off with the polishing cup and dental paste.
The main uses of the dental paste on the rubber cup/polisher are to remove surface stains and to make it harder for plaque to reattach to your tooth’s surface. To do this, the dental paste has to be a bit abrasive. If you have areas in your mouth that are already worn down or eroded, the standard dental paste may wear away more of these areas. In addition, when I was in school, we were taught to polish all the teeth. More recent studies have questioned whether the routine polishing causes tooth sensitivity, since more people are reporting tooth sensitivity. Most schools now teach the “selective polish” technique—meaning that instead of polishing all the teeth with the rubber cup and dental paste, only the ones that have stain or tend to attract plaque or calculus are polished. Because that is now the standard of care that is being taught, many dental professionals are adopting it in their offices as well—so don’t be surprised if your teeth cleaning doesn’t involve polishing all your teeth with the rubber cup and dental paste. They’ve still been cleaned by the instruments we use.
*Note: The information in this article is not meant to replace the clinical judgement of your healthcare professionals.
Dr. Jennifer Robb is a general dentist who treats all ages (children and adults). She is taking new patients at her office at 1320 Cooper Foster Park Rd., Lorain, OH 44053. Call 440-960-1940 to reserve your time! You can also find Dr. Robb on Facebook at www.facebook.com/DrJenniferRobb or at her website www.drjrobb.com