Why "I just want a cleaning" isn't always an option
posted: Mar. 14, 2021.
We get many calls asking for "just a cleaning". But did you know there are different types of teeth cleaning depending on your level of dental health?
All teeth cleanings are designed to remove plaque (soft buildup), calculus (hard buildup, also called tartar) and stains from your teeth, but they go about it in different ways and for different reasons.
The most common type of teeth cleaning has a big name—prophylaxis--but you’ll often see it shortened to prophy or pro. If you have dental insurance and check your plan, most will place this in the "preventive" category of their coverage--meaning it is designed to prevent future chronic problems. In a prophy, plaque, calculus and stains are removed from your teeth above and perhaps slightly below your gumline. The goal is to control the local irritating factors so that your teeth and gums stay healthy. Most children and the adults who do not have periodontal disease will have this type of cleaning. For most people, it is recommended every 6 months.
If you haven’t been to a dentist in a while and have so much calculus and plaque that the dentist cannot examine or evaluate your teeth and gums, you will have a full mouth debridement or a scaling with inflammation. Often an ultrasonic cleaning device is used to break up the large pieces of hardened buildup. Some hand instruments may be used as well. The goal here is to remove the bulk of the buildup so that the level of health of your teeth and gums can be determined. You may need additional “cleaning” type appointments to complete your care, depending on your level of dental health.
If your gum examination and/or x-rays show that you have periodontal disease, you are beyond preventive measures and already have an active problem. In this case, "just a cleaning" does not address the problem you have. With active periodontal disease, you will either be recommended to see a periodontist (gum specialist) or you will have a specialized type of cleaning called Scaling and Root Planing. This type of cleaning is often called a Periodontal Cleaning or a Deep Cleaning. Periodontal disease creates pockets between your tooth and gum. These pockets trap food, bacteria and plaque between your tooth and gum. Calculus often forms because your toothbrush and floss can’t reach far enough into the pocket to remove what’s trapped there. Because we are going below your gumline, scaling and root planing removes plaque and calculus buildup from both tooth and root surfaces. The goal is to help your gum tissue to heal and allow your pockets to shrink. You may have “novocaine” or topical anesthesia with this type of cleaning to make it more comfortable for you and allow for removing as much of the trapped material as possible. This is a therapy or treatment (as opposed to a preventive measure). There is no cure for periodontal disease, it can only be managed. It’s critical to continue your treatment with Periodontal Maintenance on a schedule determined by your dental care professional (usually 3 to 4 times a year). (Note: depending on your level of disease, there are times that surgical periodontal treatment is also indicated or needed.)
Once your periodontal disease is brought under control, regular visits to your dentist or hygienist are crucial to keep it that way. Remember, periodontal disease can only be controlled, it can't be cured! These visits are called Periodontal Maintenance and are more complex than a prophylaxis or regular cleaning. Periodontal Maintenance involves a full-mouth deeper cleaning that removes plaque and calculus from above and below your gumline, even into any deeper pockets that may remain after your intitial treatment. Because of that, it may also involve some scaling and root planing if an active periodontal disease site is found. Surface stain removal and polishing of your teeth are also part of this procedure. The goal of this type of cleaning is to reduce the number of bacteria that cause gum disease. Though levels of bacteria are lower after your visit, they build back up again within 3 to 4 months of your periodontal maintenance visit and can start breaking down the bone around your teeth again. (This is why we ask you to have this 3 or 4 times a year!)
*Note: Information in this article is not meant to replace the clinical judgement of your healthcare professionals.
Dr. Jennifer Robb is a general dentist with an office at 1320 Cooper Foster Park Rd., Lorain, OH 44053. To schedule an appointment, please call 440-960-1940. You can also contact Dr. Robb by using the contact form on her website at www.drjrobb.com or interact with her on facebook at www.facebook.com/DrJenniferRobb