Dental Cleanings

Regular vs. Deep Dental Cleanings

A dental cleaning is a professional cleaning you receive from a dentist or dental hygienist to remove the tarter or calculus that builds up over time on the teeth. Calculus is the same as the hard water deposit that builds up in teapots or coffee makers. It’s made from calcium and phosphate from the saliva that crystallize roughly onto the teeth, and can’t be removed by a toothbrush. It’s porous, so when bacteria lodge themselves in it, they can’t be cleaned off at home.

Over time, if the bacteria aren’t cleaned off, the gums become inflamed. This problem is called “gingivitis.” At this stage, the inflammation should be reversed by a regular cleaning to remove the calculus above the gum line.

People with a lot of calcium and phosphate in their saliva build up calculus quickly, and need cleanings every six months. People without as much calcium and phosphate often need cleanings only once per year (they tend to be more prone to cavities, so having the teeth professionally evaluated every year is still very important).

If the calculus sits on the teeth for too long, it can begin to build up beneath the gum line, allowing bacteria to settle in near the underlying bone. Over time, the bone permanently shrinks away from around the teeth. This problem is called “periodontitis.” Some of the bone destruction is caused by harmful enzymes released by the bacteria. Some of it is from too many bone-destroying white blood cells, called “osteoclasts,” flooding the area to respond to the long-term inflammation. It’s a painless, gradual, process, and people often don’t know they have the problem until their teeth become loose.

Every time you come in for a routine dental evaluation, we will check for any destruction of bone around your teeth. If we detect any pockets of bone destruction 5 mm or deeper, we will recommend a deep cleaning, also called a “scaling and root planing,” in which we numb the area, and clean the side of the root so the gums can reattach. The goal is not to replace the destroyed bone, but to stop the process of bone destruction.

Once bone loss has happened, it can easily happen again, so people who have had a deep cleaning typically need to have their teeth cleaned by a dentist or hygienist every three to four months. These cleanings are called “periodontal maintenance” appointments, and are different from regular cleanings. They focus beneath the gum line, and include repeat deep cleanings in problem spots when needed.

The first time you come in for a complete dental exam, we thoroughly evaluate your gums, and discuss the type of cleaning that is appropriate for you. We then re-evaluate the gums on a yearly basis to make sure problems are addressed before they have a chance to grow.

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