Do I need a deep cleaning or a simple cleaning?
As you keep going to your dentist over the years, at some point you’re bound to hear “you need a deep cleaning”. Now keep in mind that deep cleanings can expensive, time consuming and somewhat painful. In fact they are so much fun that dentists usually break them down into several visits stretched over the course of a few weeks. So should you go for a deep cleaning? Or should you try to convince your dentist to settle for a regular one instead?
What is a deep cleaning?
A deep cleaning, also referred to as scaling and root planning, is required whenever you accumulate hardened plaque, known as tartar or calculus, underneath your gums. Basically, if you have tartar and calculus you need a deep cleaning. The cleaning focuses on removing harmful calcified buildups from tooth root surfaces. This is in contrast to a simple (regular) cleaning which doesn’t pay much attention to teeth roots and is performed in absence of tartar and calculus buildups.
How can you tell if you have tartar and calculus buildup on your teeth?
Your dentist needs to determine this for you. Here is how dentists determine the condition of your gums:
- In the most extreme cases, tartar and calculus will actually be visible in your mouth. It will be sitting right along your gumlines with a stained dark brown/blackish appearance.
- Many times tartar and calculus will show up on X-rays. Your dentist or hygienist can point it out to you if this is the case. Tartar appears like a small triangular ledge which sits in between two adjacent teeth.
- To conclusively determine how much tartar and calculus is present on you teeth, your dentist or hygienist will perform a gum exam. This will determine how healthy your gums are and what type of dental cleaning you require. This is known as a gum pocket (periodontal pocket) charting examination.
How does gum pocket (periodontal pocket) charting work?
Your dentist or hygienist will an instrument along your teeth, known as a periodontal probe. He or she will read out some numbers which determine how deep pockets surrounding each tooth are. This is a time consuming and painful exam, but helps establish a baseline for your gum health and monitors your improvement over time.
Gum pocket numbers show how much bone support there is around each tooth region. Smaller numbers are better, as these are areas which have strong bone support and small pockets. Larger numbers are dangerous as they indicate areas with bone loss and deep pockets which can trap food and bacteria. Numbers above 5 mm are dangerous and demonstrate early signs of gum disease and bone loss starting to develop.
Periodontal pocket depth chart and explanation
|1, 2, 3 mm||Excellent numbers; Strong bone support; Great attachment levels; Nice and shallow gum pockets; No signs of gum disease|
|4 and 5 mm||Borderline numbers; Some bone loss; Some loss of attachment; Mediocre gum pocket depths, Sign of early gum disease|
|> 6 mm||Dangerous numbers, Advanced bone loss; Serious loss of attachment; Deep, dangerous gum pockets; Sign of moderate to advanced gum disease|
Benefits of a deep cleaning
You can only remove tartar and calculus with a deep cleaning
All our gum problems start off with particles getting trapped and accumulating underneath our gum lines. Food and bacteria initially form plaque, which is a soft, sticky buildup which harbors bacteria. You can remove plaque from your teeth surfaces by brushing or flossing your teeth regularly.
However, if plaque is not removed from teeth within a timely fashion, it starts to calcify and becomes a hard after a few weeks. This calcified, hardened plaque is referred to as tartar or calculus. Unfortunately you can not remove tartar and calculus buildups by yourself. A toothbrush, dental floss or no other at-home dental cleaning device has enough force to dislodge these stubborn particles. Tartar and calculus can only be removed by your dentist or hygienist using a set of special set of instruments.
Tartar and calculus also attract bacteria which produce acidic byproducts that damage your gums. These acidic products damage your gums, destroying your gums and causing them to bleed. It can also destroy the supporting jawbone which holds your teeth in place. This causes tooth sensitivity and gradually leads to loosening of your teeth.
So if you do have tartar and calculus buildup below your gum lines then you definitely need a deep cleaning to remove these harmful buildups. A deep cleaning is your only solution to remove tartar and calculus from teeth surfaces and prevent damage to your gums and supporting jawbone.
Deep cleaning results in healthier gums and supporting jawbone
Removing harmful buildups helps eliminate the source of bacteria accumulation which is responsible for damaging and destroying your gums and jawbone. Once this occurs, your gums and bone structure start to gradually heal back to a healthy state. You’ll notice less bleeding along with your gums becoming firmer and healthier over time.
To remove tartar and calculus, your dentist or hygienist uses a series of metal-based instruments known as hand-scalers to manually scrape these particles from teeth surfaces. Or they may use an electronic device known as a cavitron instead which uses vibrational motion to loosen and dislodge buildup from teeth surfaces. cavitron works a bit faster than hand-scalers, but causes a bit more pain and sensitivity during treatment. Both techniques work equally effective if done correctly and patiently.
Deep cleanings can be time consuming, difficult and expensive… but saving your teeth make it worthwhile!
Simple dental cleanings usually take only a few minutes. It’s not that difficult to remove food or soft plaque from teeth. Typically a simple polish over 15 to 30 minutes along with maybe some fluoride paste or irrigation will get the job done.
A deep cleaning on the other hand is not something that could be rushed if you’re expecting good results. Don’t forget that it has taken tartar and calculus months if not years to build up to where they’re at right now. So don’t expect your dentist or hygienist to make up for years of neglect in just a couple of minutes.
How many sessions do deep cleanings usually take?
Several rounds of scraping your teeth surfaces will most likely be required to properly remove all buildup particles. It usually takes anywhere from one to four appointments to complete. This will depend on the amount of buildup, your pain threshold and your individual dentist or hygienist style and technique.
Single appointment deep cleaning
Easier cases with gingivitis and no advanced periodontitis can be completed within one session occasionally. Most gum treatment maintenance is also performed over one session as well. You can’t do all of your deep cleaning in one session if your teeth are sensitive and you require anesthesia. Don’t insist, as the end result is you’ll end up with a poor cleaning job and tartar remaining on your teeth!
Two appointment deep cleaning
If you’re in pain and need to get numb, then it’s best to perform your deep cleaning over two sessions. We recommend doing right side and left side separately. This way you can chew on the opposite side, just in case you end up having swelling or pain after your dental cleaning. This is ideal for deep cleaning cases associated with advanced gingivitis or early/ moderate periodontitis.
Four appointment deep cleaning
Most advanced deep cleaning cases require as many as three or four sessions. Spreading out your deep cleanings over multiple visits allows your dentist or hygienist to focus on a small number of teeth. This way they can thoroughly numb each region and remove buildup particles that have been gathering for several months or years! Four session deep cleanings are advised to treating advanced periodontitis or very sensitive patients. Most dental schools and educational clinics stick with 4 cleaning session methods for best results.
Protocol for deep cleaning and subsequent follow-ups
- Deep cleanings start off with a series of cleanings, typically one to four sessions, to thoroughly remove all tartar and calculus from teeth surfaces.
- Your dentist or hygienist will work with you to help improve your oral hygiene habits, monitor your progression and measure your gum pocket (periodontal pocket) depths over time. This allows them to look for signs of improvements as time passes and your gums and jawbone start to heal hopefully.
- The initial healing phase takes several months, between 1 to 6 months depending on the seriousness of your gum condition. Additional advanced treatment may be required if your gums don’t respond well to initial therapy. These may include use of antibiotics, mouthwashes, laser or surgical therapies to bring your gums and bones to a healthy state.
- Once stabilized your dentist will determine how frequently you need to come back for maintenance. Don’t be surprised if you are placed on a 3 to 4 month regimen as this is completely normal. If you fail to keep up with maintenance, you will be back to where you started within a year or so!