Dental Cleanings: Keeping Your Teeth in Your Smile
Most of us know that dentists provide different types of dental cleanings, and we know that cleanings are important. But, not everyone knows why.
- Regular cleanings remove the food, plaque and bacteria that regular brushing and flossing miss.
- Left uncleaned, that same food, plaque and bacteria will cause bone-destroying gum disease and lead to early tooth loss.
- In other words: “Clean em” or they eventually fall out!
What do you mean there are five types of dental cleanings?
When you call to schedule a “cleaning”, you probably think that you’re asking for a specific service. Right? Not exactly…
In reality, dentists actually offer five clinically different types of dental cleanings. Why hasn’t anyone told you this before? Well, we dentists may be great at fixing teeth, but we don’t always have stellar communication skills.
Think of a dental cleaning like a car wash. Full service car washes usually offer different types of washes:
- a basic wash = a 6-month regular cleaning
- a heavy duty wash = scaling in the presence of inflammation
- a bug scrubbing service = debridement
- a deep clean detail wash = scaling and root planing)
Let’s see how these compare to different types of dental cleanings. The similarities will amaze you!
#1 The Basic Wash Cleaning - Regular 6 Month Cleaning - Designed to Prevent Gum Infection
If you’re a regular city driver who washes your car regularly and vacuums it at home, then you’ll rarely need anything more than a basic wash to get it sparkling clean.
It’s the same way with dental cleanings.
If you get your teeth cleaned regularly, then each cleaning consists of simple removal of the debris and bacteria that have built up around the teeth over the past six months. The hygienist shouldn’t need to clean far below your gumline.
With regular cleanings, the gums jas am easy job of shielding the teeth from invading bacteria. You can tell that the gums are happy when the poking part of the cleaning (called perio-probing) measures gum probings at three millimeters or less.
With a basic cleaning, you’ll be back out the door with a fresh, healthy smile in an hour. (This preventative appointment usually includes yearly x-rays, an anti-cavity fluoride treatment and by a doctor evaluation to confirm all is in good order.)
#2 The Heavy Duty Cleaning - Scaling (Cleaning) in the Presence of Inflammation - Gingivitis Therapy
What if you usually wash your car regularly, but then you miss a few washes?
Your car will need a little extra help to get it clean, right? Maybe it will require some extra scrubbing or rinsing in some places. Or it might need a second run through the basic car wash to get the extra dirt off.
The same thing applies to your teeth.
Maybe you normally get them cleaned every six months, but you suddenly realize it’s been more than a year. That means that you have more than two cleanings worth of food, plaque and bacteria built up around your teeth. In that time, bacteria have multiplied and the plaque has caked onto the teeth into rock hard tartar and calculus.
At this point, your gums probably appear red and puffy and bleed when you floss. We call this gingivitis, and it’s an infection in the gums.
With gingivitis, perio-probings measure longer than 3 mm. Some deeper 4mm and 5 mm pockets have snuck in.
A different type of dental
In order for the hygienist to remove the extra build up, she has to clean deeper under the gums as well as around the teeth. This becomes a different type of dental cleaning and requires special techniques. It will take two appointments to guarantee that we have dealt with the infection: one appointment for the preliminary cleaning and another one a few weeks later after inflammation has gone down. This second cleaning allows us to catch any tartar and calculus that remains.
If someone gives you “just a cleaning” when you haven’t had your teeth cleaned in over a year, beware! We can guarantee that you will not have clean teeth afterwards, because a hygienist cannot see through the red, puffy, bleeding gum tissue in order to give a detailed, effective cleaning in that first appointment.
#3 The Bug Scrub Cleaning - Debridement - Cleaning followed by healing time and doctor's exam
Now, imagine you’re a city driver who lives in San Antonio, and it’s butterfly season. Without having a bug scrub before your car wash, you’ll end up with a semi-clean car dotted with yellow bug guts.
This proves true for your teeth too.
Sometimes people come in with a lot of visible plaque built up on their teeth. We can see that their gums are inflamed, and we can see that they need a cleaning. However, we can’t see underneath the plaque to be able to tell if they’ll need a basic wash or a deep clean once the bugs are gone. Whenever a patient has a lot of build-up, we have to do a “bug scrub” first. In dentistry, we call this a debridement.
#4 The Deep Clean Detail Cleaning - Scaling and Root Planing - Periodontal Disease Therapy
Picture your car if you hadn’t washed it in years. Pretend that you don’t ever vacuum it or wipe down the windows. Getting that car clean again will require a multi-step deep clean detailed wash—inside and out.
This also happens with your teeth if you have gum disease. Once the plaque is cleared away by the “bug scrub” (debridement), perio-probings will show multiple places where the perio-probe slides deep into the gums. Perio-probings of six, seven and eight millimeters will appear. These deep “pockets” are places that the gums have separated from the teeth. We call this advanced gum disease or Periodontitis.
Why do these “periodontal pockets” pose problem? Those pockets offer the perfect home for bacteria, who go on to kill the bone. Cleaning these pockets requires a special kind of cleaning that is able to remove the plaque, tartar, calculus, bacteria, toxins, and dead gum tissue out of the pockets—out from under the gums and off the tooth roots. Oftentimes, treating periodontitis also requires a laser treatment in order to clean the dead cells and kill the bacteria. This deep cleaning gum therapy is called root planing and scaling. It can take several appointments of one to two hours each to clean the whole mouth.
SPOILER ALERT: If anyone claims to perform a root planing and scaling but completes your whole mouth within an hour, seek a second opinion. Either they did not perform root planing and scaling, OR you didn’t have the pockets that they claimed you did. Always ask the dentist how long the treatment will take before you accept the treatment. Root planing and scaling typically takes a minimum 1 hour and 30 minutes per half of your mouth.
#5 Deep Clean Maintenance - Maintaining the Results of Gum Infection Therapy every 3-4 months
This final type of cleaning doesn’t exactly fit our car wash analogy because the human mouth, as opposed to cars, is alive and coping with bacteria. Cars, on the other hand, cannot get infected. When people need deep cleaning gum therapy, the fault belongs to Periodontitis, that nasty infection deep under the gums. Once this infection takes root, it cannot ever be completely cured. You’ll never get over periodontitis like you would a cold or sinus infection. Once it takes root, you only have two choices: keep your teeth by keeping them clean OR lose your teeth as the infection kills your bone.
Keeping the infection cleaned up and under control requires cleanings every three to four months because that is approximately the time it takes for the infection to flare up again after a deep cleaning. Once you have periodontitis, a basic cleaning is never going to be enough because it won’t clean the infection out from the teeth roots. Periodontal Maintenance Cleanings are key to keeping your teeth.
How do I know which cleaning I need?
Just reading about the five kinds of cleanings, you probably already have an idea about which type of cleaning you need. A dentist will be able to tell you exactly what you need after looking at your gums and perio probings.
What are the benefits of regular dental cleaning?
- Whiter Teeth: Dental cleanings remove stain!
- Healthier Gums: Removing bacteria helps prevent bleeding and puffiness.
- Fresher Breath: Plaque, bacteria and food build up in the mouth stink. Cleanings keep your breath fresh.
- Fewer Cavities: Dental checkups, along with dental cleanings, catch small cavities before they become big expenses.
- Avoid Dentures: Regular cleanings are the best way to prevent tooth loss because they prevent periodontitis, the disease that causes tooth loss.
- More Confidence: People with clean teeth, bright smiles and fresh breath have more confidence!
- Fewer Stressful Surprises: Consistent dental visits ensure that we catch small problems before they become large problems. Smaller problems mean smaller bills and prevent unexpected dental emergencies.
- Stronger Teeth: Double up on benefits by adding back fluoride with a fluoride varnish. This turbo teeth booster strengthens enamel, making it harder for cavities to form.
- Personalized Tips and Tricks: Get answers to your burning dental questions! Why does your floss always rip? Why does your tongue look fuzzy? Why do your gums always bleed under your lingual retainer? Why is your upper left tooth always sensitive? Get solutions for YOUR mouth.
It’s been a while, but my teeth don’t seem that dirty. Why can’t I just get a regular cleaning?
We hear this question A LOT. People feel like it’s unnecessary to have a special cleaning just because they haven’t been in a while. We find this even harder to explain when many other dental offices offer regular cleanings to almost everyone. Why are we so stuck on the whole five cleaning thing?
We’re stuck on it because our primary mission is to get our patients healthier—not to make a profit by treating masses of people with any treatment that they will accept.
Some dentists make the excuse that any cleaning is better than none at all, but we disagree. If you haven’t had a cleaning in over a year, then you have more bacteria built up deeper under your gums than someone who has had regular cleanings. That build up will remain in your mouth even with a regular cleaning. Because of this, the built up bacteria causes periodontal disease and leads to infection, bone loss and, eventually, dentures.
We believe that practicing with integrity means only offering you the cleaning that your specific mouth needs to be healthy. Offering a regular cleaning when you really need a different type of dental cleaning is like putting a band-aid on a cut that needs stitches. The band-aid may feel like treatment in the moment, but it won’t heal the cut properly.
Getting healthy requires getting clean—all the way clean.