Regular & deep dental cleaning: when do you need one?

A dental cleaning has the aim of removing “buildup” from your teeth. This doesn’t mean it’s only recommended for patients whose oral hygiene leaves a lot to be desired.

This “buildup” is not only food debris that most people manage to remove daily. No matter how vigorously you brush your teeth, plaque and tartar always build up and have to be removed at the dental office.

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How often should you have your teeth cleaned?

Depending on the state of your mouth (your everyday oral hygiene and how often you visit your dentist) you might need a regular or a deep cleaning.

A standard cleaning is a minor and very common procedure that should be performed twice a year. A deep clean is recommended for those who have missed a couple of those periodic appointments and therefore have developed gum disease. The appointments may need to be more frequent for those who are:

  • smokers,
  • diabetics,
  • under significant stress,
  • taking medication that causes dry mouth,
  • affected by HIV/AIDS or cancer,
  • experiencing orthodontic issues,
  • pregnant, or
  • those who have a history or gum disease or take oral contraceptives.

Dr. Namrita Harchandani
You might also need extra appointments throughout the year if you have significant dental restorations such as crowns, bridges, or implants. Those with crowded teeth should also come in more often.

Regular teeth cleaning

A standard teeth cleaning, otherwise called a prophylaxis (or a prophy), is a routine dental procedure. Special tools are used to remove plaque, calculus, and stains from the teeth. This takes place above the gumline.

A professional dental cleaning is appropriate for primary, transitional and adult dentition. This appointment will likely include an exam performed by the dentist along with some X-rays.

A periodic prophy is often conducted by a dental hygienist working under a dentist’s supervision. The entire procedure usually takes about 30 to 60 minutes.

Preliminary chat

You should let the dental professional know if there have been any changes to your dental history or whether you are taking any medication. You will then be given instructions and information on what’s going to happen. An X-ray, for example a bitewing, might also be taken.

Periodontal charting

This step can also be referred to as periodontal probing. The hygienist will measure the depth of your gum pockets with a special tool. The ideal depth is between 1-3 mm, while any more than that might mean you have periodontitis or gingivitis.

Scaling

If your gum pockets are within the norm, the dental professional will use an ultrasonic scaler and/or hand instruments to remove plaque and tartar from the surface of your teeth. You might hear some scraping, that is completely normal.

Polishing

A gritty toothpaste (you can usually pick the flavor) will be used to polish your teeth. Afterward, an air polisher might be used to smooth them out even more.

Flossing

A teeth cleaning is a great opportunity for an expert flossing session. All contact areas will be cleaned.

Fluoride treatment

A combination of a rinse that contains liquid fluoride, trays, and/or fluoride varnish might be used to remineralize the dentition.

Deep dental cleaning

Also referred to as a scaling and root planing, a deep dental cleaning is necessary if your probing session suggests you might have gum disease. This often happens to patients who have not been to the dentist in a while.

The calculus and plaque which would normally be removed during a professional cleaning migrate down below the gumline. The bacteria and their by-products gather around the tooth, infecting the gums and causing bone loss.

Symptoms you can look for yourself include:

  • bad breath or taste,
  • gums bleeding easily,
  • red, swollen, or tender gums,
  • gums pulled away from the teeth,
  • loose or separating teeth,
  • changes in the bite, and
  • partial dentures no longer fitting properly.

Scaling and root planing can be preventive or therapeutic, but counter-intuitively, both deal with active periodontal disease. SRP is often the only procedure needed to manage periodontitis. The important thing is the extent of the problem.

Dr. Henry Hackney
Periodontal disease has a multitude of causes including, but not limited to, age, tobacco use, oral hygiene, and genetic predisposition.

If your periodontitis has not spread to more than 30% of your mouth, you may get away with preventive or localized SRP. Otherwise, you will be rescheduled for another appointment, after an oral exam.

The process of a deep cleaning may start out very similarly to that of a regular prophylaxis.

Preliminary chat

Any changes in your dental history or new medication should be reported to the dentist. After that he or she will let you know what is going to happen step by step. An X-ray is likely to take place.

Periodontal charting/probing

The hygienist will use a special tool to measure the depth of your gum pockets. Pockets should not be 4 mm or deeper.

X-ray

If those pockets do turn out to be concerning a radiograph will be taken. If it shows significant bone loss or calculus below the gums, scaling and root planing will be performed.

Anesthetic

Some kind of anesthetic will most likely be used. This might be a local injection or a topical gel.

Scaling

A hand-held scaler will be used to manually remove the plaque from the teeth and roots. An ultrasonic tool may be used to aid this process.

Root planing

The dental professional will use a rubbing motion to scrape off roughness from your roots. Those spots are where the bacteria reside.

Application of antibiotics

Time-release antibiotics might be applied to manage the inflammation in the gums. You will be given instructions on how to care for your mouth for the next few days or weeks.

Referral to a periodontist

In very extreme cases surgical treatment might be necessary. The patient is often but not always referred to a specialist.


A single deep cleaning procedure might take one to two hours. If the periodontitis has spread over a significant area in your mouth the procedure might have to be stretched out over several appointments.

Your gums might be slightly tender or swollen after your visit. It’s a good idea to avoid very hot or cold foods for a few days. After the procedure is complete, you will have to wait four to six weeks before returning for a check-up.

There might also be a follow-up appointment with a periodontist if the situation in your mouth does not improve or if your bone needs intervention.

Is professional tooth cleaning necessary?

Yes. A professional teeth cleaning cannot be equaled by the best oral hygiene conducted at home. About half an hour after you finish any meal or snack your saliva production slows. The pH of your mouth allows a certain kind of bacteria to thrive.

Dr. Nicole McKenna
Dental professionals will not be able to do as good of a job if the patient is not doing their part daily.

The bacteria consume the starch and sugar left behind after the food you ate. They will digest it and excrete a shiny film called plaque that will cover your teeth. This gives them a hiding spot, safe from brushing and mouth rinsing. They also produce lactic acid, which begins eroding the enamel, causing cavities.

The only way to remove calculus (hardened plaque) is to have your teeth professionally cleaned.

How much does teeth cleaning set you back? You should consider the cost of a dental evaluation every six months or so. The price for a prophylaxis should be included in your budget twice a year as well, while paying for a deep clean is only required if the need arises.

Dental cleaning risks

The biggest risk connected to dental cleaning is not having it as regularly as you should. Putting it off could lead to:

  • loss of this connective tissue,
  • bone loss,
  • tooth loss, or even
  • heart trouble.

However, some might have extra steps to take before having their teeth cleaned. If you take blood-thinning medicine you might have to stop for a few days before your procedure. Don’t make this decision yourself though; always follow instructions of a licensed medical professional.

Some patients are more likely to develop an infection after a deep cleaning. If you:

  • had anything replaced with an artificial counterpart,
  • have a heart condition,
  • suffer from liver disease or AIDS,
  • or if you have any other condition that might weaken your immune system

you must let your dentist know before having any of the procedures mentioned in this article. He or she will advise you on how to proceed.

FAQ

How long does a dental cleaning take?

A prophylactic cleaning can take between 30 minutes up to an hour.

Is dental cleaning painful?

If you practice regular oral hygiene at home, complete with brushing and flossing, a cleaning should cause minimal discomfort. Sensitivity and pain are reactions that concern patients who neglect to take care of their mouths as advised by the ADA.

In the case that you are highly sensitive to pain or suffer from dental anxiety you can take an OTC painkiller before your appointment or ask for anesthetic. It is also a good idea to switch to a desensitizing toothpaste or mouth rinse a few weeks prior to your appointment.

What not to do after dental cleaning?

It’s a good idea to avoid eating until you no longer feel numbness in your mouth. In particular, do not eat acidic foods like citrus fruits, as your enamel might be sensitive after the procedure. Hot and cold foods can also cause you pain directly after a cleaning.

What are side effects of teeth cleaning?

You might experience some tenderness or swelling in your gums, but that should subside within a day. Slight bleeding from soft tissues in the mouth can also happen.

You are free to take OTC painkillers to numb discomfort after the procedure or rinse your mouth with saltwater.

How is dental cleaning related to general health conditions?

Neglecting dental care can lead to general health conditions, just as those conditions can lead to poor oral health. In particular, foregoing these appointments has been linked to heart disease.

Other general conditions that make themselves apparent in the mouth include asthma, cancer, HIV or AIDS, obesity, diabetes, as well as kidney, lung, and liver disease.