Depending on the condition and health of the periodontium (the gums and underlying bone that holds the teeth in place), there are four different cleanings that may be done. Each cleaning has a different goal to return the soft tissues of the mouth to health.
Prophylaxis (Standard Cleaning)
A standard or “regular” cleaning is the most common cleaning performed. Think of this as the typical six-month checkup cleaning. This cleaning is appropriate for adults and children who have normal, healthy gum tissue and show no signs of periodontal disease.
- The goal of this cleaning is to remove plaque (the soft, gooey buildup of bacteria) and calculus (the firm tartar buildup that results from unremoved plaque) to provide a clean, smooth surface that resists the return of subsequent plaque and calculus.
- The hygienist removes plaque and calculus build up from around the teeth with various instruments such as ultrasonic scalers (ultrasonic vibration helps remove tough tartar build up), Prophy Jet (an instrument that uses gritty particles and air pressure to remove stain and rough areas on teeth), and manual hand scalers (fine instrumentation that allows the hygienist great tactile sensation to ensure a smooth tooth surface).
- The hygienist will use a soft rotating rubber cup to polish all the teeth with a gritty paste to ensure a high shine and super smooth surface to leave a fresh, clean-feeling surface.
- The cleaning finishes with a thorough flossing to remove hard to reach plaque from between teeth.
When it has been a while since your last professional cleaning, plaque and calculus build up may require more than what a Standard Cleaning can provide.
- The goal of a debridement is to focus on removing the dense calculus buildup that can cause gum tissue to become inflamed, irritated and bleed easily.
- The hygienist will remove the calculus buildup with the same instruments as in the Standard Cleaning, but the ultrasonic scaler is the instrument of choice to remove the difficult buildup.
- After the debridement, the irritation and inflammation in the gums disappears and a fine polish can be performed at a later date. Patients will notice pink, firm healthy-looking gums that do not bleed only days after the debridement.
Periodontal Scaling and Root Planing
Commonly referred to as a “Deep Cleaning,” it is required when periodontal disease is present. Periodontal disease is an infection of the gum tissue and bone that holds the teeth, diagnosed by taking measurements of the tiny pockets between the teeth and the gum tissue. Deep pockets are impossible to clean with a toothbrush.
- The goal of a Scaling and Root Planing is to remove plaque, calculus and dangerous bacterial buildup from below the gumline in difficult to reach pocket depths. This is important to protect the bone that holds the teeth in from damage by the infection.
- A Scaling and Root Planing procedure is typically performed in two appointments because it requires great attention to detail to ensure a smooth tooth surface that resists bacterial growth.
- The dentist, to ensure patient comfort, first numbs the areas of the mouth that are to be scaled. The hygienist uses various instruments to remove plaque, calculus and bacterial buildup, especially from the deep pockets.
- After the bacteria have been removed, the gum tissue heals over time and the deep pockets become more shallow and easier to clean. The patient is then put on a three-month recall schedule for cleanings because the bacteria can accumulate to a level that causes bone damage after only 90 days.
This is a cleaning done every three months for patients who have been through Periodontal Scaling and Root Planing. The more frequent cleanings help maintain the results achieved by the Scaling and Root Planing treatment.
- The goal of the Periodontal Maintenance cleaning is to remove the damaging bacteria from the teeth before it accumulates to a level that can cause bone loss.
- Research has shown that bacteria can accumulate to a dangerous level in only 90 days, so it is important to perform consistent three-month cleanings to remove that bacteria before damage is seen.
- The hygienist performs a Standard Cleaning with additional attention and care to the areas that are particularly difficult to reach. Sometimes antibacterial rinses will be used as an additional defense to bacterial accumulation.
It is important to remember that every patient is unique and a proper diagnosis and course of treatment will be discussed with you and determined by the entire dental team at your first visit.