Dental Cleanings: Keeping Your Teeth in Your Smile
Most of us know that dental cleanings are “important,” but not everyone knows why.
- Dental 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 cleanings?
When you call to schedule “a cleaning,” you’re asking for a specific service, right?
In reality there are asking five clinically different kinds cleanings. Why hasn’t anyone told you this before? Well, we dentists may be great at fixing teeth, but we aren’t known for stellar communication skills.
Understanding the different cleanings is probably easiest if you think of a dental cleaning like a car wash. Full service car washes usually offer different types of washes: a basic wash, a heavy duty wash, a bug scrubbing service, a deep clean detail wash, etc… Let’s see how these compare to dental cleanings. You’ll be amazed at the similarities!
#1 The Basic Wash Cleaning
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 is a 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’ job of shielding the teeth from invading bacteria is easy. 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
What if your usually wash your car regularly, but then you miss a few washes?
Your car is going to need a little extra help to get it clean, right? Maybe it will need some extra scrubbing or rinsing in places or a second run through the basic car wash to get the extra dirt off.
Your teeth are the same.
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 been multiplying and plaque has caked onto the teeth until was rock hard tartar and calculus.
At this point, your gums are probably red and puffy and bleed when you floss. We call this gingivitis – and it’s an infection in the gums.
With gingivitis, perio-probings are no longer all 3 mm and less. Some deeper 4mm and 5 mm pockets have sneaked in as well.
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 cleaning requires special techniques and it will take two appointments to guarantee that the infection has been dealt with: one appointment for the preliminary cleaning and another one to finish up a few weeks later after inflammation has gone down allowing us to see what is left.
If someone gives you “just a cleaning” when you haven’t had your teeth cleaned in over a year, we can guarantee that you aren’t getting your teeth back to completely clean because a hygienist cannot see through the red, puffy, bleeding gum tissue to do the detailed cleaning in that first appointment.
#3 The Bug Scrub Cleaning
Now, imagine you’re a city driver who lives in San Antonio and it’s butterfly season. Without a bug scrub before your car wash, you’ll end up with a semi-clean car dotted with yellow bug guts.
This is 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, but 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, this is called a debridement.
#4 The Deep Clean Detail Cleaning
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 is going to require a multi-step deep clean detailed wash – inside and out.
And that’s what happens if someone has gum disease too. 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. This is called advanced gum disease or Periodontitis.
Why are these “periodontal pockets” a problem? Those pockets are the perfect home for bacteria that kills 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 is to clean the dead cells and kill the bacteria. This deep cleaning gum therapy is called root planing and scaling and can take several appointments of one to two hours each to clean the whole mouth.
SPOILER ALERT: If anyone claims to perform root planing and scaling but completes your whole mouth in an hour, either they were not performing 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 minimum 1 hour and 30 minutes per half of your mouth.
#5 Deep Clean Maintenance Cleaning
This final type of cleaning doesn’t fit our car wash analogy because the human mouth is alive and coping with bacteria and cars can’t get infected. When people need deep cleaning gum therapy, it is because they have Periodontitis, that nasty infection deep under their 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 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. Regular dental cleanings keep breath fresh.
- Fewer Cavities: Regular 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: Regular dental visits insure that problems are caught small. 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 and unfair to have to get a “special cleaning” just because they haven’t been in a while. This is even harder to explain when many other 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 is not going get cleaned out with a regular cleaning. The built up bacteria is what 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 mouth needs to be healthy. Offering a “regular” cleaning when you need more is like putting a band-aid on a cut that needs stitches: the band-aid feels like treatment but it won’t heal the cut properly.
Getting healthy requires getting clean – all the way clean.
Is Gum Disease really that big of a deal?
Gum disease or Periodontitis is one of the most deceptive diseases in the human body. In its beginning stages, periodontitis is painless and invisible to a non-dentist. It gives hardly any warning signs until it is too late.
How is this possible? Well, periodontitis is an infection under the gums in the dark spaces that we can’t see and can barely feel. As the disease advances, we begin to smell the infection and can see the gums get red and puffy and bleed. However, without x-ray images, we can’t see the bone melting away. Most people who lose their teeth to periodontitis can’t believe that teeth without cavities would just get loose and fall out without hardly any warning.
Gum disease is the number one cause of adult tooth loss and is a disease that increases inflammation throughout the body. The inflammation from gum disease causes complications for diabetes, heart disease and autoimmune disorders. When periodontitis hurts, it’s too late to save teeth. Save your teeth today by keeping your gums healthy and infection free!