Why Are Dental Cleanings Important?
Most people think about coming to the dental office to get their teeth cleaned every 6 months. But what does this really mean? What am I having cleaned off, who is doing it and what happens if I don’t get this professional service regularly? These are all important questions to answer and what we will be addressing today!
The official term for a dental cleaning is “prophylaxis” sometimes shortened to “prophy”. Prophylactic means a preventative measure. In general terms, it is a medication or treatment designed and used to prevent a disease from occurring, in this case periodontal disease and dental decay. A prophylaxis in dentistry is known as a healthy cleaning. The teeth are cleaned or scaled above the gumline where plaque and tartar are gently removed. Plaque is a sticky bacterial colony that lives on teeth, multiplying rapidly when exposed to carbohydrates. When your dental hygienist is scaling your teeth, she is interrupting the adhesion between the plaque and enamel and the harmful bacteria is taken off. Tartar, officially called calculus, is hardened plaque formed by minerals from saliva depositing into plaque that has been present on a surface for a longer period of time. Calculus is a non-living, hard crust. It is rough and causes even more plaque to adhere to its surface. By removing the calculus, you also remove the bacteria that are living in the calculus.
The prophy appointment has several steps. Most of your appointment is spent with a dental hygienist then an examination is completed by your dentist- Dr Van Huffel. Your hygienist will review your medical history, take your blood pressure and ask questions about any problems you may be having with your teeth. She will take any x-rays that Dr. Van Huffel requests and perform a head and neck cancer screening and a periodontal probing to look for gum disease. See our blog on X-Rays to find out more about just how valuable x-rays are. Your hygienist will use instruments to gently remove all plaque and calculus from around your teeth above the gumline. A soft rubber cup and special toothpaste remove the protein layer and any fine stains from the enamel. After the healthy cleaning or prophy is completed, an instrument called a Diagnodent is used. It measures the presence of material related to decay in the enamel. The numbers range from 1-99. The higher the number the more evidence of decay and need for a filling. Dr. Van Huffel’s exam revisits some of the above items and looks for decay, broken teeth or fillings and weakened teeth. Your hygienist and Dr. Van Huffel can also discuss improvements to the appearance of your smile and chewing function.
In a healthy prophy, the procedure of scaling removes the rough calculus and plaque from the teeth. This process is done by scaling with hand instruments or an ultrasonic instrument called a Cavitron. A Cavitron has a slender tip that produces high frequency sound waves that vibrate the calculus off the teeth. A gentle stream of water flows from the tip which gives the added benefit of flushing food debris, bacteria and biofilm from the gums. Biofilms are the beginnings of plaque formation. The hygienist can monitor your brushing and flossing technique and coach you to healthier gums that do not need more advanced periodontal treatment.
The next step is measuring between the teeth and gums with a periodontal probe that is placed gently into an existing space at the top edge of the gums. The gums should be snug around the teeth and a healthy pocket will usually measure 1-3mm. If the gums are not snug and the space and number is greater than 3mm with the presence of bleeding, then a different procedure is needed. This more advanced gum care is called Scaling and Root Planing and it will be explained later.
The frequency of the prophy will usually be determined by the amount of calculus that is accumulated on your teeth and how effectively you are removing it. However, some medical conditions can also affect the optimal frequency of hygiene visits for you. Diabetics, people with heart disease and pregnant women will commonly come into the office every 3-4months for professional hygiene cleaning visits. Gum health can have a huge impact on heart, brain and lung health, the immune system and healthy pregnancy. The inflammation and blood bacteria levels are key to these diseases and many others. Determining and committing to keeping the right dental hygiene frequency is very important for overall health.
When the spaces between the teeth and gums are 4mm or greater, you have Periodontal Disease, also called Gum Disease. Pockets that are 4mm or greater and bleed when measured contain bacteria in your mouth are too deep to clean with a regular prophy. That is when a periodontal cleaning is necessary. Periodontal cleaning can also be known as Scaling and Root Planing or Deep Cleaning. Local anesthetic is used to numb the area to make it more comfortable to remove the bacteria and calculus. Usually when a full mouth of Scaling and Root Planing is done, 2 separate appointments are needed. After the treatment is completed, 4 weeks is allowed for optimal healing and recovery from the periodontal infection. You will then see your hygienist again to measure and assess the healing. For patients with lingering active gum disease or history of gum disease, it is usually necessary to come in every 4 months to keep the bacteria from colonizing and risking the need for a deep cleaning again.
This time spent with your hygienist and Dr. Van Huffel is so valuable. Reviewing your medicines helps us alert you to side effects that show up in your oral cavity. You may not be aware of treatments for dry mouth. Acid reflux can cause significant tooth problems as well as airway problems. High blood pressure can be caught simply by having the blood pressure taken. The x-rays help the provider see calculus or tartar under the gum tissue and if there is bone loss or decay present or starting. Decay caught early saves teeth and money.
Prophy visits for children are a bit different from adult visits. Please check back soon for our “Kid’s Cleaning” blog post!
Anyone can have a confidence-boosting smile. Please call us today for an appointment to discuss how we can help you keep your smile healthy for a lifetime!
Dr. Maria Van Huffel