As a dental hygienist, I know many people have wondered what a teeth cleaning is.
Have you been putting off this procedure?
Afraid of what might happen during your visit?
I am here to explain everything you can expect from this routine dental visit.
Oftentimes, people avoid going to the dentist simply because they are uncertain of what to expect.
Or maybe you are familiar with the dentist but do not understand what the procedure entails.
I want to fill you in on everything that happens during this visit to put your mind at ease as to what a teeth cleaning is.
This article will explain step by step the what, when and why of each portion of this very important visit.
I will be referring to you as the patient throughout this article.
After your teeth have been cleaned they will appear brighter and your mouth will feel fresher.
However, the reason for a teeth cleaning is not all about appearances.
More and more studies have shown the correlation between a healthy mouth and your overall health.
This means that a teeth cleaning will benefit more than just your mouth. It will benefit your whole body.
You can learn more about a teeth cleaning from Wikipedia.
Arriving To the Hygiene Appointment
When you, the patient, appears for a dental evaluation, cleaning, exam and xrays, you will be scheduled with the hygienist.
This appointment may be either a recall (returning visit) or a new patient exam.
Initially, you will fill out all registration information, insurance information and a complete medical history.
Your health history should be updated at every appointment for any changes to health, recent illnesses or surgeries and any new or different medications.
Why is this important?
The reason for this is that certain conditions or medications affect the health of the mouth and your dental professional needs to know how best to treat you.
For example, certain medications may cause inflammation and blood thinners may cause bleeding gums. Conditions such as diabetes will affect the health of your gums as well.
Also, it is important to know about any artificial joints or heart valve replacements.
Dental procedures may require antibiotics to help protect your health against infections.
Knowing your blood pressure status is also very important as dental anesthetic can affect your blood pressure.
Be sure to be complete when listing all your health conditions and medications as this will help your dentist treat you based on your specific needs.
Don’t forget to list any supplements you may be taking as well.
Most people forget that certain supplements act the same way as prescribed medications. An example of this would be fish oil which is also a blood thinner.
If you have a current medical history on file with your dentist, it is best to have this information reviewed with you and updated for any recent changes prior to your appointment.
At the Beginning of Your Appointment…
You will be greeted kindly at the beginning of your appointment and made to feel comfortable. Your hygienist will ask you if you have any concerns with your teeth or gums.
Listening to any concerns you have is very important.
Upon listening, your chief complaint can be determined as well as any other concerns.
Certain considerations and risk factors will be determined in evaluating your concerns.
Such factors may include: your age, medications, tobacco usage, stress and social and economic status.
Also, your medical history will be taken into consideration noting if there are any systemic diseases like diabetes present.
Next, an extra oral and intra oral exam are completed.
During the extra oral exam, your lymph nodes, skin, eyes, lips and jaw joint (TMJ joint) will be examined.
Any abnormalities will be noted in your chart. These abnormalities may include such things as swelling, inflammation and discoloration. The jaw joint will be examined for any unusual pain or clicking and popping noises.
For the intra oral exam, the hard and soft palate (roof of your mouth), tongue, cheeks and throat are examined.
This is an oral cancer screening and you will be notified of any suspicious areas that may need further evaluation by your medical doctor.
The inside of your lower mouth, inside and outside of your lips, borders and underneath side of your tongue, tonsil area and back of your throat are all areas included in this exam.
The intra and extra oral exams are very important and will be done at every cleaning appointment regardless of whether you are a new or existing patient.
A Restorative Evaluation Is Next
You may wonder what this is. A restorative evaluation is an exam looking for work that needs to be done.
This would include looking for decay (cavities), broken teeth, chips, cracks or infections of existing teeth.
The hygienist will perform the initial restorative evaluation looking for anything suspicious to bring to the dentist’s attention.
A dental hygienist cannot legally diagnose any work that is needed but they can alert the patient as to areas that the dentist will need to further evaluate.
After a thorough investigation of your teeth is complete, it is time to evaluate your gum tissues.
This is called a periodontal evaluation and you will have this done at each teeth cleaning appointment.
The reason this is needed at each visit is that a lot can change with your gum tissues from one visit to the next.
Your gums will be evaluated by the dental hygienist with a small measuring device called a probe.
What the probe measures is the depth of the gum tissue in millimeters that is surrounding the teeth.
A normal healthy gum measurement would be anything 3mm or less.
Any measurement above 3mm would indicate a pocket or loss of attachment. This would be a sign of gum disease.
Your hygienist will take measurements of your whole mouth once a year and a PSR screening on 6 month evaluations. PSR stands for periodontal screening report.
There are other things your hygienist will be evaluating when checking your teeth and gums. You will also be evaluated for mobility (loose teeth), bleeding and receding gums.
Why Xrays Are Important
As part of the restorative exam, xrays will be used to evaluate any areas that cannot be seen in the mouth just by looking clinically.
What these mean are the areas underneath existing fillings, between the teeth, under the gumline, the bone structures supporting your teeth and infections of the teeth.
Learn more about the importance of dental xrays from Wikipedia.
There a different types of xrays taken by your dentist.
The bitewing xrays show decay best and are usually taken as a set of 4 xrays for an adult or a set of 2 xrays for children under the age of 12.
Children under 12 do not usually have their second or twelve year molars erupted yet so 2 xrays are adequate to see all of their teeth.
The panoramic xray is an xray of your full mouth. You will usually have this xray taken at your teeth cleaning appointment if you are a new patient or once every 5 years.
This is an xray that shows the entire jawbone, sinus area, TMJ (jaw joint), bone levels and signs of infection.
This is also used as an oral cancer screening as it shows possible cysts and tumors and oral cancerous lesions.
Ideally your dentist will want to update your xrays on a once a year basis for bitewing xrays and once every 5 years for a full mouth xray.
Your dentist will ask your permission before taking xrays.
Why Do You Need a Teeth Cleaning?
Your dental hygienist and dentist will put together a treatment plan on how your teeth should be cleaned based on the information gathered during your assessment.
Tartar forms on your teeth when dental plaque is not fully removed on a regular basis with your day to day home care routine.
Minerals in your saliva combine with the unremoved plaque to form crystals that harden into tartar.
This tartar acts as an area to trap more bacterial plaque. The plaque give off toxins which cause inflammation in the gums.
In defense to rid you of this inflammation, the bone and supporting structures of your teeth will slowly be lost.
This is considered periodontal disease or gum disease.
There are supplements to help with inflammation that your dentist may suggest to treat and prevent gum disease.
You need to have your teeth cleaned on a regular basis to remove the deposits that form above and below the gumline.
There are areas where it is impossible for you to reach with your home care routine that only your dental hygienist can remove.
Plaque and inflammation in the mouth has been shown to be correlated with many other health conditions of the body.
Ongoing research is proving the correlation between gum disease and diabetes, heart disease, Alzheimer’s Disease, strokes, cancer and premature births to name a few.
A healthy mouth with minimal plaque, tartar and minimal inflammation will require a routine dental cleaning.
When there are signs of disease present, you may require a more in depth cleaning referred to as a “deep cleaning” or gross debridement.
A gross debridement is usually followed up by a second appointment to remove the remaining deposits from your teeth once the inflammation has subsided.
If you have gum disease present, you may require a series of appointments to completely remove all the tartar deposits completely.
This type of cleaning is called scaling and root planing and will require anesthetic or “numbing” to make you more comfortable.
What A Teeth Cleaning Is……
Another name for a teeth cleaning is a dental prophylaxis. The procedure usually takes 45 minutes. A one-hour appointment is reserved if it is your first visit.
The purpose of a teeth cleaning is a measure to preserve a healthy mouth.
A teeth cleaning is done to remove bacterial plaque (biofilm) and tartar from all surfaces of your teeth.
A routine cleaning is performed on a healthy mouth where there is no inflammation or bleeding.
If there is a heavy build up of tartar above and below your gumline, you may require a more in depth cleaning.
This type of procedure is called scaling and root planing and will be done using local anesthetic for your comfort.
Scaling and root planing is done in several visits and the purpose is to remove tartar and toxins from the roots of your teeth as well as the crown portion.
This deeper type of cleaning it done to reduce the pocket formation caused by gum disease.
When your pockets are reduced, this allows you to effectively clean your teeth and maintain gum health with your own home care techniques.
Your dental hygienist will use a series of tools and instruments to remove all deposits and stains from your teeth.
Hand instruments are used called scalers and curettes. These are sharp metal instruments that can scrape and smooth the teeth and root surfaces to remove tartar deposits.
Another tool used is called an ultrasonic scaler. This is a power driven scaler which works by supplying high-frequency vibrations to remove plaque and tartar from your teeth.
There are different types of power driven scalers but they all work in a similar way. An electromagnetic force is created in the scaler which causes the tip to vibrate at a very high pace.
These vibrations are faster than the speed of sound and they will effectively remove any plaque, tartar or stains from your teeth in a third of the time it takes to use hand instruments.
A flow of water comes through the tip to keep it cool since the high frequency vibrations create heat.
Some people prefer the use of ultrasonic scalers versus hand scalers because of their efficiency and less pressure needed to remove the deposits. Less pressure can mean better comfort.
Usually a combination of regular instruments and power driven instruments will be used during your appointment.
Polishing is done once instrumentation is complete. A medium to coarse grit polish is used for most adults whereas a fine grit polish is adequate for children.
The coarse grit polish is advised for removal of surface stains from tobacco, mineral deposits, coffee and tea.
A handpiece will be used with a disposable polishing tip that has a soft rubber cup.
This rubber cup will be positioned on all surfaces of your teeth.
The purpose of the polishing is not purely aesthetic. Polish contains fluoride and it will be incorporated into your teeth enamel with the polishing procedure. This will help to strengthen and protect your teeth from cavities.
The polishing also provides a nice smooth surface on your enamel following the scaling procedure. This makes it more difficult for bacterial plaque to reattach in the future.
Following the polishing procedure, you will have all of your teeth flossed to remove any remaining polish from between your teeth.
Fluoride varnish can be applied if you wish to further strengthen and protect your teeth.
This is a very concentrated form of 5% Sodium Fluoride and it is recommended to have this applied following the teeth cleaning procedure.
You will be instructed not to eat or drink for a period of time (usually 30 minutes) to allow it to stay on your teeth for as long as possible for better absorption.
Also, it is advised not to brush or floss for a period of 4-6 hours following application to keep the fluoride in place on your teeth.
The Most Important Part of a Teeth Cleaning…
Oral hygiene instructions are the most important part of a teeth cleaning.
Your dental hygienist and dentist will evaluate how well you are taking care of your teeth.
You will be questioned on your home care techniques and given advice on how you may improve the health of your teeth and gums.
Nutritional counseling is also a part of a teeth cleaning appointment. Soda consumption, sugar intake and acidic foods and drinks in your diet will be evaluated.
Many people are not aware of how diet and nutrition affect the health of their teeth and gums.
You will be informed of areas that need improvement and instructed on what you can do to maintain a healthy mouth.
Home care guidelines are specific for each person dependent on their teeth, dexterity and the health of their mouth.
Floss is most often recommended for the in between areas but water flossing may prove to me more effective for cleaning these areas.
Studies have shown that oral irrigators remove twice as much bacterial plaque from between your teeth as flossing does.
Some people may be instructed to use an electric toothbrush versus a manual brush.
You will find that by using an electric toothbrush you will remove much more bacterial plaque.
You might be given advice to use a product combining an electric toothbrush with an oral irrigator. This product is called SonicFusion by Waterpik.
This type of technology is at the forefront of optimal oral hygiene home care products.
The reason for this is the fact that an electric toothbrush will provide you with 30,000 to 50,000 brush strokes per minute versus the mere 500 brush strokes per minute a manual brush will provide.
Electric toothbrushes also have a built in timer to allow you to brush for the full dentist recommended 2 minute time frame.
If you have compromised saliva flow, your dental professional will console you on ways to deal with a dry mouth.
Saliva is very important for keeping our teeth healthy and a lack of saliva can create lots of problems for our teeth including increased decay (cavities).
If you have a concern about ways to whiten you teeth, your hygienist will gladly explain your best options.
A Dental Exam Is Included in the Teeth Cleaning
After your teeth are thoroughly cleaned and polished, you will be asked if you have any questions.
You can also express any concerns to your hygienist or dentist at any point during the teeth cleaning procedure.
At the end of the appointment, the dentist will provide a thorough examination. This examination will take into consideration your oral cancer screening, gum health, xrays and a clinical evaluation.
You will receive a diagnosis of the condition of your teeth and gums and what work will be needed to treat your specific condition.
This diagnosis may include cavities, broken teeth, infections, gum disease or teeth that require extractions.
You will be given a treatment plan by your dentist that will restore your mouth to optimal health.
Options for restoring teeth or replacing missing teeth with implants will be thoroughly discussed.
Also, included in the appointment are any home care tips and alternative treatments that may help you achieve optimal oral health.
Some of the latest research focuses on preventing inflammation in the mouth to prevent disease.
Another area of promising research is in dealing with your oral microbiome. Just like probiotics for the gut, there are now probiotics for the mouth.
These specific oral probiotics are designed to help treat such maladies as bad breath, cavities and gum disease.
These work by encouraging the presence of good bacteria over bad bacteria.
A recall time frame will be established as to when you should return for your next check up.
If you have a healthy mouth, it will be advised that you return for your next teeth cleaning in 6 months. Most insurance companies provide this twice yearly protocol as part of their benefits.
Having conditions like gum disease or systemic conditions like diabetes will make it important for you to have more frequent teeth cleanings. A common recall for these conditions is every 3-4 months versus every 6 months.
Insurance also recognizes the importance of more frequent cleanings and will oftentimes provide you with additional benefits.
Now You Know What A Teeth Cleaning Is
I encourage you to get to your dentist and have a teeth cleaning done.
Your dental professional will help you stay on track to the most healthy version of you!
Knowing what to expect during a dental cleaning will help you to be comfortable during your visit.
You now know each of the individual components that make up the entire procedure and are well informed on what a teeth cleaning is.
Now you are going to be prepared for your visit and you will be prepared to ask questions of your dental professional.
Do not be afraid to ask questions! Your dentist and hygienist are specially trained to be able to answer your questions and concerns.
Please feel free to ask any questions below as well. I would be happy to help!