What is a deep teeth cleaning and how is it different from a routine dental cleaning?
When we come in for our routine cleanings, basically what we're trying to do is clean off the little bit of plaque and tartar that builds up around our teeth, usually around the gums. That plaque and tartar can cause what's called gingivitis, where the gums get inflamed, they're a little infected, they're a little angry. But when the hygienist cleans all that plaque and tartar off, then that infection goes away.
Now, if left unchecked, if someone has gingivitis and that plaque and tartar is allowed to stay there, that infection will actually spread from the gums to the surrounding bone around the roots of our teeth. And when that happens, it actually causes the bone to kind of melt away. It's almost as if you had a post that was buried in the ground, and you start digging away the dirt. Once you start digging away the dirt and you get to a certain level, that post is going to start to get a little loose, and eventually that post is going to come out. Well, it's the same thing with our teeth.
When that gum infection called gingivitis spreads to the surrounding bone, it then becomes what we call periodontitis. And that's an infection of not only the gums, but also the bone around your teeth. That causes the bone level to recede, and more and more plaque and tartar is going to attach along the root surface of the tooth. If that's left unchecked, eventually that's going to lead to losing your teeth. So, in order to stop that, we've got to go in and clean all that plaque and tartar off of the root surfaces of your teeth so that your bone and your gums can heal.
When do you recommend a dental deep cleaning for patients?
Whenever you come in for your routine examination, one of the things that the hygienist is going to do is probe your gums, and they're going to measure how deep the little pocket is around your tooth. Your gums come up and attach to your teeth. But right where they attach, there's this little pocket. It's usually about 1 to 3 millimeters deep, and that's normal. When that pocket gets deeper, say 5, 6, or 7 millimeters, that's how we know someone has that gum disease that's called periodontitis. When you have that, that's when we have to start off by doing the deep cleaning. It's also known as scaling and root planing, but just in layman's terms, people tend to say a deep cleaning.
What signs or symptoms might indicate someone needs a deep cleaning on their teeth?
Typically, the signs and symptoms of someone who needs a deep cleaning are red, inflamed gums that tend to bleed when you brush or when you floss. Now, usually, interestingly enough, periodontitis or gum disease is asymptomatic, meaning it doesn't hurt. You don't feel pain. But certainly, a lot of times you'll bleed a little more easily. And really, the way to definitively get a diagnosis is to come into the office so that the hygienist can probe around your teeth and measure the pocket depths around your teeth.
What is the deep dental cleaning process, and what can patients expect during the appointment?
Here's what to expect if you're coming in for a deep cleaning or scaling and root planing: The first thing that's going to happen is the hygienist is going to bring you back into the chair, probably check on your vitals, and make sure those are doing well, your blood pressure and pulse. And then she's going to get you numb because, in order to get the root surface clean, we've got to get underneath the gums to get that clean. She's going to get your gums numb, and then she'll go in, usually with a couple of different instruments.
One, she'll often use the ultrasonic scaler. This is a little instrument that vibrates at the very end of it. And what it does is it breaks up all of the deposits that you get on your tooth. She's going to use that. She'll also typically follow up with the hand scaler that many of us are familiar with, where she scrapes all that tartar off the teeth.
Sometimes there are some other adjuncts that we'll also use. We may use a laser, actually, to help clean out and sterilize the gum pockets around the teeth. Sometimes we might even use some antibiotics or antimicrobials, things that kill bacteria down inside of the gums. Those are some other things that we may or may not use, but for sure, we're going to go down and get all of the tartar off of the root surface of the teeth.
What are the benefits of deep cleaning teeth for patients with gum disease?
When someone has gum disease, it's really just a matter of time before those teeth are going to be lost. The other thing is, when you have a chronic infection like gum disease, it's actually a precursor for other types of diseases in your body.
There have been a lot of studies that have shown there's a link between gum disease and certain heart diseases. There's a link between gum disease and certain cancers. And so there are lots of other medical problems that gum disease is actually linked to. So, we want to eliminate gum disease, for sure, because we don't want you to lose your teeth, but we also don't want that to predispose you to other medical problems.
Are there any disadvantages of deep cleaning teeth or temporary side effects that patients should know about?
There are really no disadvantages to doing a deep cleaning. Now, there are some temporary side effects. Oftentimes, after a deep cleaning, it can be a little sore in the gums. Usually, Tylenol or ibuprofen, and using warm salt water rinses can really help soothe that and make it feel better. But usually that's only for a short while after the cleaning. Really, doing that deep cleaning when it's needed will help stop the effects of periodontitis, so you don't lose your teeth.
Why do some patients notice gaps in their teeth after a deep cleaning?
What happens with periodontitis or gum disease? It causes the bone to recede around your teeth. Now, eventually it's going to cause the gums to recede, too. But sometimes what does happen is, because the gums are so inflamed, they'll actually get bigger and expand while that gum is getting lower and lower. And so, it's almost this false sense of security where your gums and your bone really are receding, but because they're so swollen, sometimes it looks like they're at the normal level. Then, when we go in and get things healthy again, clean everything out, those gums, as they get healthier, will kind of shrink and get tighter. So because of that, oftentimes you don't know you have receded gums until after they're healthy again, because, as they get healthy again, the swelling in the gums will go down, and then you'll be able to see a little bit more of the root surface.
What kind of results can patients expect from deep cleaning teeth before and after treatment?
Patients can typically expect to have great results from a deep cleaning. Most of the time, when we have people come in, and they have gum disease, aka periodontitis, when they have their deep cleaning, most of the time that will resolve the problem.
Now, in some rare cases, there are other steps that we have to take, but that's really something that we would look at probably about 4 to 6 weeks after you have your deep cleaning. And like I said, most of the time that's all people need, just to have that deep cleaning.
We do want people to come in more frequently after a deep cleaning. Typically, we'll set a recall schedule of maybe every 3 months or 4 months rather than the normal 6 months because we really want to make sure that that gum disease stays at bay, that it's not coming back. Because that is one important thing to know: if you don't stay on it, that gum disease, periodontitis, can come back, and we don't want that to happen.
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