Dental Cleaning - Process, Techniques & Recovery After Cleaning

Listed below is the step by step procedure of Dental Cleaning:

1. What is dental cleaning?
2. When is tooth cleaning required?
3. Diagnosis
4. Steps in tooth cleaning process
5. Types of dental cleanings
6. Techniques for dental scaling
7. Recovery after cleaning
8. Advantages and Disadvantages of deep cleaning the teeth
9. Can dental cleaning harm the teeth?

What is dental cleaning?

Dental cleaning or teeth scaling is the procedure for removing accumulated plaque, tartar, and stains from the teeth. Professional teeth cleaning can be of two types - routine cleaning and as a part of oral prophylaxis. 

Routine cleaning is performed once every 6-8 months to maintain oral hygiene and prevent severe gingival or periodontal issues. During routine cleanings, your dentist helps you assess which areas in your oral teeth are prone to plaque accumulation to help you clean them better.

On the other hand, oral prophylaxis, or deep dental cleaning, is a dental treatment performed to clean the oral cavity to halt the progress of developing periodontal and gingival issues. It is generally required in patients who have never had a dental checkup in the past and includes dental deep cleaning, dental x-rays, periodontal probing, and oral cancer check.

When is tooth cleaning required?

The origin of many health issues like cardiovascular disease, digestive issues, etc., can be traced back to poor oral hygiene, thus, good oral hygiene is a proven way of improving health and preventing certain systemic disorders. Tooth cleaning is generally required if the patient has:

• Dental plaque and calculus accumulation
• Oral malodor (Halitosis)
• Gingival pain and inflammation
• Bleeding gums
• Frequent food lodgement in teeth, etc.

Tooth cleaning is also recommended in patients with calculus on the visible tooth surfaces, giving poor smile aesthetics. Clean and polished teeth will improve the appearance of the patient’s smile and self-confidence. 

Diagnosis

Before the tooth cleaning process, the dentist will thoroughly examine your oral cavity for signs of plaque accumulation, food stains, gingival or periodontal disease, tooth decay, etc. Diagnosis before tooth cleaning entails:

• Teeth examination: An oral examination is performed using a dental probe and mirror. The dentist notes how much plaque and calculus are present on the tooth surface. They also check for signs of caries, tea/coffee stains, etc.
• Gingival/periodontal probing: Following the teeth examination, the dentist uses a gingival or periodontal probe to look for signs of gingival inflammation and recession. If the patient has red and inflamed gums with gum bleeding, then it is a sign they have gingivitis/periodontitis, and they should get root planing along with scaling.
• Dental X-rays: Dental x-rays are required if the patient has severe pain in a tooth. It helps the dentist diagnose root disease and the severity of tooth decay (if present).

Steps in tooth cleaning process

Tooth cleaning can be a daunting process for many people, especially because of the generalized phobia regarding dental clinics and treatments prevalent in society. However, dental cleaning is a completely painless process and can be successfully completed in less than an hour without any complications.

The steps involved in a dental cleaning process are:

Removal of plaque and tartar

Using the dental mirror as a guide, the dentist will use a scaler to remove the plaque and calculus accumulated next to the gum line. The scaler can be hand-held or connected to a device that makes it vibrate at a high frequency. You will experience slight discomfort, but there will be no pain. During this process, there is usually a small amount of bleeding from the gums, but it is usually insignificant and painless.

Tooth polishing using an abrasive polishing paste

Following scaling, the teeth will be polished using a plastic cup and an abrasive tooth polishing paste to any leftover tea, coffee, or food stains present on the teeth. It generally feels like regular tooth brushing, but the shape of the polishing cup and consistency of the paste provides more thorough cleaning than possible if done by hand.

In addition to these, your dentist may also perform expert flossing and fluoride application to prevent caries if you need them. While you can floss yourself, dentists help floss hard-to-reach areas and clean in difficult spots. Fluoride generally helps in caries prevention, and fluoride application is done if the patient is suspected to be prone to caries.

Types of dental cleanings

Based on your oral healthcare needs, there are 4 major types of dental cleanings:

Dental scaling

Dental cleaning, or prophylaxis cleaning, is usually performed in patients with an overall healthy oral cavity who only need slight help in managing oral hygiene. They need very little tooth cleaning or polishing for unwanted plaque and stains on the teeth.

Scaling and root planing

Scaling and root planing are performed if the patient has severe calculus around the gums, along with recession of gums or bone loss. In addition to teeth cleaning and polishing, it involves smoothening of the roots. It can take multiple dental appointments to complete, and the initial appointment may need local anesthesia if the patient has unavoidable gum pain.

Gross debridement

Gross debridement is usually required in patients who haven’t visited a dentist in a while and have severe periodontal disease. It is a multi-step process in which the dentist assesses the amount of help the patient needs and plans out their treatment accordingly.

Periodontal maintenance

Periodontal maintenance is required in patients with severe generalized gingivitis or periodontitis, along with slight tooth mobility. The patient has to visit the dentist regularly to prevent tooth mobility and complete tooth loss.

Techniques for dental scaling

Hand scaling

During hand scaling, the dentist uses a combination of hand scalers to clean the teeth based on the tooth shape and location. It requires more effort from the dentist, takes more time, and can lead to more patient discomfort and gum bleeding, but it is generally considered to be the most thorough dental cleaning process.

Ultrasonic scaling

For ultrasonic cleaning, the scaler is attached to a motor that vibrates it at a high frequency to dislodge the accumulated calculus and plaque. Since the vibrating motion can heat up the scaler, it is connected to a water source to cool down the heated scaler and prevent damage to the tooth surface. It is faster and causes less discomfort to the patient but is less thorough than hand cleaning.

Most dentists prefer a combination of both hand scaling and ultrasonic scaling, i.e., ultrasonic scaling followed by hand scaling, for the best results. 

Recovery after cleaning

After tooth cleaning has been completed, you may have slight pain and sensitivity in your gums for a few days because of gum inflammation. You can manage them by following the given tips:

• Eat soft room temperature foods like yogurt, applesauce, mashed potatoes, etc., for a couple of days. Once the sensitivity recedes, you can go back to your regular diet.
• Avoid extremely hot or cold foods and drinks. Also, avoid drinking fizzy drinks like sodas.
• Rinse your mouth with lukewarm saline water at least 4-5 times a day and after meals.
• Brush and floss your teeth properly on a regular basis. If your gums are too sensitive, you should use a soft-bristled toothbrush. Make sure you follow the proper brushing technique. You can also use mouthwash if you think you need it.
• Take over-the-counter pain medicines, but only if you need them.
• Get regular dental checkups to ensure your teeth are in good condition. 
• Quit smoking. The nicotine and tar present in cigarettes can lead to gum disease and poor dental hygiene.
• Don’t brush or floss your teeth too aggressively, as that will put undue stress on the gums and strip them away from the proper position.
• Sugar-free gums can also help dental hygiene as they promote saliva production. Saliva has natural antibacterial properties that fight bacteria and prevent gum disease.
• Certain foods, like raw carrots, apples, celery, and popcorn, can also help clean teeth and prevent food lodgement in teeth.

Advantages and Disadvantages of deep cleaning the teeth

Advantages of tooth cleaning:

• Prevents the advancement of gum disease
• Promotes healing from oral gum and bone diseases
• Removes bad breath
• Protects roots of teeth from infection and mobility
• Promotes healthy gums
• Prevents tooth loss

Disadvantages of tooth cleaning:

• Slight pain and gum sensitivity for a couple of weeks after cleaning
• Can lead to slight gum recession in patients with gingivitis
• Increased risk of gingivitis after treatment
• Does not guarantee that gum will re-attach with teeth

Overall, the pros of tooth cleaning outweigh its cons. The after-effects of tooth cleaning usually only last for a few days, as long as the patient doesn’t already have severe gingival or periodontal disease. Patients who already have a severe gingival recession and bone loss due to poor oral hygiene should carefully consider whether they should get tooth cleaning, as it may exacerbate their symptoms.

Can dental cleaning harm the teeth?

No, dental cleanings do not harm the teeth. The scaler has a blunt surface that is not capable of eroding the tooth enamel. Normally, patients may have slight gum sensitivity due to inflammation, but it resolves itself within a few days. Patients with periodontal disease and bone loss can experience more severe after-effects of cleaning due to loss of gingiva, but the dentist will properly guide the patient on how to deal with them to prevent pain and tooth loss.