Do I need a deep teeth cleaning?

One of the most common scenarios we see are patients who haven’t been to the dentist in a while and are told they need a deep teeth cleaning. They don’t have any pain, which makes them skeptical of this diagnosis given the cost of deep cleaning teeth, and come to me for a second opinion.

Deep teeth cleanings are often misdiagnosed when a routine teeth cleaning is really all that is needed for the patient. Unfortunately, some dental clinics take a more aggressive approach when prescribing this treatment. To ease the patients’ mind, I tell them there are several signs deep cleaning treatment is needed. All of which we can show them during the appointment.

Before having that conversation, I think it’s important to understand the purpose of deep cleaning teeth.

What is deep cleaning teeth?

Deep cleaning teeth – also known as scaling and root planning, or non-surgical periodontal therapy – is the process of removing tartar that forms beneath the gum line to stop the progression of gum disease.

If left untreated, the accumulation of tartar (hardened plaque) can result in inflamed gums that break the seal between the tooth and healthy gum tissue. Thus, allowing the disease to migrate down the root and cause more inflammation. This inflammation is the first sign of gum disease – it’s called gingivitis.

At this stage, gum disease is reversible. However, it must be treated, which is where a deep teeth cleaning comes in. If you put off deep cleaning teeth for too long, the disease will progress and you will begin to lose bone around your teeth, eventually causing tooth loss. Once the disease progresses to this point (periodontitis), it is irreversible.

What’s the difference between deep cleaning teeth and a routine teeth cleaning?

A routine teeth cleaning is what most people experience when they visit the dentist clinic. It is very unlikely that someone who visits the dentist every six months for a routine cleaning will need a deep cleaning. Rather, it’s typically necessary when someone hasn’t been to the dentist for a teeth cleaning for many years or does not practice proper hygiene on a daily basis. There are many habits and behaviors that lead to rapid tartar buildup, and eventually gum disease, when tartar is ignored: sipping on sugary drinks throughout the day, forgetting to brush teeth and gums regularly, never flossing your teeth, and more.

Signs you need a deep teeth cleaning

Should you need a deep cleaning, it’s important that you get one, and soon. There are several telltale signs that you can look for to confirm this diagnosis – both at home and with your dentist. Signs you can look for at home include:

1. Bleeding gums when you brush or floss Bleeding or swollen gums are one of the first signs of gum disease. This is your body’s way of trying to get rid of the disease, and is caused by a buildup of plaque along the gum line. You may also have sore gums, or gums that look red and puffy.
2. Bad breathConsistently bad breath – not just in the mornings or after a meal – is another sign that you may need a deep cleaning. This is caused by the bacteria in your mouth that is actively destroying your bone.

Another sign to look for is tartar (or dental calculus) around the bottom front teeth. If you notice this, or have bad breath and/or bleeding gums, it’s best to make a dentist appointment to have this checked out. During your appointment, the dentist will be able to confirm your diagnosis. Signs they look for – which they will be able to show you – include:

1. Periodontal pockets of 4mm or greaterIf you think back to your last dentist appointment, you may recall the hygienist spouting out a list of numbers. These are likely the measurements of your periodontal pockets, or the vertical space between the tooth and gum. Healthy gums have pockets that measure no more than 3 mm. A deep cleaning is needed when you have one or more pocket per quadrant that are 4mm or greater. At 5mm, the patient will be diagnosed with periodontitis, and at 6mm or 7mm with advanced periodontitis.
2. Radiographic bone lossThe combination of periodontal pockets and tartar buildup will eventually begin to affect the bone and change its structure. The bone will become scalloped and uneven and bone volume will decrease. If you need a deep teeth cleaning, you will have bone loss that is visible on an x-ray. Your dentist will be able to show you on the x-ray where your bone is, and where it should be. At this point, the damage is irreversible. But it’s important to stop it before it gets worse.

If you have both periodontal pockets and bone loss, you need a deep cleaning. However, you may not have bad breath or gum bleeding. Not all symptoms are required for a definitive diagnosis. The two most important signs to look for are those that your dentist will look for.

If in doubt, get a second opinion and ask the dentist to show you the periodontal pockets and bone loss. This will be very easy for them to do and give you peace of mind knowing that your diagnosis is accurate.

If you’re unsure of whether or not you need a deep teeth cleaning, schedule an appointment with our dentist in Harrow, Middlesex. We’ll be happy to confirm your diagnosis and deep clean your teeth.