What’s involved with a dental deep cleaning and when is it necessary?
We deep clean many things—our carpets, cars, offices, and homes. The decision to do so rests on our shoulders. However, a dental deep cleaning isn’t a choice but a necessity to prevent receding gums, bone loss or lost teeth. Deep cleaning is designed to clear out bacteria that have invaded below the gumline. In fact, if left unattended, a severe bacterial infection in the mouth can impact your heart, kidneys, brain, and overall bodily health. Although a spreading infection like that is rare, prevention and proactive dental care is the best practice to maintain oral health and avoid that type of complication.
What do pockets have to do with it?
The pocket depth refers to the level of gum tissue extending above the bone and how much it comes up over the tooth. It should lay tightly or snugly against the tooth. Normal, healthy tissue has a pocket depth of one to three millimeters. Picture it like a short sleeve shirt. Your arm represents the tooth and the short sleeve the gum tissue. This tissue creates a pocket where your tooth resides.
Proper home care like brushing and flossing sweeps out the debris from that pocket to prevent bacteria or inflammation. Other causes of inflammation in addition to poor home dental habits can include smoking, poor nutritional habits, and genetic factors.
In fact, gum disease (beyond gingivitis) will impact close to half of all adults over the age of 30 in the United States. As we age, we experience bone loss. And other habits picked up over time, such as clenching or tooth grinding, which can occur even as we sleep, contributes to bone and tissue change around the teeth. Not only does tooth grinding wear away or even fracture teeth, but it can also cause the pockets at the gumline to deepen, resulting in new places for bacteria to accumulate.
When bacteria or debris accumulate in this pocket, the tissue swells, forming a deeper pocket. Bacteria create toxins that result in the bone pulling away from the gum tissue. As the pocket depth increases beyond four millimeters, disease sets in. Deep cleaning can help clear a pocket depth of up to eight millimeters.
The dental deep cleaning process
First, know that you can relax. Because the deep cleaning involves penetration below the gum line, patients will receive a localized anesthetic or numbing agent so there shouldn’t be any pain during the procedure.
The same dental hygienist who performs routine cleanings will likely perform the deep cleaning as well. Plaque is a sticky film of bacteria and tartar is a hardened layer of this plaque. A process called “scaling” scrapes or removes both plaque and tartar from below the gum line.
A second process called root planing smooths the tooth root. As the roots of the tooth become uneven, this uneven surface area makes it easier for bacteria to hide within the pocket.
The dentist determines the need for deep cleaning through pocket depth, the status of the gum tissue (whether or not it is swollen) and finally, radiographically. As the material under the gumline builds up over time, it can become dense and look like bone and show up on an x-ray.
Best home practices for better oral health
Patients will always be impacted by genetic factors outside of individual control. However, every patient can improve their dental health outlook by following routine maintenance procedures and by paying attention to personal habits. The professionals at Empire Dental Arts recommend that multiple times per day, every person will:
- Brush
- Floss
- Rinse with mouthwash
- Use an oral irrigator, such as a Waterpik (at least once per day, in the evening)
- Avoid smoking tobacco and try to eat a balanced, nutritional diet
Even in the instances when a patient follows these instructions, those unavoidable genetic factors and age-related deterioration or wear and tear will necessitate a deep cleaning every few years.
As another final warning, don’t neglect routine dental visits. A pocket that moves beyond eight millimeters in depth might require surgical intervention to arrest the problem. At that point, it might not be possible to save the tooth.
Follow up after a dental deep cleaning
The dentist might prescribe a site-specific, localized antibiotic as a follow-up to a deep cleaning procedure. Patients would only apply this topical antibiotic to the area that was deep cleaned, not the entire mouth.
The dental staff might ask patients to come in for regular cleanings more frequently following a deep clean. Initially, this might involve a regular dental cleaning and inspection every three to four months. This is to ensure that the bacteria and plaque are not returning and that those home routines are sufficient to take care of oral health. Once the dental staff determines that oral health is restored, the patient can return to a six-month routine of regular checkups.
As a final note, dental insurance normally covers this procedure, but it is always best to check with your insurance carrier prior to a visit.
If you experience any type of discomfort, reach out to Empire Dental Arts immediately. We’re here to help you experience the best oral health possible.