3 Types of Dental Cleanings, Which Kind Do I Need?

Teeth cleanings every 6-12 months are very important to staying healthy. Cleanings are typically the first appointment for new patients. One question new patients need to be thinking is "Which type of teeth cleaning do I need?"  If you have severe gingivitis and inflammation or worse, gum disease, you will be not be eligible for a "regular cleaning." Receiving news for the first time that you have gum disease can be emotional, but it doesn't have to be. We work hard at our office to do a very thorough exam of your tissue conditions and bone health in order to educate and show you the current state of your mouth and why. If you have gum disease, it is only appropriate to have a deep cleaning. Gum disease is a serious threat to anyone wanting to keep their teeth because the main threat from gum disease is loosening teeth and eventually it requires extractions of otherwise healthy teeth. Therefore, we take gum disease serious at our office and require the deep cleaning as the only appropriate treatment, as recommended by the American Dental Association (ADA). Deep cleanings will require separate appointments, and insurance companies often do not cover the full costs, so there will usually be copays involved. We can't control those factors and we apologize in advance for those inconveniences, but to ignore gum disease and refuse the appropriate treatment will be a much greater inconvenience and cost if and when it leads to losing some of your teeth.

1) "Regular Cleaning"

2) "Gingivitis Cleaning"

3) "Deep Cleaning"​

Known as a prophylaxis or "prophy," a regular cleaning is the most common, and is the standard treatment for patients without severe gingivitis or gum disease. It includes the removal of plaque, calculus, and stain from the teeth. If you are diagnosed with severe gingivitis or gum disease, you are not eligible for a "regular cleaning" or "prophy."

Healthy Gums

Healthy Gums

Mild Gingivitis

Known as scaling in the presence of inflammation (SPI) or "gingivitis cleaning". In this case, the mouth is in a state of gingivitis or inflammation of the gum tissue.  Gum inflammation includes swollen, red, tender, and bleeding gums.  This cleaning still includes the removal of plaque, calculus, and stain from the teeth, but since the gums are already in a state of disease, this is not a preventive cleaning.  The gums generally bleed during the cleaning process and anesthetic may be administered for the patient’s comfort.  Since gingivitis can be reversed, there is often a good prognosis with healing of the gums after a gingivitis cleaning.  
If you are diagnosed with severe gingivitis and inflammation, you are not eligible for a "regular cleaning."​

Inflammation and Gingivitis

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Before & After Gingivitis Cleaning on the Same Patient

Known as Scaling and Root Planing (SRP), a deep cleaning is the required treatment for periodontal disease (gum disease). Untreated gum disease destroys the supporting structures of the teeth including the gums themselves, periodontal ligaments, and jaw bone.  Once the supporting structures of the teeth are destroyed, they do not grow back.  Gum disease is not reversible, nor is there a cure, but it can be kept in an inactive state to prevent further destruction.  Gum disease usually shows generalized bleeding of the gums, bone loss, gum recession, and deep “pockets” or gum measurements that mean the gum is not attached on the tooth where it should be.  The deep cleaning involves removing the plaque, calculus, bacteria, and stain in these deep pockets where a toothbrush or floss can’t reach. Anesthetic is usually always administered due to the need to clean below the normal gum tissue level (which can be very uncomfortable). The gum tissue can heal as long as everything is removed from the pocket and no other further irritation is present. Thorough homecare and more frequent and consistent hygiene appointments are essential to keeping gum disease under control. If you are diagnosed with gum disease, you are not eligible for a "regular cleaning."

Before & After Deep Cleaning on the Same Patient

Refusing a Deep Cleaning At the Dental Office

Of course you can refuse a deep cleaning at the dentist because without your consent, we are not legally able to perform treatment on you. It is your right to refuse and we can't touch you unless you permit us to.
However, it may not be in your best interest to put off the deep cleaning if you truly need it. There will be consequences and your overall health of your mouth will suffer as a result of not getting it treated.
Different offices may have different policies regarding treatment refusal, but at our office, we will not continue to see patients who refuse the appropriate treatment diagnosed by the dental hygienist and dentist. We will always be happy to help transfer all of your dental records and xrays for you by request, without any fees, and we still want to ensure you are treated with respect and have a good experience at our office while you are with us, even if we disagree.

The affects of gum disease are often unnoticed until it is too late, and it can lead to the loss of some or all of your teeth. This is why it is imperative that treatment not be ignored or neglected.