Are your ? If so, a deep dental cleaning might be on the agenda at your next dentist appointment. Your dentist might recommend a deep cleaning when you develop certain concerning signs of gum disease, like receding gums, bone loss or loose teeth, Dr. Sally Cram, periodontist based in Washington, D.
C., and spokesperson for the American Dental Association, tells TODAY.com.
"When that gum starts pulling away and the gums are very inflamed, your dentist may say, We need to do more than just a regular cleaning above your gums," Cram says. Unlike a routine dental cleaning, the techniques used in a deep cleaning get below the gum line to remove bacteria stuck there. The procedure, which involves local anesthetic to temporarily numb part of the mouth, can sound dramatic.
But, experts say, it's a conservative treatment that can help — and help your mouth feel much better. It’s similar to your usual routine cleaning, but goes deeper beneath the gum line where brushing and flossing simply can’t reach. Technically, a deep dental cleaning involves two procedures: tooth scaling and root planing, Dr.
Elbert Tom, assistant clinical professor and group practice director at the UCLA School of Dentistry, tells TODAY.com. Tooth scaling removes tartar at and below the gum line, the .
And root planing smooths out the root of the tooth to help the gums reattach. "Regular cleanings are generally above the gum and maybe a millimeter or two below the gum," Cram says, but root planing gets down further to remove more tartar that may be irritating the gums. Healthy gums should look pink and tight around the teeth, Cram explains.
If you develop gum disease, the look and feel of your gums will start to change. Gum disease develops when "the gooey, sticky plaque in your mouth starts attaching to your teeth and down under the gum," Cram explains. If plaque is left there undisturbed because you're not , it hardens within a few days.
At that point, you can't brush or floss it out. That leads to inflammation in the gums and can cause the gums to start pulling away from the teeth, Cram says. You'll also notice your gums start to bleed easily, which are early signs of periodontal disease and suggest that a deep cleaning could be beneficial.
Additionally, your dentist might notice bone loss on your X-rays, excessive bleeding during a cleaning or crevices forming between the tooth and gums (also called pockets), Tom says. Deep gum pockets are often another sign of bone loss. If you or your dentist notice any of these issues, they may have a conversation with you about deep dental cleaning.
Keep in mind that gum disease is common and can arise from many different factors, Tom says, including a genetic predisposition, underlying health conditions (such as diabetes), hormonal changes and poor dental work in the past. "(But) if the patient does not take care of their teeth — if they do not brush, if they do not floss — they will have a tendency to form hard deposits on their teeth," he says. While you can't control everything contributing to tartar and gum disease, you stay on top of .
When it's time for your deep dental cleaning, your dentist, periodontist or dental hygienist will typically only work on one half of the mouth at a time, Tom says. For more advanced cases, they may only cover one quadrant of the mouth in an appointment. So it will take at least two 45- to 60-minute appointments to clean your entire mouth, Cram says.
First, you'll get a local anesthetic that will numb whichever part of the mouth is getting the procedure during that appointment, Cram says, "so that the dentist can get down under that gum tissue without making it too uncomfortable for you." Then, the person performing the procedure will use a familiar tool — an ultrasonic cleaner with a vibrating metal tip — to "chip tartar off the teeth above and below the gum line," Tom explains. "It's accompanied by a water spray that washes the tartar and flushes the plaque from the gum pocket," he adds.
After that, they'll use a manual instrument called a scaler or a curette to "fine tune" their work and "remove the small remaining pieces of tartar," Tom says. They also use the scaler to smooth the area around the root, which allows the gums reattach to the tooth. Some patients also receive antibiotic medication delivered directly into their gums during the deep cleaning to help reduce the bacteria causing the issue.
Crucially, you should also receive individualized recommendations and demonstrations for moving forward, Cram says. In the few days following your deep dental cleaning, your gums will likely be a little sore, sensitive and tender. This is perfectly normal and will subside naturally as your mouth heals.
Your dentist will give you instructions for foods to avoid during this time, Tom says, which will likely include anything that's too hot or too cold. And you should try to stick to soft foods, he adds. But, as quickly as three to five days after a deep dental cleaning, you should start to see and feel improvements, Cram says, such as less when you brush and floss.
Patients often report that their gums feel "strong and not tender" after the procedure, she adds. "They can see a big difference." You'll likely be called back in for a follow-up appointment a few weeks after the cleaning.
Different practices follow different timelines for the follow up appointment, Tom says, but you should expect it to be somewhere between three to six weeks of the initial appointment. Not necessarily. "Root planing is really your first line of defense," Cram says.
"It's a conservative therapy to try and resolve the issue." Many times, a deep cleaning and improved home care can "solve the problem," she adds. Even in cases where someone has gone a while without seeing a dentist and may have a more advanced stage of periodontal disease, a deep cleaning can be enough to avert the need for more intense treatment — especially when followed by better oral hygiene at home and a new routine cleaning schedule.
Sometimes, people do need additional intervention after a deep cleaning, which might include antibiotic mouth rinses or a systemic antibiotic (like a pill) to reduce inflammation. Dentists generally decide whether or not a patient needs one of these prescription options if they're not healing properly or at the follow-up appointment, Tom says. In cases where people need surgery after a deep dental cleaning, the root planing can still help drastically reduce the amount of surgery they'll need, Cram says.
For instance, in a patient with more advanced gum disease, "the scaling and root planning may resolve 80% of the problem," she explains, "and so they may only need to have surgery in one or two spots as opposed to their whole mouth." While some people do end up needing more than one deep dental cleaning in their lifetime, Cram says, others will say, "I'm going to do my home care and I'm not going to get back in that position again.".
