Do You Need a Deep Cleaning?

As part of a regular dental and checkup, the dental hygienist who performs the cleaning part of the exam will check the gums for gaps or pockets. These pockets are home to millions of bacteria that cause tooth decay and periodontal infections. If the depth of these pockets is four millimeters or greater, the hygienist is likely to recommend a deep cleaning or root planing procedure in order to reverse the damage caused by periodontal disease. 

Deep cleaning, also known as scaling, is a process in which plaque and tartar are physically removed from the deep pockets surrounding the teeth through ultrasonic or manual scaling. Plaque is a biofilm full of bacteria, that blankets the teeth in between brushings. While plaque is soft enough to be brushed and flossed away, if a patient does not practice good oral hygiene, plaque calcifies into tartar. Tartar is a hard, bony substance that cannot be brushed away. Tartar spreads over and in between teeth and also stretches below the gumline. 

When plaque and tartar live deep in the gums, periodontal infections develop. These infections put patients at risk for tooth decay, tooth loss and dental abscesses. Abscesses in the mouth leave patients with health risks, like cardiovascular and pulmonary complications and dementia.

The American Academy of Periodontology recommends patients with pockets measuring four millimeters or deeper undergo scaling. Everett, Wash. dentist Dr. Amy Norman, D.D.S., P.S., agrees with the AAP’s recommendation. 

"Measuring the gum pockets is a critical part of the dental examination, and helps hygienists and dentists to identify if a serious situation is brewing unbeknownst to the patient below their gumline," Norman said. 

Some patients with deep gum pockets have bacterial infections that require prescription antibiotics and antiseptic mouth rinses. 

"Eradicating pathogenic bacteria from the gums is important for the patient’s oral and overall health," Norman said. "If you do not remove all of the bacteria, the patient will continue to have periodontal infections."

These infections loosen teeth and compromise the health of the jaw, cautions Norman.

"When bacteria take up residence in the gum pocket, they do a lot of damage, over a long period of time," Norman said. "Most patients don’t know what is happening, and then they wake up one morning with a serious, and usually painful, problem."

To prevent periodontal infections, Norman advises patients to practice good oral hygiene by brushing at least twice per day and flossing at least once per day. These actions remove plaque and food debris left behind on the teeth after eating. Norman also advises patients to make and keep their dental check up appointments. The AAP recommends that at least once per year, adult patients have their gum pockets checked and measured during their checkups. This is especially important for patients who may have gone long periods without dental care.

"Most patients only need to see the dentist twice per year, but there are some who visit more frequently out of necessity or preference," Norman said. "If a patient has missed regular checkups for a few years, or even a year, it is important to check everything in depth in order to make sure they are healthy." 

Some patients also require root planing. During the root planing procedure, the hygienist goes even further below the gumline to remove plaque and tartar build-up from the surface of the roots of the teeth. Root planing is a lengthy process, typically spread over a few visits. After the procedure, the dentist may require a follow up to check pocket depth and gum health. The dentist will ask their patients to return at three-month intervals to ensure that periodontal disease is being reversed. 

"Deep cleaning is a great way to get your teeth and gums back to good health," Norman said.

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