A routine dental cleaning, technically known as prophylaxis, is a preventative measure performed by a registered dental hygienist to maintain oral health. Understanding the standard procedures performed during a professional cleaning can demystify the experience and highlight its importance. The entire process is designed to be thorough yet comfortable, focusing on both diagnosis and physical cleaning.
The Initial Assessment and Examination
The appointment begins with a comprehensive review of your current medical history, including any new medications or recent health changes, which can impact oral health. This is followed by a visual and physical examination of your entire mouth. The hygienist or dentist looks for signs of decay, inflammation, or other issues, using a small mirror and specialized instruments to inspect the soft tissues, tongue, and gums for any abnormalities that require attention.
Diagnostic imaging, such as dental X-rays, is included to check for problems not visible to the naked eye, like decay between teeth, bone loss, or cysts. Bitewing X-rays are taken yearly to show the crowns of the back teeth and the height of the surrounding bone. Periodontal charting is also part of this assessment, involving a tiny probe to measure the pocket depth between the gum tissue and the tooth surface in millimeters. Healthy tissue measures between one and three millimeters, but deeper readings, especially when accompanied by bleeding, can indicate gum disease and guide the type of cleaning required.
The Mechanical Cleaning Process
Once the diagnostic phase is complete, the physical removal of accumulated deposits begins, focusing on plaque and calculus, or tartar. Plaque is a soft, sticky film of bacteria that hardens into calculus when left undisturbed, and this hardened deposit can only be removed professionally. The hygienist performs scaling, which involves dislodging and removing these deposits from the surface of the tooth and below the gumline.
Two primary tools are used for scaling: manual instruments and ultrasonic scalers. Manual instruments are thin, curved metal tools used to scrape away smaller deposits with controlled precision. Ultrasonic scalers use high-frequency vibrations (typically 25,000 to 50,000 cycles per second) to disrupt calculus and bacterial biofilms, often using a fine spray of water to flush away debris. This method is highly efficient for bulk removal, though the noise and vibration can feel intense.
After the scaling removes the hard deposits, the hygienist polishes the teeth using a motorized handpiece fitted with a soft rubber cup and a gritty prophylaxis paste. This paste is mildly abrasive and works to smooth the tooth surfaces, removing minor surface stains left by coffee, tea, or other foods. The smooth finish left by polishing makes it more difficult for new plaque to adhere immediately to the enamel. Finally, professional flossing is performed to ensure any remaining polishing paste or debris is thoroughly removed from the tight spaces between the teeth, completing the physical cleaning.
Post-Cleaning Care and Scheduling
The final stage involves a protective fluoride treatment applied to the newly cleaned and polished tooth surfaces. Fluoride, usually a varnish painted onto the teeth, promotes remineralization, strengthening the enamel and making it resistant to acid attacks from oral bacteria. This application is effective immediately after cleaning because the tooth surface is free of biofilm for maximum absorption.
Following the fluoride application, you may be instructed to avoid eating or drinking for about 30 minutes to allow the varnish to set. Temporary gum sensitivity or slight soreness for a day or two is normal, especially if significant buildup was removed. The hygienist will review home care techniques, emphasizing proper brushing and flossing. The appointment concludes with scheduling the next preventive visit, typically recommended every six months to maintain optimal oral health and prevent minor issues from escalating.