A professional dental cleaning, often called prophylaxis, is a comprehensive procedure performed by a dental hygienist or dentist to maintain the health of your teeth and gums beyond what daily brushing and flossing can achieve. This systematic cleaning removes harmful deposits that accumulate over time, preventing the progression of common issues like gum disease and tooth decay. The entire experience is a multi-step approach that moves from a detailed examination to the physical removal of buildup and concludes with protective treatments.
Plaque and Calculus: The Cleaning Targets
The primary objective of a professional cleaning is the removal of a soft bacterial film known as plaque and its hardened form, calculus. Plaque is a colorless, sticky biofilm constantly forming on the teeth, composed of millions of bacteria, food particles, and saliva proteins. If this film is not removed regularly, the bacteria within it produce acids that attack the tooth enamel, leading to decay and gum irritation.
If plaque remains on the tooth surface for approximately 48 hours or more, it begins to mineralize by absorbing minerals from saliva. This process creates calculus, also called tartar, which is a hard, rock-like deposit that firmly adheres to the tooth. Unlike soft plaque, calculus cannot be removed by simply brushing or flossing at home, which is why professional intervention becomes necessary. Calculus creates a rough, porous surface that attracts even more plaque, accelerating the cycle of decay and gum inflammation.
Initial Assessment and Screening
The cleaning procedure begins with a detailed assessment of the oral cavity by the dental professional. This initial screening involves a visual examination of the teeth, gums, and surrounding tissues for any signs of disease, such as inflammation, redness, or swelling. A small, angled mirror is used to inspect hard-to-see areas for existing dental issues like cavities or cracked fillings.
A periodontal probe is then used to measure the depth of the gingival sulcus, the shallow space between the tooth and the gum tissue. Measurements greater than three millimeters may indicate gingivitis or periodontitis. This probing helps the hygienist map out the severity and location of calculus deposits, especially those below the gum line, guiding the subsequent cleaning steps.
Mechanical Removal: Scaling and Debridement
With the assessment complete, the hygienist proceeds to the mechanical removal of plaque and calculus through a process known as scaling. This is the most intensive part of the cleaning, directly addressing the hardened deposits that at-home care cannot eliminate. Modern dental practice employs two main methods for this physical debridement.
The first method uses specialized manual instruments, such as dental scalers and curettes, shaped to scrape the calculus off the tooth surface. These instruments are used with careful strokes to dislodge deposits both above and below the gum line (supragingival and subgingival). The manual approach allows the hygienist to use tactile feedback, ensuring the complete removal of small, stubborn pieces of calculus.
The second method involves the use of ultrasonic devices, which utilize high-frequency vibrations. The tip of the ultrasonic scaler vibrates rapidly against the tooth surface, efficiently shattering large deposits of calculus. These devices simultaneously emit a fine mist of water, which cools the vibrating tip and flushes away the loosened debris. This combination of mechanical vibration and water spray makes the ultrasonic scaler highly effective for bulk removal.
Polishing and Protective Treatments
Once the calculus and large plaque deposits have been mechanically removed, the cleaning process moves to smoothing and protecting the tooth surfaces. Polishing is performed using a slow-speed rotary handpiece fitted with a soft rubber cup and a mildly abrasive prophylaxis paste. This gritty paste is applied to all tooth surfaces to remove residual plaque and surface stains caused by food or beverages.
Polishing creates a smooth tooth surface, making it harder for new bacterial plaque to adhere quickly after the cleaning. Following this, the hygienist performs a thorough flossing to remove any polishing paste or debris from between the teeth. The procedure often concludes with a professional fluoride treatment, applied as a foam, gel, or varnish. This high concentration of fluoride is absorbed by the enamel, strengthening its structure and increasing its resistance to acid attacks.