Professional dental cleaning removes hardened deposits, known as calculus or tartar, along with soft plaque and surface stains from the teeth. This intervention is necessary because these materials cannot be fully removed by routine brushing and flossing at home. The procedure a patient receives is not a matter of choice but a prescribed treatment. The specific type of cleaning performed depends entirely on the current health status of the patient’s gums and the surrounding bone structure.
The Routine Cleaning
The most common procedure, often called a regular cleaning, is clinically known as prophylaxis. This is a preventative measure intended for patients whose gums are generally healthy or only show signs of mild, reversible inflammation called gingivitis. Prophylaxis focuses primarily on removing plaque and calculus deposits from the surface of the teeth and slightly above the gum line.
During prophylaxis, the dental hygienist uses specialized instruments, such as ultrasonic scalers and hand tools, to clear the deposits. The procedure concludes with polishing the teeth to remove minor stains and create a smooth surface, making it more difficult for new plaque to attach. This cleaning is typically recommended every six months to maintain oral health. It does not involve working deep into the pockets below the gum line or treating active bone loss.
Therapeutic Treatment: Scaling and Root Planing
When a patient has active periodontal disease, involving inflammation, infection, and measurable bone loss, a therapeutic procedure called Scaling and Root Planing (SRP) is necessary. This treatment, often referred to as a “deep cleaning,” is the initial non-surgical intervention for periodontitis. It is required when bacterial infection has created deep pockets between the gums and the tooth roots.
The SRP procedure is typically performed using local anesthesia, as it involves working significantly below the gum line. The scaling phase removes calculus and bacterial toxins from the root surfaces within the infected periodontal pockets. Following this, the root planing phase involves smoothing the root surfaces to eliminate rough areas where bacteria can easily hide.
This smoothing action encourages the gum tissue to reattach firmly to the cleaner, healthier root surface, reducing the depth of the periodontal pocket. A full mouth SRP is often divided into two or four separate appointments to allow for thorough cleaning and effective use of local anesthesia. SRP addresses an active disease process that causes the destruction of bone and tissue.
Long-Term Specialized Care
Once a patient completes the initial Scaling and Root Planing procedure, they transition to a specialized form of ongoing care called Periodontal Maintenance. Periodontitis is a chronic condition, and this maintenance phase prevents the recurrence and progression of the disease. These specialized cleanings are performed much more frequently than prophylaxis, usually every three to four months.
The shortened interval is necessary because it takes approximately three months for harmful bacteria to repopulate the periodontal pockets. During maintenance appointments, the hygienist monitors the stability of the gum tissue and bone level by measuring pocket depths. The procedure involves meticulous scaling and cleaning both above and below the gum line to disrupt bacterial colonies in the subgingival areas.
How Dental Professionals Determine the Type of Cleaning Needed
Dental professionals determine the necessary cleaning type through a comprehensive periodontal assessment. The most objective diagnostic tool is periodontal probing, which uses a calibrated instrument to measure the depth of the gingival sulcus, or pocket, around each tooth. Healthy gum tissue typically yields pocket depths of 1 to 3 millimeters, indicating the patient is a candidate for routine prophylaxis.
Measurements of 4 millimeters or deeper, especially when accompanied by bleeding, signal the presence of gum disease and the need for SRP. The dentist also assesses the degree of inflammation and the amount of gum recession. Dental X-rays are reviewed to check for visible bone loss around the roots of the teeth, confirming a diagnosis of periodontitis and mandating therapeutic treatment. These combined clinical findings dictate the specific classification of the patient’s oral health and the appropriate course of professional cleaning.