When people talk about getting their “teeth cleaned” at the dentist, they are usually using a general term that covers at least two distinct medical procedures. The specific procedure depends entirely on the current health status of a patient’s gums and the presence of active disease. Understanding the correct terminology is important because each procedure addresses a different stage of oral health. The decision between them is based on precise diagnostic measurements taken during a dental examination.
The Standard Preventative Cleaning: Dental Prophylaxis
The most common procedure is called dental prophylaxis, a term derived from the Greek word meaning “to guard beforehand.” This preventative measure is reserved for patients whose gums are generally healthy, showing little to no signs of inflammation or bone loss. The primary goal of prophylaxis is to remove plaque and hardened deposits, known as calculus or tartar, from the visible surfaces of the teeth and slightly above the gum line.
During this appointment, a hygienist first performs a visual examination of the oral cavity, looking for early signs of decay or gum inflammation. Specialized instruments, such as hand scalers or ultrasonic devices, are then used to scrape away accumulated calculus. After deposit removal, the teeth are polished with a mildly abrasive paste to smooth the surfaces and discourage future plaque adhesion. A fluoride application is often the final step, helping to strengthen the tooth enamel against acid erosion.
The Therapeutic Deep Cleaning: Scaling and Root Planing
When a patient has active periodontal disease, a preventative cleaning is no longer sufficient, and a therapeutic procedure known as Scaling and Root Planing (SRP) becomes necessary. Often referred to as a “deep cleaning,” SRP is a non-surgical treatment aimed at controlling the infection and halting the progression of gum disease. This procedure targets areas of the tooth surface far below the gum line, where regular cleaning cannot reach.
Scaling involves the careful removal of bacteria, plaque, and calculus that have built up on the root surfaces within the deepened gum pockets. Local anesthesia is frequently administered to ensure patient comfort during this process. Root planing then follows scaling, which is the process of smoothing the rough spots on the tooth roots. This smoothing eliminates surfaces where bacteria can easily gather, allowing the gum tissue to potentially heal and reattach firmly to the clean root surface.
This therapeutic approach is typically performed over multiple appointments, often treating one side or quadrant of the mouth at a time. The goal is to reduce inflammation and pocket depth, ultimately creating a more stable foundation for the teeth.
How Dentists Determine the Right Procedure
The choice between standard prophylaxis and therapeutic Scaling and Root Planing is made by precisely measuring the space between the tooth and the gum tissue, known as the periodontal probing depth. A small, calibrated periodontal probe is gently placed into this space, and the depth is recorded in millimeters at six points around each tooth. Healthy gum tissue is tightly attached, resulting in probing depths typically between one and three millimeters. Measurements of four millimeters or greater, often accompanied by bleeding, indicate active periodontal disease requiring SRP. Dentists also use X-rays to check for loss of supporting bone; following successful SRP, patients are typically placed on a more frequent schedule of specialized cleanings, known as periodontal maintenance, to prevent recurrence.