Ultrasonic teeth cleaning is formally known as ultrasonic scaling. This method utilizes a specialized instrument that generates high-frequency vibrations coupled with a stream of water to clean the tooth surface and below the gumline. Unlike traditional hand scaling, which relies on manual scraping tools, the ultrasonic approach uses technology to physically loosen hardened deposits. This procedure effectively removes plaque and calculus.
The Technology Behind Ultrasonic Scaling
The instrument’s handpiece contains a transducer that converts electrical energy into mechanical energy. This energy drives a slender metal tip to oscillate at an extremely rapid rate, typically between 25,000 to 50,000 cycles per second. The physical contact of this rapidly vibrating tip against the tooth surface mechanically fractures and dislodges tenacious calculus (mineralized plaque).
A concurrent process called cavitation occurs due to the constant water spray surrounding the oscillating tip. The high-frequency waves create millions of microscopic bubbles in the water, which then rapidly collapse or implode. This implosion generates shockwaves that help disrupt the cell walls of bacteria and flush out the subgingival biofilm.
The two primary types of ultrasonic scalers, magnetostrictive and piezoelectric, achieve this rapid vibration through different mechanisms. Magnetostrictive units use magnetic fields, while piezoelectric units rely on ceramic crystals that change shape when an electric current is applied. Both types achieve the dual action of mechanical cleaning and bacterial disruption through the combined force of vibration and cavitation.
The Ultrasonic Cleaning Procedure
The procedure begins with the dental professional guiding the tip of the instrument over the tooth surface and into the gingival sulcus. The tool is used with light pressure, allowing the high-frequency motion to perform the bulk of the cleaning work. The focus is on removing large, hard deposits of calculus that are difficult to dislodge with manual instruments.
A continuous stream of water is directed at the tip during the entire process, serving two important functions. This coolant spray prevents the rapid friction of the vibrating tip from overheating the tooth structure. It also provides constant irrigation, which flushes away the dislodged debris, bacteria, and toxins from the periodontal pocket.
Due to the substantial amount of water spray involved, a high-volume evacuation (HVE) or suction tool is continuously used by the dental assistant. This suction manages the water flow and debris, ensuring patient comfort and maintaining a clear field of vision for the clinician. Patients typically perceive the experience as a persistent humming sound and a cool, constant flow of water, often finding it less jarring than the sharp scraping sensation of hand instruments.
Primary Advantages Over Manual Methods
The primary advantage of ultrasonic scaling is the increase in procedural efficiency compared to traditional hand instrumentation. The rapid, powered movement of the tip allows the clinician to remove deposits much faster. This speed is particularly beneficial for patients with extensive calculus buildup.
The slim design of the ultrasonic tips, combined with the flushing action of the water, offers superior access to challenging areas. This includes deep periodontal pockets and complex root anatomy like furcations. The water stream also provides subgingival lavage, which helps reduce the bacterial load in these deep pockets beyond the mechanical reach of manual tools.
The method reduces the physical strain on the clinician. Less manual force is required to remove deposits, providing ergonomic benefits and reducing the risk of fatigue for the dental hygienist. For the patient, the technique is associated with greater comfort due to the lack of a sharp, scraping sensation and the lower force applied to the tooth surface.
Safety Considerations and Limitations
A safety consideration involves patients with implantable electronic devices, such as pacemakers or defibrillators. The electromagnetic fields produced by magnetostrictive ultrasonic scalers can potentially interfere with the function of these devices. Patients with such implants should inform their dental professional, as a piezoelectric unit or manual scaling may be necessary.
The procedure results in the production of bioaerosols, which are fine mists containing water, bacteria, and blood particles generated by the water spray and vibration. The consistent use of high-volume suction is required to minimize the risk of aerosol spread. Patients experiencing heightened dental sensitivity may also find the vibration temporarily uncomfortable, although power settings can be adjusted.
The intense vibration can potentially damage or disrupt the margins of delicate dental restorations, such as porcelain crowns, composite bonding, or certain types of cement. In these specific areas, the clinician may switch to manual instruments to ensure the integrity of the dental work is preserved.