A professional dental cleaning, known as prophylaxis, is a foundational preventive procedure focused on maintaining oral health. This process uses specialized equipment and materials to remove accumulated plaque and hardened calculus, or tartar, that cannot be eliminated by at-home brushing and flossing. The cleaning involves multiple distinct stages, each relying on specific instruments to achieve a smooth, healthy tooth surface.
Tools for Removing Hard Deposits
The initial phase focuses on eliminating dense, calcified deposits of tartar that adhere firmly to the tooth surfaces. Bulk removal is often initiated using a high-tech instrument called an ultrasonic scaler. This device utilizes a rapidly vibrating metal tip that oscillates at high frequencies, often between 20,000 and 45,000 cycles per second. The intense vibration mechanically shatters the calculus, while a continuous stream of water flushes away debris and cools the tip.
Following the ultrasonic scaler, the hygienist employs hand instruments for precision work and thoroughness. These manual tools, primarily scalers and curettes, scrape and dislodge residual deposits. Scalers typically have pointed tips for deposits above the gum line, while curettes feature rounded tips designed for removing calculus from root surfaces beneath the gum line, a technique known as root planing. The combination of power scaling and manual instrumentation ensures complete removal of deposits necessary to prevent gum inflammation and periodontal disease.
Materials and Methods for Polishing
After the scaling phase, the focus shifts to polishing, which smooths the tooth surface and removes fine stains. This procedure uses a slow-speed handpiece, known as a prophy angle, fitted with a disposable, rotating rubber polishing cup. The cup is designed to flare slightly to access the contours of the tooth surface as it applies the abrasive material.
The abrasive material is a specialized prophylaxis paste, often pumice-based, containing particles of varying coarseness, referred to as “grit.” The hygienist selects the specific grit—fine, medium, or coarse—based on the patient’s level of surface staining. While a coarser paste removes heavy stains quickly, it requires a follow-up with a finer-grit paste to achieve a smooth, glossy finish. Professional flossing concludes this stage, clearing the spaces between the teeth of any residual polishing paste or fine debris.
Applying Protective Agents
The final stage of the professional cleaning involves applying agents designed to strengthen and protect the tooth structure. Fluoride treatments are the most common protective application, working to enhance remineralization, which is the natural process of rebuilding tooth enamel. Fluoride is applied to the clean tooth surface, where it is incorporated into the enamel structure, forming fluorapatite, a compound more resistant to acid erosion than the original enamel.
The fluoride is typically applied as a varnish, foam, or gel. Varnish is often a prevalent choice due to its ability to adhere to the teeth for several hours, maximizing the contact time with the enamel. Patients are usually instructed to avoid eating or drinking for a short period and to stick to a soft diet for the rest of the day to ensure the fluoride properly adheres and is absorbed by the teeth.
Specialized Rinses
In addition to fluoride, specialized antiseptic rinses, such as those containing chlorhexidine, may be used for patients with specific needs. This includes those at high risk for cavities or those with significant gum inflammation. Chlorhexidine works by disrupting the cell walls of harmful bacteria, offering a potent antimicrobial effect that complements the protective action of fluoride.