A professional dental cleaning performed by a hygienist is a preventive procedure designed to maintain oral health. This process involves the systematic removal of bacterial plaque and hardened mineral deposits, known as calculus or tartar, from the surfaces of the teeth. Left untreated, these deposits can lead to gum disease and tooth decay. The cleaning utilizes a specialized suite of precision tools, each engineered for a specific task, from initial diagnosis to the final protective treatment.
Tools for Initial Assessment
The cleaning procedure begins with a thorough evaluation of the oral cavity using specialized handheld instruments. The small, angled mouth mirror provides the hygienist with indirect vision to examine the back surfaces of the teeth and illuminate dark areas.
The periodontal probe is a slender, calibrated instrument used to assess the health of the gum tissue. The probe is gently inserted into the gingival sulcus, the space between the tooth and the gum line, to measure its depth in millimeters. These measurements help detect and monitor periodontal disease, as increasing pocket depth indicates tissue detachment and bone loss.
A dental explorer, a thin, sharp, hook-like instrument, is also used to detect irregularities on the tooth surface. By running the explorer along the enamel, the hygienist can feel for minute defects, such as early decay, failing restoration margins, or subgingival calculus deposits. The tactile feedback guides the hygienist in planning the subsequent cleaning steps.
Instruments Used for Scaling and Calculus Removal
The removal of calculus is the core function of a professional cleaning and requires two distinct methods: manual and ultrasonic scaling. Manual scaling relies on handheld instruments such as sickle scalers and curettes, which have specialized working ends. Sickle scalers have pointed tips and are primarily used to remove larger deposits from above the gum line.
Curettes feature a rounded toe and back, allowing them to be safely inserted below the gum line to remove subgingival calculus and smooth the root surface. Specific designs, such as Gracey curettes, have blades angled for precise access to the different anatomical surfaces of the tooth roots. The manual technique depends on the hygienist’s skill and tactile sense to effectively shear deposits without damaging the surrounding soft tissue.
The ultrasonic scaler offers an efficient alternative for bulk calculus removal. This device uses a tip that vibrates at high frequencies (25,000 to 50,000 cycles per second) to fracture the deposits. A continuous stream of water flows from the tip, serving two purposes: cooling the instrument and flushing away dislodged debris and bacteria. The combined action of high-frequency vibration and water irrigation allows for the rapid debridement of both supragingival and subgingival calculus, often reducing the total time required for cleaning.
Equipment for Polishing and Stain Removal
Once calculus has been removed, the hygienist proceeds to the polishing stage to smooth the tooth surfaces and eliminate external stains. This is accomplished using a slow-speed dental handpiece fitted with a disposable rubber prophy cup or a small brush attachment. This equipment spins the cup or brush at a controlled speed to minimize heat generation.
The rotating cup holds a mildly abrasive material called prophy paste, a specialized polishing compound. Prophy paste comes in various grits, allowing the hygienist to select the appropriate level of abrasion based on the patient’s stain and sensitivity. The polishing action removes extrinsic stains caused by coffee, tea, or tobacco, creating a smooth enamel surface.
A smooth tooth surface is less retentive, making it more difficult for new plaque and bacteria to adhere to the enamel. Throughout this and the preceding scaling phase, an air-water syringe is used to rinse the mouth. A saliva ejector or high-volume evacuation (HVE) system constantly removes excess water and debris, which maintains a clear working field and ensures patient comfort.
Applying Protective Treatments
The final step in a professional cleaning involves the application of a protective agent to fortify the newly cleaned enamel. Fluoride is the most common agent used for this purpose, as it facilitates the natural process of remineralization. When applied topically, fluoride ions are incorporated into the tooth structure, forming fluorapatite, a crystal that is more resistant to acid erosion than the native hydroxyapatite of the enamel.
Fluoride is typically applied in the form of a varnish, gel, or foam. Varnish is painted directly onto the clean, dry tooth surfaces and is a highly concentrated resin that adheres to the enamel, slowly releasing fluoride over hours. This prolonged contact time makes varnish an effective delivery system for promoting enamel strength and preventing new carious lesions. The hygienist selects the specific type and concentration of the protective agent based on the patient’s individual risk factors for decay.