I was told a need a deep cleaning, do I really need one?

Your dentist told you that you need a deep cleaning, but you have some questions. First and foremost you are probably wondering if you even need one. 

Unfortunately, this is the number one area that I see patients being taken advantage of. Deep cleanings, also known as scaling and root planing, are a vital procedure for people who need it, but it also gets heavily overused on people that do not need it. Especially in the corporate dentistry setting.

Let’s start with what a deep cleaning, or scaling and root planing, actually is. Scaling and root planing is the first line of treatment for someone with periodontal disease. Periodontal disease is defined by what we call attachment loss. It is the loss of the bone and associated structures that hold your teeth in. The most common visible sign is gum recession. Basically, the calculus or tartar build-up on your teeth works its way below the gums. This calculus is full of bacteria and causes inflammation of the gums and bone. This inflammation slowly destroys the bone that holds your teeth in. If left untreated, teeth will start to get loose, and eventually they will fall out or need to be extracted. Once this bone is gone there is no way to get it back. Scaling and root planing is the process of cleaning below the gums to remove this calculus and associated bacteria in order to allow the gums to heal and stop this process of bone loss.

There are specific ways we determine if someone needs a deep cleaning. First, we need a complete set of x-rays to evaluate your bone levels. We then use a small probe to measure the pockets in your gums around the teeth. In a person with healthy tissues, this pocket is typically about 3mm deep and the bone levels are normal. In a person with periodontal disease, we will see a reduction in the normal bone levels on the x-rays. We may actually see the calculus buildup on the x-rays if it is significant enough. We also will see pocket depths of 5mm and up in all or some areas of the mouth. 

How can you know if you really need a deep cleaning or if someone is trying to take advantage of you? Here are a few guidelines to try and help you out.  Have you been seeing a dentist regularly for cleanings every 6 months? If you have then rarely would you need a deep cleaning? I have seen some cases of neglect where a prior dentist never probed the patient’s gums, but this is pretty rare. Has it been a long time since you had a professional cleaning at a dentist? Even if you are diligent at brushing and flossing, we all still build up calculus. If it has been over 1-2 years since a cleaning, there is a high chance you have the beginnings of periodontal disease. Are your gums red and puffy or are they a nice pink color? Typically if you need a deep cleaning you will find some redness or puffiness around the edges of your gums. Do your gums bleed when your brush or floss? If they do then you could need a deep cleaning. Do you have a strong case of bad breath? Periodontal disease produces a particular odor that is very unpleasant. Did your dentist show you your x-rays and probing depths and thoroughly explain them to you? If they have not, or will not, it might be worth getting a second opinion.

Scaling and root planing is a necessary part of periodontal therapy, but it often is abused as a way for offices to make more money. I strongly believe that you should include your patients in the treatment planning process. That means showing you all of our x-rays and diagnostic findings. That way we are all on the same page and you feel comfortable starting treatment. If you are in need of an honest second opinion do not hesitate to contact our office. I look forward to meeting you!