What is a Deep Cleaning and Why Do I Need It?

If you’ve gone to the dentist and been told that you need a “deep cleaning” – also known as scaling and root planning (SRP) – you may be wondering why.  The answer lies in the fact that they type of cleaning that is recommended for you depends on the condition of your gums and teeth.  Not all dental cleanings are the same.  Routine cleanings are recommended for those with healthy gums for prevention and maintenance of gum health. SRP (“deep cleaning”) is recommended if you have gum disease, also known as periodontal disease.

Diagnosing Periodontal (Gum) Disease

In order to assess your gum health, your dentist or dental hygienist utilizes x-rays and a clinical examination of your mouth.  Your x-rays show your bone levels between your teeth, which are key in maintaining a healthy foundation of your teeth.  They also reveal areas of calcified plaque, also known as calculus or tartar, around teeth.  The clinical examination involves assessing the appearance of gums.  Redness, swelling, and bleeding are signs of gum inflammation and infection.  The dentist or hygienist will also record your periodontal pocket depths.  These are measurements of the pockets that form between the teeth and the gums. 

Progression of Periodontal Disease

In healthy mouths, gingival (gum) pockets are shallow and bacteria, viruses, and other microbes are easily cleaned out by brushing and flossing.  However, if these microbes are allowed to stay in gingival pockets, they cause the gums to detach from the teeth leading to deeper and deeper pockets.  You may have heard your dentist tell you that pockets that are 3mm or less are healthy, and those that are 4mm or more are signs of inflammation or infection.  That’s because these deep pockets allow bacteria to hide so that they cannot be cleaned out by brushing and flossing.  As bacteria, viruses, and other microbes accumulate in the gum pockets, they cause the body to mount an immune response leading to red, swollen gums that bleed easily.  Over time, infected gums cause the bone between your teeth to disappear.  Bone loss eventually leads to teeth becoming loose and falling out.  This bone loss can be evaluated on your xrays.

Treatment of Periodontal Disease

If you have periodontal disease yet are treated with a preventative cleaning (meant for healthy gums), your teeth may feel smooth and clean but the gum disease will continue to progress.  A routine, preventative cleaning involves removing plaque and tartar from your teeth, between your teeth, and along the gumline.  SRP, or a deep cleaning, involves going under the gums to remove the bacteria and viruses responsible for wreaking havoc on your gums.  In order to keep you comfortable, your dentist or hygienist will often numb the area.  Depending on the extent of the periodontal disease, SRP often requires more than one appointment to complete.  Your SRP appointment should include an assessment of your current oral home care and tips to help you keep your gums healthy.

After your SRP is completed, you’ll have a follow up appointment to remeasure the pocket depths and evaluate the healing of your gums.   Once you’ve had deep pockets and bone loss, you’re more vulnerable to getting gum disease again.  Because of this, you’re dentist will likely recommend that you return every 3-4 months for ‘periodontal maintenance’ which include re-evaluation of your gums and a cleaning.  The shorter intervals reduce the likelihood that your periodontal disease will progress to the level where you need SRP again.

If you have been told that you have periodontal disease, you are not alone; over half of the population suffers from gum disease.  Although the symptoms of periodontal disease are often mild, it has been linked to other conditions including heart disease, diabetes, and dementia.  If you need a dentist or would like to be evaluated for gum disease, Dr. Tina Subherwal and the team at Smile Studios in Redmond, WA would be happy to help you.  To schedule, you can call (425) 584-3242 or book online at www.smilestudiosredmond.com.