Deep Teeth Cleaning

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Dental - deep cleaning worthwhile?

April 2012

My dentist has recommended that I have a ''deep cleaning'' rather than a regular cleaning. Has anyone had this? Is it worthwhile? Unfortunately I hadn't had a cleaning for over 5 years and so I do have a lot of plaque build-up (but no cavities!). But I've never heard of a deep cleaning. It requires local anesthetic and has to be done in two separate visits (1/2 the mouth per visit, one hour each time). While insurance covers 100% of a regular cleaning it only covers 80% of the deep cleaning, for a total cost of $300. Also, I have two young kids and it will be difficult to go in for two longer appointments. I'm contemplating just asking for the regular cleaning now, seeing if it does an adequate job on the plaque, and holding off on the deep cleaning. Any advice based on experience greatly appreciated! Thanks. Maria

I asked the BPN community this same question a few months ago. My dentist was recommending deep cleaning and I'd never heard of it. I got mixed replies, some said it's worth it, others said it's just a way to generate fees. My theory is that the dentistry profession devises new procedures because fewer and fewer people and children have cavities due to flouridated water, they then persuade the insurance companies these procedures are necessary, and the insurance companies make a code for it, and there you go. Despite this, I went ahead with it, it took about an hour for one side and another hour for the other. Here's my recommendation to you. If you haven't had your teeth cleaned in 5 years then you should do it. If you get your teeth cleaned regularly it's not so clear it's needed. Jane

It really depends if you have gum disease or not. I do have gum disease. The dentist / hygentist measure the pockets between the teeth and the gums and measure 4s and 5s. We work on getting the 5s back to 4s and bath to 3s. If your gums are improving, no need for the deep clean. If you have gum disease and are too busy to spend a lot of time cleaning & working on your teeth, then maybe the deep clean is for you. Note that gum disease is totally different from cavities. Leads to bone loss between teeth, but not necessarily cavities there. working on better gums.

Dentist Recommends ''Deep Cleaning'' - What is it?

Dec 2011

My dentist has recommended I undergo ''deep cleaning'', I've never heard of it and want to know if it's a customary procedure. It involves numbing a quadrant of the mouth and doing some deep under-the-teeth cleaning. Each quadrant takes an hour, so to do the whole mouth takes 4 hours (not necessarily all at once), with each quadrant numbed. This sounds excessive. Has anyone out there undergone this procedure and is it worth it? It has an insurance code and is partly covered by my dental plan. I don't have great teeth but haven't had a cavity in years, and I think I have normal gum recession. Thanks! Jane

Usually you need a deep cleaning for your gums, and it's a pretty routine procedure. I've had several, and my results (including follow-up care like using floss/gelcam/toothpicking) usually last 5-10 years, so this doesn't have to be a regular thing. For the long-term health of your gums/teeth, I think it's worth it, and my insurance usually covers about 2/3rds of the cost. I think it's painful--I have to be very numbed, otherwise I'd be jumping out of the chair. Be sure to take some tylenol before hand--it will help with the swelling. Don't want dentures!

Back in the early 90s, I had a dentist who recommended this. This same dentist (in SF on Sutter St.) sent a huge bouquet of flowers to each new patient of his. I had never had as much as a cavity since I was 12 and visited his office when I was about 27. He strongly recommended a ''deep cleaning.'' I thought it was bunk and went and got a second opinion from my current dentist, who's been taking care of my teeth since approximately 1993. He thought it was completely unnecessary and to date has never recommended any such thing. I should add that I've had one filling and no other dental work since then, but I do take impeccable care of my teeth at home. I don't know if this story is of any help to you, but I think you are right to be skeptical. Anon

I've had this type of cleaning a few times at my periodontist's office (deep cleaning way below the gum line under anaesthesia). It's for periodontal disease, not cavities, to try to decrease bacterial growth and get the disease under control. I've had two quadrants at a time. I believe it's also referred to as 'scaling' or 'planing'. Some insurance will only cover it once every 2 years. If you have bad gum disease it seems appropriate, but it sounds like you don't think you do. Good luck. anon

Darn. I wrote a long-ish post, but failed on the submit part. Anyhoo, if your gum measurements are 2 or 3, my take is that you're fine and probably do not need any deep cleaning. If you hear 4 and 5, your gum recession may be ''normal,'' but it's not healthy. My only concern would be whether the dentist is proposing this work (and $$) for her/himself. Mine has referred me to a podiatrist in another practice the two times (over 10 or so years) that I've needed this. I get a (copay) consultation before committing to anything. I would personally be leery of my dentist proposing to do 4 hours of pricey work on my gums.

NOTE FROM MODERATOR: I think the poster means periodontist, not podiatrist!

It is not as bad as filling a cavity but is sort of unpleasant. However, going to the periodontist is much worse from what I have heard. If it's being recommended for you, you do need it and should go ahead. Don't do more than one quadrant per visit. Get Over with It

my understanding is that a deep subgingival cleaning is done when someone has lost gum tissue where the gum attaches to the root of the tooth and the gap between the gum and tooth is deeper than it should be. bacteria gets down there and forms calculus (tarter) and requires a lot of digging to remove. doing it without numbing would be too painful since it's pretty aggressive. you shouldn't need this unless your gums are detaching from your roots (per my understanding). but if you do have calculus down there, you definitely want to get it removed, as the bacteria will continue to deteriorate your gum tissue. anon

I had to have it done, and I never have cavities either. It has to do with your gum health, not your teeth. It's no picnic, but you should definitely do if it is recommended. I don't think the dentist would recommend this procedure if you didn't have periodontitis, an pervasive infection under your gums. They will go in and clean deep underneath the gums, which is why you need the numbing. Each section will be swollen and painful afterward while the gums heal, but it will be worth it to have healthier gums. Leaving the infection untreated isn't good for your overall health. For example, it has been found that women with periodontitis during pregnancy have more problems -- preterm labor, if I remember correctly -- than women without it, apparently due to the stress of constantly fighting a low-level infection. Your mouth will feel better and so will you. Also, you will find you no longer get the bad morning breath you probably get now. Do it! Anon

I would get a second opinion. A few years ago I picked the cheapest dental insurance I could get and went to the most sketchy dentist office I have ever been to because it was the only one that took that insurance (in SF). They told me I needed a ''deep cleaning'' and it sounded serious, so even though I think I questioned it, I went through with it. It was just like a normal cleaning, and I think they said it would involve scraping the roots under my gumline, but I don't think they even did that. I was up nights stressed and freaked out, and the whole thing was traumatic, and in the end I don't think it was necessary at all. No dentist before or since the sketchy one has ever even mentioned ''deep cleaning,'' so I would definitely question it. grateful to have good Dental insurance

I've had this done twice in the last 8 or so years, (one of the answers here: was from me). I was much more nervous about it than is warranted--I too had never heard of it, nor knew anyone who had it done, but once I started talking to people about it, I realized it is not that uncommon, and it's a procedure that consistently gives good results. Note: sometimes it is also called ''root planing'' disease still happy teeth

I suggest you get a second opinion. I really hate it that dentists sometimes use procedures like this just to make money, but some do. So a second opinion can really save you time, money, and worry. anon

I've had this done because I have gum disease. I have deep pockets in the back teeth so my dentist recommended it. I have no idea if it helped, but I wanted to reassure you that it's a normal recommendation for gum disease (I don't get cavities either; it's not about that). Mom with good oral hygiene, but bad gums

Don't worry, ''deep cleanings'' are actually quite common. Usually deep cleanings are recommended for patients who have active periodontal disease. Often times, you may see signs of gum disease if you have gums that are red, inflammed, or bleeding upon brushing/flossing. Deep cleanings are meant to remove as much as possible the bacteria that are deeper in your gum pockets that the ''regular cleanings'' aren't adequate for. That is why it is necessary to numb you up and do a more thorough cleaning quadrant by quadrant. Occasionally, some dentists are willing to do two quadrants at a time.

Once you have been diagnosed with gum disease, you must be extra diligent with your home care- brushing, flossing, etc. to maintain healthy gums. Otherwise, deep cleanings may need to be repeated every couple of years or so if the disease continues to have detrimental effects.

Also, the bacteria that causes gum disease does not have any correlation with the bacteria that causes cavities. Although gum disease can often be related to hygiene and home care, it sometimes can occur to people who do everything right, but just was born with the genes of gum disease. Left untreated, the bacteria from gum disease can spread to the heart, and can affect pregnancy. Hope this helps! anon

My old dentist recommended the same thing. He said my teeth and gums were in terrible shape and he wanted to get in there and apply antibiotics to attack the biofilm. Trouble is, I'm a microbiologist and what he was saying didn't make sense. You can't kill all of the bacterial cells with a single treatment of antibiotics (especially bacteria in biofilm!), and even if you could clean them away for a moment, other bacteria elsewhere in the mouth would migrate to the newly cleaned spots below the gumline. I did a lot of research in the scientific literature and couldn't find any rationale or justification for this procedure. So, when I saw the dentist the next time, I asked him to explain how it worked and I raised my concerns. He became unbelievably defensive and said, ''I have a dental degree. You don't know what you're talking about.'' Just for the record -- it was University Dental on San Pablo. Out of curiosity, is that where you go?

Anyway, I got myself out of there. I've been going to a different dentist for the last five years. None of the dire consequences (root canals, etc.) that the dentist at University Dental predicted have come to pass. In fact, I haven't had a single cavity, my teeth are in great shape, and the dentist I see now has actually recommended that I have X-rays less frequently because he sees no problems on the horizon.

My advice -- don't do it. And consider the possibility that your dentist is incompetent or a fraud. anon

Have you had deep cleaning done at the dentist?

Aug 2004

Has anyone had a deep cleaning done at the dentist? My understanding is you go in for two separate appointments that last 2 hrs each where they really dig deep and clean around the gum base. My dentist is recommending it but to be honest, I'm not looking forward to going through this at all. My questions are: has anyone done this and were the results positive enough to make it worthwhile? Has anyone instead pursued another option and been successful in reducing the amount of plaque build up around the gum line? How painful was this or was it no big deal? I'm wondering if going in for 3 month cleanings for a year is an alternative. Any suggestions or experiences would be welcome. Wimpy dental patient

I had deep cleaning done early this year. It was two appointments about 45min each. The dentist numbed the area, cleaning one side of the mouth each time. It wasn't a pleasant process but very effective. Judy

Don't hesitate! Despite good intentions, I never end up going for cleanings often enough and I'm poor at regularly flossing, so I consider this procedure a life-saver, as I'm prone to heavy plaque build-up and gingivitus. I've had a deep-cleaning procedure done twice in the last few years, the first time by an oral surgeon and just recently by my new dentist. Both times it was not very uncomfortable or painful at all -- really not a big deal -- and the results in dental/gum health are well worth it! Do yourself a big favor ! and just do it. One who knows

I asked about this about a year ago, and thanks to the advice I got from people on this list, I went ahead and did it. My pockets went from mostly 6's and 5's to mostly 2's and 3's, and my dentist was very happy with the results (and so was I!). I was very nervous about doing it, but it's really not a big deal-- they will use the local anesthetic and it is uncomfortable to have half your mouth numb for a few hours after the cleaning, but that's the only drawback. I am now doing cleaning every 3 months to maintain things. I don't think that just doing more frequent cleanings will accomplish the same thing--they need to really get in deep to remove the plaque and make a nice surface for the gums to heal back onto. signed: happy teeth

I just had a deep cleaning on three quadrants. If you are told you need it, it's because they need to get beneath the gums where you cannot reach with dental floss or toothbrush and where your regular hygienist usually doesn't go when you get your teeth cleaned biannually. It didn't hurt for me. In fact, I felt like my gums were getting massaged, and I liked that feeling. If your gums/teeth are more sensitive than mine, you can get anesthetic applied. It may take a little longer and cost a little more (may not be covered by insurance.) I would definitely recommend doing it to guard against further decay and gum disease. If you don't do it, you take the risk of bacteria continuing to build, possible inflammation and tenderness, and then your body's immune system reacting to the presence of bacteria. I have also had periodontal surgery, and you don't want to go there! My periodontist is Dr. Gauss at Rockridge Dental. She is very! smart and very good. anonymous

I'm a wimp like yourself and was pretty anxious when given the same recommendation (partly my fault, though, for not sufficiently flossing). I was numbed up, and after getting over the shots, didn't feel anything but the pressure from the cleaning. My gums/mouth definitely felt better/cleaner, and outside of the quick pricks from the shots, completely painless. It might have helped that my dentist's office offers headsets that allow patients to watch movies while having work done. Honestly, I truly dread my annual visit, and these additional trips weren't that bad. If anything, it made me better at flossing! Good luck! anon

Scaling and root planing

July 2003

My dentist is recommending a periodontal scaling and root planing. I had never heard of this, but their explanation convinced me that it is a good idea (some of my tooth pocket measurements were 6 mm). Can anyone give me insight into this procedure? Is it painful? Did your pocket depth improve? Did you have to do it more than once? Does it matter who does the procedure? don't want my teeth to fall out before I'm 40 (which is next year)

I had to have scaling and root planing about 8 years ago. Since I had been a student and had not gone to the dentist on a regularly scheduled basis, my dentist recommended that I have this process done. I had deep pockets of 5 and one or two 6's in the back and regular flossing and brushing were not going to make it better. It is much more instrusive than a regular cleaning.

My dentist, Dr. Sean Sullivan in Concord (925-689-7300, suggested that we do it on two appointments because he had to use a local anesthetic and didn't want my entire mouth to be numb. The procedure itself takes about 1.5 hours each time to do and is not painful (maybe because I have never been afraid of going to the dentist and have a high tolerance for pain. However, you will be sore for 2-3 days following this procedure.

Since that time, I have gone to the dentist 2-3 times per year and have not had any more problems. According to my dentist, the key is to have this procedure done once and then floss and brush to maintain everything clean.

Luckily, my insurance covered the whole procedure that can run upwards of $1200. I'm glad that I had it done because I didn't want to get premature gum disease. Clean teeth and gums

I had a scaling and root planing done about 15 years ago (I/m 50 now). I don't remember it being any more painful than having a filling done. Well, maybe two fillings. My pockets went from 8-9 mm for the worst ones to 5-6 mm. The improvement was very clear. I also ceased having problems with bleeding gums. I haven't had it done again, but I have remained on alternating cleaning visits to the periodontist and my regular dentist ever since, and I have acquired a fine collection of little dental cleaning devices (floss, proxabrushes, etc.) for getting at those gum/tooth boundaries. I don't know if there are different skill levels - I suspect so. My periodontist was (is) Dr. Pia Lodberg near Alta Bates in Berkeley. been there, done that

I think that root planing and scaling are pretty much synonymous. The procedure involves numbing a quadrant of your mouth and really getting in between the gum and tooth to scrape the hardened calculus off the tooth surface. Hygienists will usually do two quadrants during one visit. As far as I was concerned, getting the pocket reading was far worse than the actual scaling. Since your mouth is numbed up you do not feel anything, although I did feel the pressure that was being placed on my teeth. The aftermath was a sore jaw and tender gums, ibuprofin or some such pain reliever can help with that. Ask your hygienist for what they recommend.

My pocket depths have improved and my gums look pink and healthy now. After the root planing you will probably need to go in every three months for a cleaning. Flossing is key for gum health. I had no idea and my grandfather (probably rolling over in his grave) was a dentist. I was always under the impression that it was cavities that led to tooth decay and subsequent tooth loss. The poor maligned gums, I underestimated their importance.

Your dentist or hygienist should be able to tell you more about the state of your gums. I was heading for periodontal gum disease with the condition that my gums were in. Do the root planing as soon as possible, go to your cleanings, and floss, floss, floss! Sonya

I was a former dental hygienist for 20 years, and I have performed the procedure of periodontal scaling and root planing hundreds of times. I have also had this procedure done in my mouth more than once. If you have 6mm pockets, I would definitely recommend it. I would recommend it with 5mm and sometimes with 4mm pockets. You have some form of periodontitis which is an inflammation of the supportive structure (gums and bone) of the teeth. It is generally caused from specific bacteria in plaque. The results of treatment vary. With a 6mm pocket you may only get shrinkage to 4 or 5mm. Ideal sulcus depths in a healthy mouth are 1mm to 3mm. It is possible you may have to have the procedure repeated again in 2, 3, 4 years or so. I am sure your dentist has told you how important your homecare is, and that you should be flossing daily, etc. The root planing will fail over time if you are not doing your part. Generally a local anesthetic (injection) is used so you shouldn't feel the actual scaling and root planing. Your mouth may be a little tender for a day or two. Usually a dental hygienist or a periodontist will perform the procedure. Hope this was helpful. Good luck! L

I had scaling and root planing done over almost 2 years ago, for the same reasons your dentist gave you. I feel the results were very effective - my pockets have greatly diminished, and I haven't had or needed any repeat treatments. I do get my teeth cleaned 4 times a year as part of regular dental maintenance. I've always have strong healthy teeth, but the condition this treatment addresses is for gum problems. I strongly recommend it. scaling worked for me!

I would definately get a second opinion. I have found many dentists to be like used car salesmen when it comes to procedures that are not really necessary. I had scaling once and I feel like a complete sucker for falling for it -- it was expensive and painful. Other dentists over the years have recommended other procedures that I did not agree to and my teeth are just fine. My current dentist (Dr. Kim in El Cerrito) does not measure ''pockets,'' gives brushing and flossing advice, cleans my teeth and sends me on my way. LC

Check the web site from the american dental hygienist association and search for scaling and root planing you will learn all you need to know. I am a dental hygenist can assure you that if you have 6mm pockets you need root planning. ITs not bad. Wendy