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Not All Dental Cleanings Are Created Equal


Dental cleanings, also known as prophylaxis, are one of the most common dental procedures performed today. However, not all cleanings are done the same, nor do they produce the same results. Unfortunately, the term cleaning is used as a general term to indicate a series of different procedures usually performed by a registered dental hygienist.

The frequency of these cleaning treatments depends on a series of factors. The most important of these is the condition of the gums at the time of the visit. A patient’s home maintenance is important in order to maintain healthy gums & supporting bone. Gum health could vary dramatically throughout a patient’s lifetime depending on their habits, diet, environmental factors and general health.

In fact, research has shown a clear link between gum disease and heart disease. Gum disease can also be a contributing factor to those suffering from diabetes. After all the bacteria and the ensuing infection they cause are not limited to our mouths. We carry these infections in our bloodstream and swallow these bacteria transporting them to the other organs in our body. Therefore, we must take our dental cleaning very seriously and make sure we are receiving the greatest benefit from this procedure.

For simplicity, we’ll break down these “cleanings” into three different types. The first is a prophylaxis. This is a dental cleaning done without the presence of gum inflammation or infection. This is usually done as a maintenance procedure and performed every four to six months. A prophylaxis is defined as the removal of plaque or tartar and the polishing of teeth above the gum line. The procedure is usually done with a combination of ultrasonic & hand instruments as well as an abrasive polish to remove surface stain. Most dental insurance companies cover this basic maintenance procedure at a frequency of twice per year.

The second type of “cleaning” is called a full mouth debridement. This is defined as the removal of plaque & bacteria in the presence of gum inflammation. Inflammation is often the first sign of infection. It is represented as bleeding and swelling of the gums caused by bacteria that have migrated below the gum line.

The goal of the full mouth debridement is to remove the inflammation-causing-bacteria in order to return the gums to a healthy state. The gums and teeth should then be re-evaluated, usually in one to two weeks, to determine if the patient’s response was favorable. At this time usually a second cleaning or prophylaxis is done to remove any residential bacteria and polish the teeth to remove surface stains.

The final cleaning is termed a scaling and root planning. This may also be commonly referred to as “deep cleaning”. This procedure is quite different in that it is usually done under anesthetic and divided into four quadrants, upper right, & upper left, lower right & lower left.

Scaling & Root planning is indicated when the bacteria migrated below the gum line and produced tartar that is difficult to remove or has caused bone loss around the teeth. Bone loss occurs when acids from bacteria erode the bone surrounding the teeth. This bone loss can be labeled slight, moderate, or severe and is termed periodontal disease.

Although the presence of periodontal disease is a very serious condition, it often does not produce obvious symptoms that patients are aware of. This disease process is often slow, and insidious. The final outcome of teeth affected by periodontal disease that remain untreated is that the teeth loose all bone support, loosen, and eventually fall out.

At Biscayne Dental Group we go to lengths to prevent periodontal disease from occurring or progressing. We accomplish this by evaluating a complete set of x-rays & then evaluate the patient in the chair. Patients’ medical history, habits, diet and other factors are all discussed.

Not all cleanings are created equal. Most dental prophylaxis appointments are about 30 minutes. During this appointment the hygienist cleans and polishes your teeth above the gum line. During your 60 minute hygiene appointment, Andrea will do the following:

  • clean and polish your teeth above the gum line
  • use a piezio platinum plus ultrasonic scaler to remove tartar deposits under the gum line
  • perform a gingival lavage using first chlohexidine gluconate 12% (a very potent antibacterial solution), then 2% neutral sodium fluoride (to aid in remineralization of the teeth and prevent decay)
  • use of air polisher with mixture of salt (removes dead tissue, stimulates circulation and regeneration of new cells), sodium bicarbonate (neutralizes acids, balances ph, and deodorizes by killing anerobic bacteria)and pumice (polishes enamel and removes stain without abrading)
  • use of MI paste (a calcium and phosphate remineralizing solution)

In addition, we also look with our intraoral camera to see a magnified view of the teeth and gums to evaluate small changes not always visible with the naked eye. Once a year, we also do an oral cancer screening with Velscope. This is a special light that allows us to see 2 layers beyond the surface of the gum to detect any abnormal cellular changes long before they are visible on the surface.

As a final bonus, we offer you a FREE WHITENING FOR LIFE! We supply you with a free refill of tooth-whitening solution twice a year just for keeping your hygiene appointments current.