What Happens During a Dental Cleaning?
When you go to the dentist for “just a cleaning”, it’s actually a lot more than that. It’s a wellness visit and your appointment may include:
Reviewing your health history and medications
It may seem like information that they don’t need, but your dental providers ask about medical conditions because many chronic conditions can affect your teeth and gums. Things like diabetes, rheumatoid arthritis, and heart disease are all linked to dental issues. Medications often have side effects like dry mouth that can increase your risk of cavities and gum disease.
Blood pressure check
Your dental office may take your blood pressure, sometimes just as a screening since you might see them more often than your doctor, but also to be sure it is safe to proceed with your care that day. Dental treatment can be stressful, and anesthetics can affect your heart, so your dentist may want to know what your blood pressure is before starting procedures.
X-rays
X-rays are an extremely important diagnostic tool for your dentist. Most offices update bitewing x-rays yearly and full mouth x-rays every 3 to 5 years. Many dental issues are not apparent just by looking in your mouth until they’ve progressed to be major issues. Taking x-rays allows your dentist to catch problems early, often before they are painful, and while they are easier and less expensive to treat. The exposure to radiation with dental x-rays is extremely low, and the benefits of early diagnosis far outweigh the risks. https://www.todaysrdh.com/wp-content/uploads/2017/12/Dental-X-Ray-Radiation-Comparison-Chart.pdf
Photos
Taking photos of your teeth and smile is another way your dentist can document conditions of your teeth and track changes over time. Photos can show the position of the teeth in the arches, the way your teeth fit together in your bite (also known as your occlusion), cracks and chips, and discolorations that are not visible on x-rays.
Oral cancer screening
Your dentist or hygienist may feel the outside of your mouth around your chin and neck to check for swollen lymph nodes or abnormalities. Using a mirror, they will look at the tissues inside your mouth and have you stick out your tongue to check for lesions or swelling on or around your tongue, cheeks, floor of the mouth, or throat. Oral cancer is rare, but is much more easily treatable if caught in early stages. Even if you don’t smoke or chew tobacco, it does not mean you cannot get oral cancer.
Periodontal examination
A periodontal examination to check the health of your gums is generally done at least once a year. It is performed with an instrument called a periodontal probe that is used to measure the space between the teeth and gums. Gum disease affects about half of adults in the United States and is linked to increases in heart disease, diabetes, Alzheimer’s disease, and colon cancer. If serious gum disease, periodontitis, is left untreated long enough, your teeth get loose and fall out. (link to: How does the dentist determine if I have gum disease?).
Ultrasonic and/or hand scaling
This is the “cleaning” part of your appointment. Specialized instruments called scalers are used to remove plaque and tartar from the teeth. Ultrasonic scalers use tiny vibrations to break up the buildup and water to flush debris and bacteria from between your teeth and under the gums. Hand scalers are the traditional dental instruments used to scrape the deposits from the tooth surfaces. Plaque that has hardened onto your teeth to form tartar cannot be removed with your toothbrush and floss anymore, and needs to be removed by a professional cleaning. If tartar (also known as dental calculus) is left on the teeth, it will irritate the tissues and contribute to gum disease.
Polishing
To polish your teeth, your provider uses an abrasive paste on a rotating instrument. Polishing removes residual surface stain and soft plaque on your teeth that was not removed with scalers. During polishing, a protein layer called the acquired pellicle is removed, which is why your teeth feel extra smooth afterwards. This protective layer starts reforming immediately, and is fully reformed within a few hours.
Flossing
At the end of the cleaning, floss is used to remove any plaque or polishing paste that is left between your teeth. Your dental hygienist or dentist is also making sure everything feels smooth and nothing is left behind.
Fluoride Treatment
Fluoride treatments strengthen the enamel to reduce cavities. Most often it is applied as a sticky coating called varnish that you will leave on your teeth for a few hours after your appointment. For more detailed information, check out our Flouride Treatment in-depth article.
Oral Hygiene Instruction
Seeing your dentist regularly is only part of keeping your teeth healthy. Taking care of your teeth at home is critical to maintaining your smile, so your dental team will try to give you advice and tips on the best ways to improve your brushing and flossing. It can feel like a lecture if you haven’t been doing everything you’re “supposed to”, but they do it because they care about you, and they spend all day seeing the consequences of people not taking care of their teeth. Try to think of it as coaching instead of scolding.
Dental Exam
Up to this point, you’ve probably spent all your time with a dental hygienist, and now the dentist is going to come in and check your teeth. They will look at your x-rays to make sure everything is normal, and use an instrument to feel for cavities and check the edges of your fillings and crowns to be sure they are sealed and have not developed any issues. If your dentist finds any problems, they will recommend treatment to correct them before they get worse.
And after all that is done, the last thing you will do is… set up follow-up appointments to come back for any necessary dental treatment, or hopefully, “just another cleaning”.
