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Let’s take an in depth look at each of these procedures and what they include.

What is a regular or standard cleaning?

A regular cleaning is known as a prophylaxis in dental terms. The American Dental Association describes a prophylaxis as removal of plaque, calculus, and stains from the tooth structures. The removal of plaque, calculus, and stains is accomplished by dental instruments that scrape away deposits from the teeth. An electric device, called an ultra sonic or sonic scaler may also be used. This deposit removal is performed on tooth structures that have not been affected by bone loss, typically the crowns of the teeth.
-Calculus is also known as tarter and is a hard, mineralized deposit, somewhat like cement, that is formed from the plaque in the mouth and the minerals in saliva.
-Plaque is a soft, sticky substance that forms on teeth, regardless of what types of foods are eaten, which is composed of bacteria and bacterial byproducts.
A regular cleaning is recommended for persons who do not have any bones loss, periodontal disease, or infection around their teeth. There should also be no bleeding, mobility of the teeth, receded areas where the gums have pulled away from the teeth, or gaps where the spaces around the roots of the teeth. In other words, the mouth should be healthy, with no gum and bone problems.

What is a root planing procedure?

A root planing procedure removes bacteria and other toxins, tartar, and diseased deposits from the surfaces of the tooth roots. Scraping or scaling is required on the full length of the root surface, down to where the root, gum, and bone meet. Root planing is typically one of the first steps in treating gum and bone disease.
Periodontal disease is very common, but does not always have distinct symptoms. It is an inflammation and infection of the supporting structures of the teeth (gums, bone, ligaments, root surfaces) that eventually results in the loss of teeth. You may notice that your gums bleed easily, that you have a bad taste in your mouth, that your gums appear red or swollen, that your teeth appear longer or have shifted. Or you may not notice anything at all.
If you have periodontal disease, you may require root planing to remove diseased deposits from the roots of your teeth. Other treatment, including surgery, may be required. After the disease process is under control, a regular cleaning is not appropriate anymore. Instead, you will require special on-going gum and bone care procedures, also known as periodontal maintenance to keep your mouth healthy.

What is a periodontal maintenance procedure?

The American Dental Association describes periodontal maintenance as a procedure…instituted following periodontal therapy…(which) continues at varying intervals, determined by the clinical evaluation of the dentist, for the life of the dentition (for the life of the teeth) or any implant…(and) includes the removal of plaque and calculus from the supragingival and subgingival regions, site specific scaling and root planing.

-Following periodontal therapy means that a patient has received surgery or root planing in the past.
-Removal of plaque and calculus from the supra and subgingival regions means that any deposits and/or bacteria that are in place above or below the gum line are scaled away.
-Root planing means that root surfaces, both and above and below the gum line are scaled and smoothened to remove calculus, and diseased cementum and/or dentin.

A periodontal maintenance procedure is not the same treatment as a regular cleaning even though a hygienist may perform both services. A periodontal maintenance procedure, also known as supportive periodontal treatment (SPT), includes but may not be limited to:
-An update of your medical and dental history
-X-ray review
-Mouth/face exam inside and outside including cheeks lips, tongue, gums, and throat
-Tooth examination by the dentist. The dentist’s exam is usually separate from the periodontal maintenance.
-Gum and bone examination (periodontal probing around each tooth to check for bone loss)
-Review of home care
-Scaling and root planing as needed
-Polishing of teeth as needed
-Gum and pocket irrigation with medication as needed

What is a prophylaxis?

A prophylaxis is also called a cleaning. It is the removal of plaque, calculus and stains from tooth structures not affected by bone loss. (Typically the crowns of the teeth).

How often do I need to have my teeth cleaned?

The old system of everyone having their teeth cleaned only twice a year has fallen out of favor. In fact, many believe that the idea actually came from the recommendations of a 1940 toothpaste advertisement!

While some people may be able to maintain their dental health with semi-annual cleanings, many patients find that their mouths and teeth stay in better shape when they have their teeth cleaned more frequently. Many dentists and hygienists are now setting up a patent’s cleaning schedule based on their personal needs. This may be as often as four times a year.

My insurance pays for teeth cleaning twice a year. Why should I have it done more often?

Dental insurance isn’t really insurance (a payment to cover the cost of a loss) at all. It is actually a money benefit, typically provided by an employer, to help their employees pay for routine dental treatment. The employer usually buys a plan based on the amount of the benefit and how much the premium costs per month. Most benefit plans are only designed to cover a portion of the total cost of a person’s necessary dental treatment. For example, a dentists may recommend a crown for a tooth that has extensive decay, however, the dental plan may only cover the cost of a filling. This does not mean that the patient does not need a crown, only that the benefit is limited to a filling.

While twice a yearly insurance payment toward the cost of teeth cleaning is common, that type of payment arrangement actually has no relationship to what any patient might really need. Many patients need cleanings more frequently. People who have heavy plaque and tenacious calculus buildup are prime candidates. Also people who are generally healthy but have certain types of systemic conditions such as diabetes or those taking specific medications, may require more frequent cleanings. The good news is that with the help of dental benefits, the amount you have to pay is reduced.

I have been told that I have periodontal disease and need to have root planing and scaling. What is periodontal disease? What is root planing?

Periodontal disease can be described as an inflammation and/or infection of the gums and bone which support the teeth. Bacterial plaque, and its toxic byproducts, plus calculus and roughened root surfaces can overwhelm the mouth’s defenses. Typically, the unhealthy gum tissue covers eroded bone, resulting in abnormal pockets around the roots. Left untreated, periodontal disease can result in loss of teeth. It is a common, and sometimes silent condition in many adults.

Root planing and scaling are therapeutic, meticulous and time consuming treatments designed to remove toxins and bacteria from the root surfaces of the teeth, thereby allowing the body’s immune system to begin the healing process. Calculus (tartar), diseased cementum and/our dentin are scaled away. Cementum is the hard tissue tissue that covers the tooth root. Dentin is the part of the tooth that is underneath the cementum. These procedures are used as a complete treatment in some stages of periodontal disease, and as part of preparing the mouth for surgery in others. Several appointments , treating sections of the mouth, and local anesthesia may be required. Your dental hygienist or dentist may provide the service. The American Academy of Periodontology considers scaling the root surface to be a critical element in establishing periodontal health. In addition, recent studies are beginning to show a relationship between gum and bone health and certain heart conditions and other systemic disease.

Typically, and interval of three months between appointments is effective, but more frequent appointments may be needed. As in many other chronic conditions, successful long term control of the disease and prevention of tooth loss depends on continual, and possibly life time maintenance.

I understand that I need to come frequently for periodontal maintenance. How often will my insurance pay?

Many insurance plans pay for periodontal maintenance twice a year, even though most patients require appointments four time a year. Remember that insurance plans limit the number of exams, cleanings and periodontal maintenance appointments that they will cover because these are the types of treatments that many people need to have frequently. The good news is that any amount paid reduces what you have to pay out of your own pocket. It helps!

If my insurance plan will only pay for periodontal maintenance twice a year, why should I have it done more often?

Your insurance plan can help you pay for the treatment that you need, however it was never distend to pay for everything. Most plans typically pay a minimum regardless of what you might need as an individual . It is a mistake to let benefits be your sole consideration when you make decisions about your dental condition. People who have lost their teeth often say that they would pay any amount of money to get them back. Your teeth, smile, ability to chew and enjoy food, and general sense of well being are dependent on your dental health. It is worth the extra time and expense to keep your teeth for a lifetime.

Patient Education

Read our brochure on The Differences Between “Regular” Cleaning, Root Planing, and Periodontal Maintenance to learn more.