Dental Cleanings

Professional dental cleanings (dental prophylaxis) are performed by your Scripps Ranch dentist. Your cleaning appointment will include a dental exam and the following:

  • Removal of calculus (tartar): Calculus is hardened plaque that has been left on the tooth for some time and is now firmly attached to the tooth surface. Calculus forms above and below the gum line and can only be removed with special dental instruments.
  • Removal of plaque: Plaque is a sticky, almost invisible film that forms on the teeth. It is a growing colony of living bacteria, food debris, and saliva. The bacteria produce toxins (poisons) that inflame the gum. This inflammation is the start of periodontal disease!
  • Teeth polishing: Remove stain and plaque that is not otherwise removed during tooth brushing and flossing.

During the initial exam, we will evaluate your gum for any active disease. We will determine the type of cleaning you will need based on our evaluation. There are different types of cleanings based on the health of your gum.

Gross Debris

Gross debris is the act of removing plaque from your teeth.  There are few instances that a Gross debris will need to be performed by your Scripps Ranch dentist:

  • Doctor can not perform an exam because there is too much plaque covering the surfaces of teeth that need to be examined.
  • Usually performed before a scaling and root planing so that your gums do not bleed as much during the scaling and root planing so that the tartar can be visualized.
  • A few days before an extraction to reduce the chance of infection of the extraction site.

In conclusion, a gross debris is performed to reduce the bacteria in the mouth.

woman smiling in dental chair

Prophy (Simple Cleaning)

A dental prophylaxis or as many call it, a prophy, is a simple cleaning performed by your Scripps Ranch dentist to thoroughly clean the teeth.  Prophylaxis is an important dental treatment for halting the progression of periodontal (gum) disease and gingivitis.

Periodontal disease and gingivitis occur when bacteria from plaque colonize on the gingival (gum) tissue, either above or below the gum line.  These bacteria colonies cause serious inflammation and irritation which in turn produce a chronic inflammatory response in the body.  As a result, the body begins to systematically destroy gum and bone tissue, making the teeth shift, become unstable, or completely fall out.  The pockets between the gums and teeth become deeper and house more bacteria which may travel via the bloodstream and infect other parts of the body and possibly lead to heart disease among other issues.

Prophylaxis is an excellent procedure to help keep the oral cavity in good health and also halt the progression of gum disease, helping you have healthy gums and teeth for life.

Here are some of the benefits of prophylaxis:

  • Tartar removal: Tartar (calculus) and plaque buildup, both above and below the gum line, can cause serious periodontal problems if left untreated.  Even while using the best brushing and flossing home care techniques, it can be impossible to remove debris, bacteria and deposits from gum pockets.  The experienced eye of a dentist, using specialized dental equipment, is needed in order to spot and treat problems such as tartar and plaque buildup.
  • Aesthetics: It’s hard to feel confident about a smile marred by yellowing, stained teeth.  Prophylaxis can rid the teeth of unsightly stains and return the smile to its former glory.
  • Fresher breath: Periodontal disease is often signified by persistent bad breath (halitosis).  Bad breath is generally caused by a combination of rotting food particles below the gum line, possible gangrene stemming from gum infection, and periodontal problems.  The removal of plaque, calculus, and bacteria noticeably improves breath and alleviates irritation.
  • Identification of health issues: Many health problems first present themselves to the dentist.  Since prophylaxis involves a thorough examination of the entire oral cavity, the dentist is able to screen for oral cancer, evaluate the risk of periodontitis and often spot signs of medical problems like diabetes and kidney problems.  Recommendations can also be provided for altering the home care regimen.

Prophylaxis can either be performed in the course of a regular dental visit or, if necessary, under general anesthetic.  The latter is particularly common where severe periodontal disease is suspected or has been diagnosed by the dentist.

Prophylaxis is generally performed in several stages:

  • Supragingival cleaning: The dentist will thoroughly clean the area above the gum line with scaling tools to rid them of plaque and calculus.
  • Subgingival cleaning: This is the most important step for patients with periodontal disease, because the dentist is able to remove calculus from the gum pockets and beneath the gum line.
  • Root planing: This is the smoothing of the tooth root by the dentist to eliminate any remaining bacteria.  These bacteria are extremely dangerous to periodontitis sufferers, so eliminating them is one of the top priorities of the dentist.
  • Medication: Following scaling and root planing, an antibiotic or antimicrobial cream is often placed in the gum pockets.  These creams promote fast and healthy healing in the pockets and help ease discomfort.
  • X-ray and examination:Routine X-rays can be extremely revealing when it comes to periodontal disease.  X-rays show the extent of bone and gum recession, and also aid the dentist in identifying areas which may need future attention.

Prophylaxis is recommended bi-annually as a preventative measure, but should be performed every 3-4 months on periodontitis sufferers.  Though gum disease cannot be completely reversed, prophylaxis is one of the tools the dentist can use to effectively halt its destructive progress.

Woman smiling in dental chairScale and Root Planing (Deep Cleaning)

A localized deep scale is almost the same as a deep scale  except that a localized deep scale is performed only in a couple sites in the mouth.  In other words, a localized deep scale is a deep cleaning in a couple sites in the mouth where as a deep cleaning is deep cleaning of all the sites in the mouth.

The objective of scaling and root planing is to remove the agents which cause inflammation to the gingival (gum) tissue and surrounding bone.  Common disease causing agents such as dental plaque and calculus (tartar) are removed by this  therapy.

These non-surgical procedures which completely cleanse the periodontium (gums and supporting bone structure) work very effectively for individuals suffering from gingivitis (mild gum inflammation) and moderate/severe periodontal disease.

Reasons for scaling and root planing

Scaling and root planning can be used both as a preventative measure and as a stand-alone treatment.  These procedures are performed as a preventative measure for a periodontitis sufferer.

Here are some reasons why these dental procedures may be necessary:

  • Disease prevention: The oral bacteria which cause periodontal infections can travel via the bloodstream to other parts of the body.  Research has shown that lung infections and heart disease have been linked to periodontal bacteria.  Scaling and root planing remove bacteria and halts periodontal disease from progressing, thus preventing the bacteria from traveling to other parts of the body.
  • Tooth protection: When gum pockets exceed 3 mm in depth, there is a greater risk of periodontal disease.  As pockets deepen, they tend to house more colonies of dangerous bacteria.  Eventually, a chronic inflammatory response by the body begins to destroy gingival and bone tissue which may lead to tooth loss.  Periodontal disease is the number one cause of tooth loss in the developed world.
  • Aesthetic effects: Scaling and root planing help remove tartar and plaque from the teeth and below the gum-line.  As an added bonus, if superficial stains are present on the teeth, they will be removed in the process of the scaling and root planning procedure.
  • Better breath: One of the most common signs of periodontal disease is halitosis (bad breath).  Food particles and bacteria can cause a persistent bad odor in the oral cavity which is alleviated with cleaning procedures such as scaling and root planing.

Scaling and root planing treatments are only performed after a thorough examination of the mouth.  The dentist will take x-rays, conduct visual examinations, and make a diagnosis before recommending or beginning these procedures.

Depending on the current condition of the gums, the amount of calculus (tartar) present, the depth of the pockets, and the progression of the periodontitis, local anesthetic may be used.

Scaling – This procedure is usually performed with special dental instruments and may include an ultrasonic scaling tool.  The scaling tool removes calculus and plaque from the surface of the crown and root surfaces.  In many cases, the scaling tool includes an irrigation process that can also be used to deliver an antimicrobial agent below the gums that can help reduce oral bacteria.

Root Planing – This procedure is a specific treatment which serves to remove cementum and surface dentin that is embedded with unwanted microorganisms, toxins and tartar.  The root of the tooth is literally smoothed in order to promote good healing. Having clean, smooth root surfaces helps bacteria from easily colonizing in future.

Following these deep cleaning procedures, the gum pockets may be treated with antibiotics.  This will soothe irritation, and help the gum tissues to heal quickly.

During the next appointment, the dentist or hygienist will thoroughly examine the gums again to see how well the pockets have healed.  If the gum pockets still measure more than 3 mm in depth, additional and more intensive treatments may be recommended.

If your last dental checkup and cleaning has been long overdue or you’re looking for a new dentist call (858) 271-1010 or contact us online to schedule an appointment.