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Alan L. Stott, DDS

Dental Cleanings

Young beautiful brunette female dentist at dentist's surgery

What is a dental cleaning?

 A dental cleaning is a procedure in which a dentist or dental hygienist cleans the tartar deposits and plaque off the teeth, polishes the teeth, and provides oral hygiene instructions. Dental cleanings are designed to treat gum disease and prevent it from returning.

What is plaque? What is tartar (or calculus)?

 Plaque is a soft sticky film of food and bacteria that forms on the teeth. If not removed, the plaque creates acids that infect the tooth surfaces and the gums. Plaque is the main cause of tooth decay and gum disease. If plaque is allowed to stay in the mouth for several days, it will start to harden and form tartar, which are deposits on the tooth surfaces.

What is gum disease or gingivitis?

Gum disease includes gingivitis and periodontitis. Gingivitis is when the gums become infected and inflamed by the plaque, tartar, and bacteria staying on the teeth and gums too long. There are three stages of gingivitis- beginning, moderate, and severe. The longer plaque and tartar remain in the mouth, the worse the gingivitis becomes. The gingivitis causes a deepening of the gum pockets around the teeth. As these pockets get deeper, they accumulate more plaque, tartar and bacteria, worsening the infection in the gum tissue and leading to the more serious part of gum disease, periodontitis.

What is periodontitis?

Periodontitis is an advanced form of gum disease. There are three stages of periodontitis- beginning, moderate, and severe. With periodontitis, the gum infection goes deeper than gingivitis and starts to wear away at the supporting tissues and bone around the roots of the teeth. Periodontitis is the most common reason for tooth loss. When the bone has been dissolved away by the infection, the teeth will fall out or have to be removed because they are too loose.

 How can I tell if I have gingivitis, periodontitis, or gum disease?

Four out of five people have some form of gum disease and don’t know it. The disease is usually painless in the beginning stages. If people do not floss and brush their teeth, they will likely have gum disease. If the plaque, tartar, and bacteria are not removed, gum disease will form. Here are some signs and symptoms of gum disease: red and puffy gums, bleeding gums, persistent bad breath, loose teeth, pus coming out of the gum pockets around teeth, and discomfort around the teeth and gums.

How can I avoid gum disease? Why is oral hygiene so important?

Gum disease can be avoided by performing good oral hygiene on a daily basis. Good oral hygiene means good brushing and flossing of the teeth and brushing the tongue. There is a lot of bacteria on the tongue and it needs to be removed daily by scrubbing with a toothbrush as far back as you can go.

 How can I avoid losing my teeth?

You can avoid losing your teeth by brushing and flossing well at home, having regular dental cleanings and exams, and having dental work done when the problems are small.

How often do I need a dental cleaning and exam?

Most people need a dental cleaning and exam every 6 months. Some people need to have a cleaning more frequently, at around every 3 months if the condition of their gums requires more frequent cleanings. Dr. Stott will likely take x-rays once a year so he can see in between the teeth and see the supporting bone. And remember, the x-ray technology we use in the office is the safest available.

What happens during a dental cleaning?

During a dental cleaning our dental hygienist checks the gums and teeth for any new problems. He/she will scale the plaque and tartar off the teeth. This is followed by flossing and polishing the teeth. The dental professional will then go over oral hygiene instructions and answer any questions.

Why is brushing your teeth so important.? What is the best way to brush your teeth? What is the best toothbrush?

 Plaque and bacteria will build up in your mouth. If you do not remove it, gum disease and decay will develop. If untreated, teeth will break, the bone will dissolve around teeth, abscesses will develop, and teeth will be lost. The best way to learn how to brush your teeth is to schedule a cleaning with your dental hygienist and have her give you a demonstration. A soft (not hard) bristle toothbrush is the best.  

Why is flossing your teeth so important? What is the best way to floss your teeth? What is the best floss?

Just like brushing, flossing will help prevent tooth decay, gum disease, bad breath, and tooth loss. Brushing will clean the sides and biting surfaces of the teeth but it will not clean the surfaces in between the teeth. Like with brushing, the best way to learn how to floss your teeth is to schedule a cleaning with your dental hygienist and have her give you a demonstration. Most dental flosses work fine. Some prefer waxed floss since it can slide in between the teeth better. Try different types and see what you prefer.  Some people say their fingers are too big or not coordinated enough to use the floss in the mouth. If that is the case, you can try some of the floss holders available at most grocery or drug stores.

Should I use a mouthwash? Which mouthwash is best?

If you brush and floss well, I don’t think using a mouthwash is that important. Some have fluoride, but you can get that in toothpaste. You can get a freshening of your breath with toothpaste, sugarless gum, or sugarless breath mints. If you feel you want any added advantage that a mouthwash may provide, I would suggest Listerine Antiseptic Mouthwash. Some studies show that it does kill some germs in the mouth due to its alcohol content. However, the alcohol it contains can also dry out the mouth.  If you have a dry mouth problem, Biotene is the mouthwash brand that may be best.

How often should I brush and floss?

You should brush your teeth at least twice a day and floss at least once a day. It is a healthy habit to get into. I can tell you that those who are middle age or older and are having serious and expensive dental problems, wish they had been brushing and flossing over the past 20-40 years. Dentures are not a good solution. Full mouth dental implants are very expensive and may not be possible if there is a lot of bone loss.

 Who can do a professional dental cleaning?

 Dental cleanings can be done by a licensed dentist or a licensed dental hygienist. Some dental assistants with extra training can help with the polishing of the teeth but not the other teeth cleaning procedures.

 Does a dental cleaning hurt?

This depends on the condition of your teeth and gums. If you have good home care and have a professional dental cleaning every six months, a dental cleaning should be very comfortable. If your home care is not good and you have not had your teeth cleaned for over a year, then you may have some discomfort during a cleaning. Often, patients who do not have good home care and have not had their teeth cleaned for a long time, will requires deep cleanings, which involve numbing the gums before the cleaning is done.

 Do different offices do dental cleanings in different ways? Does the quality of dental cleanings vary from office to office?

Often, we see dental clinics that cut corners when it comes to dental cleanings. Some of these clinics have dental assistants do all the cleanings rather than the dentist or dental hygienist. Their cleanings may take 5 minutes instead of the typical 30-45 minutes in a quality dental office.

What are the gum pockets around the teeth? Why does the dentist measure the gum pockets?

There is a space between the teeth and the gums forming a pocket that goes all the way around each tooth. It can measure from 1 mm (millimeter) to 15 mm. 1 to 4 mm is good and is one indication of healthy gums. 5-6 mm is getting moderately deep and is an indication of increasing gum disease. Usually pockets of 7+ mm indicate bone loss around the teeth. One goal of gum treatment is to keep the pockets clean and healthy, thereby helping prevent further gum infection and bone loss.

Which is better a manual or an electric toothbrush? Which electric toothbrush is better?

If you are a good brusher, hold the toothbrush at the proper angle, go around the mouth in a good sequence, and spend the right amount of time, a manual toothbrush will work fine. A manual toothbrush is definitely a lot cheaper than an electric toothbrush. If you have a dexterity problem using a manual toothbrush or you want to finish brushing your teeth faster, an electric toothbrush might be best for you. Since it has a motor and requires maintenance, the electric toothbrush will cost a lot more to use. Some people feel their teeth are cleaner with an electric toothbrush. Sonicare and Oral-B are two of the most common brands of electric toothbrushes. Personally, I prefer the manual and my wife prefers the electric. The most important thing is that you brush and floss every day.

What is a deep cleaning or root planning? When does it need to be done?

Deep cleaning is recommended when bacteria and plaque accumulate in the deepening gum pockets around the teeth. Basically, a regular cleaning cleans above the gumline while the deep cleaning or root planning cleans the root surfaces below the gumline. Usually, with deep cleaning, the gums are numbed so the procedure will be comfortable for the patient. After the treatment, the gums will be mildly sore but this can be taken care of with some over-the-counter pain medication. Some people will be reluctant to have a deep cleaning if there is any chance that pain will be involved. This treatment is like treatment of other diseases in the body- if we don’t treat the disease, we will suffer the consequences.

What is periodontal maintenance? How does it differ from a regular dental cleaning?

Periodontal maintenance is a more thorough cleaning given to patients who have had deep cleaning done or who have a lot of problems keeping their gum disease under control. Most regular cleanings are done every six months on patients with beginning to moderate gum disease. Periodontal maintenance is done on patients every 3-4 months. Patients who come in for a regular or periodontal cleaning every 3-6 months greatly improve their chances of keeping their teeth for the rest of their lives.

What causes sensitive teeth? What can be done for sensitive teeth?

Here are some causes and solutions for sensitive teeth:

Tooth Decay Solution: Remove the decay and place a filling or crown. If the decay is into the nerve of the tooth, root canal treatment will be needed.

Gum Disease Solution: Have the dentist evaluate your teeth and gums and see what type of gum treatment you need. It may be a regular cleaning, a deep cleaning, or just better home care.

Exposed Root Surfaces or Thin Enamel Solution: First, try a desensitizing toothpaste like Sensodyne. Next, stop using foods and drinks that are sugary and acidic which can make the teeth more sensitive. The dentist can place some resin coating on the sensitive areas to protect them from hot and cold foods and drinks. If these things don’t work, the dentist can place fillings and crowns on the teeth to better covered the sensitive areas.

Which tooth paste is best for sensitive teeth?

I like Sensodyne, which contains potassium nitrate and fluoride, which can help reduce tooth sensitivity.

Can I just use a Waterpik to clean my teeth? Can I use a Waterpik instead of floss?

We always use the analogy of cleaning a car. If you squirt the car with water only, when the car dries, you will see most of the dirt still there. You need to scrub the dirt off with a rag in order to see a really clean car. The same principle goes for the mouth. If you just squirt or rinse your teeth with water, the plaque, tartar and stain will not come off until you scrub the teeth with a toothbrush, floss, or dental instrument. Waterpiks do not do any scrubbing.

Can I just use a toothpick to clean in between my teeth?

Floss gets in the narrow spaces between the teeth and gums. Floss will scrub these hard to reach surfaces to remove the plaque. A toothpick can never reach these spaces. It can only remove large chunks of food. A toothpick can damage the papilla (points of gum between the teeth).

What can I do about stained or discolored teeth?

The first thing to do is have a complete exam by your dentist. A lot of stain will be caused by the use of coffee, tea, tobacco, and certain foods and drinks. The dentist will probably recommend a cleaning by the dental hygienist and some other gum treatment. If discolored teeth are caused by tooth decay, you need to have the decay removed and fillings or crowns placed. If your teeth and gums are in good shape and you still want to remove the stain or darker color of your teeth, considering using some of the whitening systems. See our question and answer section on teeth whitening.

What causes bad breath? What do I do to prevent bad breath?

Bad breath (halitosis) can be caused by several things. Everyone can have bad breath from time to time. Often, we do not realize we have it. You cannot smell your own bad breath.

Here are some of the causes and solutions for bad breath:

Dry Mouth All Night Long (Morning Breath) When the saliva flow stops, it reduces its cleaning action. Without the saliva flow, bacteria will grow, and we have bad breath. Solution: You really can’t do anything to prevent the bacteria from growing overnight. In the morning brush and floss your teeth and gums and brush your tongue well.

Certain Foods and Drinks Foods and Drinks that can cause bad breath include garlic, onion, several spices, dairy products, coffee, alcohol, and fish. Solution: Cut back or eliminates some of these foods and drinks. The odors caused by these food and drinks don’t typically come from the stomach. Some of the odor causing molecules they contain are picked up in the blood stream and work their way to the lungs. There, the odors are exhaled in the person’s breath. You can also use some fresh smelling gums, mints, toothpastes, and mouthwashes.

Poor Oral Hygiene Poor oral hygiene allows the bacteria in the mouth to grow producing bad odors. Solution: Brush and floss well. Have regular cleanings by your dentist or dental hygienist. Take care of any mouth problems like tooth decay and gum disease that can cause bad breath.

Dry Mouth We discussed before what can be done about Morning Breath. But, some people have dry mouths due to poor saliva flow from having certain medical conditions, taking certain medications, or mouth breathing. Solution: Get a physical exam by your doctor to look for any unknown medical problem. Ask your physician if medications can be used that do not reduce saliva flow. Use nasal decongestants that will help you breathe better through your nose and allow you to not breathe through your mouth. Use Biotene dry mouth products.

Tobacco Products These dry the mouth and cause gum disease. Both actions cause bad breath. Solution: Stop using these products.

Dieting Certain chemicals called ketones are released in the breath as the body burns fat. Solution: For many of us, dieting is a good thing as we lose pounds and our body gets healthier. I would say get your body healthier and do what you can to reduce the other causes of bad breath as you lose weight. Once you reach a good healthy weight for you, then any bad breath problems caused by dieting can stop.

Dehydration, Hunger, and Missed Meals Solution: This is an obvious one. Drink and eat more often. But, don’t eat and drink so much than you have to diet to get healthy again. Drinking water frequently during the day is a good habit.

Certain Medical Conditions and Illnesses Diabetes, liver and kidney problems, nose and sinus problems, lung problems like bronchitis and pneumonia can all cause bad breath. Solution: Seek medical advice on how to eliminate these conditions.

What should I do if I have bad breath?

Review in this section some of the causes of bad breath and what to do to eliminate or reduce these causes. See your dentist to have a full mouth evaluation to look for tooth and gum disease. The dentist can also give you some ideas on how to reduce bad breath.

Do teeth whitening systems work? What are the differences between the systems?

Teeth whitening systems can be effective in reducing stains and discoloration of the teeth. Review our section on Teeth Whitening for more details.

What causes gum recession? What can be done about gum recession?

There can be several causes to gum recession. The major cause is the position of the teeth in the jawbone. The teeth are on the top of the u-shaped arches. When the teeth are perfectly centered in the arch, the bone and gums cover the roots well. If the teeth are positioned too far to the cheek or lip side of the arch, the bone and gums will not cover the roots of the teeth well, giving us what is commonly referred to as gum recession. Gum recession can also be cause by brushing too hard with a hard tooth brush. Gum disease can also lead to recession. To eliminate recession, one may need orthodontics to reposition the teeth, get gum treatment to prevent gum disease, and avoid using hard toothbrushes. Sometimes tissue grafts can be placed over exposed root surfaces to eliminate sensitivity and for esthetics.

Keep in mind that not all gum recession is bad. You can have perfectly healthy teeth and gums, but due to the position of the teeth in the arch, you have some gum recession or exposed roots. If everything is healthy, the exposed roots are not sensitive, and there is no cosmetic concern, you can leave everything alone.

How can I find out more about gum disease and my oral health?

You can start by studying various dental topics online or on my website. If you do not have a dentist or have not seen one for a long time, give our office a call. We can go over any dental concerns you may have. We have a nice office and a nice staff. We are an in-network office for most dental PPO insurances, so we can save you money. We look forward to meeting you.








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