Maintaining healthy teeth and sturdy gums can be done by brushing your teeth and visiting your dentist regularly. However, if harmful plaque and tartar builds up around your gum line, then regular preventative cleanings won’t be enough to remove the infection. A special medical treatment is recommended by dentists known as deep teeth cleaning. This is also known as scaling and root planing. It removes bacteria build-up from deep within the mouth to prevent severe gum disease and protect your natural teeth.

Understanding deep dental cleanings can help improve your overall health as oral health can affect your physical health. This evidence based guide explains everything you need to know about scaling and root planing.

What Is Deep Teeth Cleaning?

A deep teeth cleaning is a specialist medical treatment for active gum disease. Unlike a regular cleaning, this procedure focuses on cleaning the area underneath your gums.

Plaque can build up around your gums. When this happens it can harden into a substance known as calculus or tartar. This cannot be cleaned off with a regular toothbrush. The tartar contains millions of harmful bacteria which irritate your soft tissue causing your gums to recede. This creates deep pockets. During a deep dental cleaning, the dentist will clean the deep pockets to remove bacteria, smooth the rough surface of your roots and allow your gums to heal and adhere to your teeth.

How Does Standard Cleaning Differ From Deep Cleaning?

Understanding the difference between a standard cleaning and a deep cleaning can help you make an informed decision.

  • Standard Prophylaxis Cleaning: This is carried out by the hygienist to clean healthy mouths or those suffering from mild gingivitis. The teeth above your gum line will be polished and the small gaps where your gums meet your teeth will be cleaned.

  • Deep Scaling & Root Planing: This is performed by dentists to treat active periodontitis. This cleans all the way down to the very bottom of your deep pockets and smooths the exposed root surfaces.

  • Goals Of Treatment: Standard cleanings aim to prevent future disease whereas deep cleanings aim to stop ongoing bacteria damage.

Who Needs A Deep Teeth Cleaning?

Patients will be recommended a deep teeth cleaning by their dentist if they have clear signs of progressing periodontal disease. Healthy gums will wrap tightly around your teeth. When probed by the dentist they will measure between 1-3mm.

However, if plaque bacteria has built up in these spaces then inflammation will occur and cause periodontitis. If your dentist measures your pockets to be 4mm or deeper then you will need a deep cleaning. If you are suffering from bleeding gums, severe inflammation, visible bone loss on x-ray and exposed roots then you will need an urgent scaling and root planing.

What Are The Warning Signs You Need A Deep Gum Treatment?

Periodontal disease doesn’t usually cause intense pain, however it is important to be aware of the signs.

  • Bleeding Gums: Healthy gums will not bleed when brushing. If your gums bleed regularly then there is active bacteria infection beneath your gums.

  • Bad Breath (Halitosis): Harmful bacteria deep within your mouth will produce volatile sulfur compounds. This causes an unpleasant taste and smell which can’t be fixed with mouthwash.

  • Red, inflamed or sore gums: Healthy gums should be firm and pale pink. If your gums are dark red, swollen or sore then there is active infection.

  • Gum Recession: If your teeth appear longer then your gums are receding.

  • Loose Teeth: As harmful bacteria eat away at your bone, your teeth will start to feel loose.

What Are The Main Causes Of Periodontal Disease?

The main cause of gum infection is bacterial plaque. However there are a number of factors that can cause accelerated bone loss.

  • Poor Oral Hygiene: Not brushing and flossing your teeth daily will cause sticky plaque to build up along your gum line. This can harden into damaging tartar within 48hours.

  • Smoking/Tobacco: Smoking or chewing tobacco greatly reduces blood flow to your gums. This weakens your immune system and speeds up tissue breakdown.

  • Medical Conditions: If you suffer from uncontrolled diabetes, heart disease, rheumatoid arthritis or autoimmune conditions then your ability to heal will be reduced and your gums will become inflamed.

  • Hormonal Changes: Hormonal fluctuations during pregnancy, menopause or puberty can cause your gums to be very sensitive to bacteria toxins.

  • Genetics: Some people are genetically more prone to aggressive bone loss and severe periodontitis.

What Happens During A Deep Teeth Cleaning Procedure?

How Is The Diagnostic Assessment Performed?

Before any deep cleaning is performed a detailed diagnostic assessment will be carried out to determine the extent of the damage.

  • Measuring Periodontal Pockets: A small periodontal probe will be used by the dentist/hygienist to measure the depth of your pockets. This will be measured at 6 points on each of your teeth.

  • Digital X-Ray: High resolution digital x-rays will show how much bone support you have lost. This is done by looking at the density of the bone.

  • Checking For Inflammation: The dentist will check for redness, bleeding on probing, pus and mobility to determine what stage of periodontitis you have.

How Is Local Anesthetic Used During Deep Cleaning?

Dentists will provide effective numbing to make sure you don’t feel any sharp pain.

  • Topical Numbing Cream: A powerful numbing cream will be applied to your gums to numb the area.

  • Local Anesthetic: Dentists will inject local anesthetic such as lidocaine or articaine near the area to numb your gums and roots.

  • Divided Appointments: Often dentists will divide your deep cleaning into 2 separate appointments. This means only half of your mouth (2 quadrants) will be numbed at one time.

How Are Ultrasonic & Manual Scaling Performed?

During the scaling process, all the tartar, soft bio-film and harmful deposits will be removed from your teeth and beneath your gums.

  • Ultrasonic Scaling: High frequency ultrasonic tips will be used to remove stubborn tartar. This will also spray a cool stream of water to wash out the bacteria.

  • Hand Scaling: Specialized sharp tools known as curettes and scalers will be used to remove any remaining tiny pieces of calculus.

  • Flushing: Antibacterial solutions will be used to wash out the open pockets.

How Does Root Planing Work?

During the root planning process, the rough surface of your roots will be smoothed.

  • Smoothing Roots: Harmful endotoxins are produced by bacteria. These soak into the rough surfaces of your roots. The rough areas will be smoothed using gentle strokes.

  • Remove Contaminated Outer Layer: The planing will remove tiny layers of contaminated outer layer of your roots. This will leave a clean glass like surface.

  • Prevent New Bacteria From Adhering: Having smooth roots means new bacteria won’t easily stick to them. This means your healing gums can adhere tightly to your teeth.

When Are Localized Antibiotics Used?

If you have deep pockets or ongoing infection then dentists will apply specialized antibiotics into the cleaned pockets.

  • Antibiotic Powder: Micro spheres of localized antibiotics such as minocycline or doxycycline will be placed into the deep pockets. This will kill any remaining bacteria over the next 2 weeks.

  • Antibacterial Rinse: The dentist will rinse the area with chlorhexidine or warm therapeutic saline to soothe your inflamed tissues.

  • Laser Sterilization: Many modern clinics will use soft tissue lasers to sterilize the open pockets. This kills the bacteria and speeds up tissue healing.

What Can You Expect During Healing?

Knowing what to expect during your healing process will make things easier.

  • Sore Gums: Your gums may feel sore, swollen and slightly bruised for 2-4 days.

  • Sensitivity To Hot/Cold: Having your roots smoothed will expose dentin tubules causing sensitivity to hot and cold.

  • Slight Bleeding: It is completely normal to see slight amounts of blood whilst brushing your teeth for the first 2 days.

  • Closing Pockets: As your tissues heal your gums will become firm, stop bleeding and wrap tightly around your teeth.

How Should You Care For Your Teeth At Home After Deep Cleaning?

Following your appointment you can follow some simple steps to ensure a speedy healing.

  • Anti-Inflammatory Medication: Take an over the counter anti inflammatory medication such as ibuprofen to relieve any localized soreness.

  • Salt Water Rinse: Rinse with half a teaspoon of salt in warm water 3 times a day.

  • Gentle Brushing: Brush with a super soft brush and sensitive fluoride toothpaste. Brush gently in circular motions near the treated areas.

  • Soft Diet: Eat soft warm foods such as yogurt, smooth soups, scrambled eggs and mashed potato. Avoid anything sharp, crunchy or hot.

  • Don’t Smoke/Drink Alcohol: Don’t smoke cigarettes, vape or drink alcohol for at least 72 hours as this will greatly slow down your healing.

What Is Needed For Long Term Aftercare?

Whilst a deep teeth cleaning will stop the active infection, it isn’t a permanent cure. You will need to continue having treatments.

  • Every 3 Months: Periodontal bacteria will grow back in the deep areas within 90 days. Therefore dentists recommend having a special periodontal maintenance cleaning every 3 months.

  • Pocket Depth Measurement: Your pocket depth will be measured at each appointment to ensure your gums stay healthy.

  • Prevent Bone Loss: By being dedicated to your 3 monthly aftercare you will prevent any future bone loss and keep your natural teeth for life.

What Are The Health Risks Of Not Treating Gum Disease?

Not treating the obvious signs of gum disease can cause serious issues.

  • Bone Loss: Chronic toxins from the bacteria will dissolve the bone structure which supports your teeth. This causes permanent damage which can only be fixed with complex surgery.

  • Tooth Loss: As your bone disappears your teeth will become loose, painful and will not be salvageable. They will need to be fully extracted.

  • Heart Conditions: Bacteria from your mouth will enter your bloodstream through your bleeding gums. This will travel to your heart causing systemic inflammation, build up of plaque in your arteries and increase your chances of having a heart attack.

  • Difficulties With Diabetes: Severe gum disease will make it extremely difficult to control your blood sugar.

What Are The Important Tips To Keep Your Smile Healthy?

  • Book a diagnostic appointment with your dentist if your gums bleed whilst brushing/flossing.

  • Ask for your pocket depths to be fully measured and digital x-rays taken.

  • Attend all your scaling & root planing appointments.

  • Brush your teeth twice a day using a soft bristled brush and fluoride toothpaste.

  • Clean between your teeth every night using floss, water flossers or inter dental brushes.

  • Use an alcohol free antibacterial mouthwash daily.

  • Eat a healthy diet full of fresh vegetables, lean proteins and vitamin C.

  • Be dedicated to your 3 monthly periodontal maintenance to keep your gums strong, firm and healthy.

What Are The Frequently Asked Questions About Deep Teeth Cleaning?

Does A Deep Teeth Cleaning Hurt?

No, a deep teeth cleaning won’t hurt as your dentist/hygienist will use effective local anesthetic to completely numb your gums and roots. You will feel slight pressure and vibrations from the ultrasonic but there will be no sharp pain. You may have some mild discomfort for a few days after the anesthetic has worn off.

How Long Does A Deep Teeth Cleaning Take?

A full deep cleaning will take between 1-2 hours. Usually dentists will split your treatment into 2 appointments. This means only half of your mouth will be treated at a time.

Will My Gums Adhere To My Teeth?

Yes, as the tartar has been removed and your roots have been smoothed the infection will clear. Your healthy gums will heal, become firm and create a tight seal around your clean roots. This will greatly reduce your pocket depths.

Can I Go Straight Back To Work?

Yes, most patients will be able to return to work or everyday activities. If your job involves heavy physical activity or public speaking whilst your mouth is numb then you may want to take the rest of the day off.

A deep teeth cleaning is an essential and effective treatment to stop progressing periodontal disease. By removing tartar, smoothing your roots and clearing your deep pockets your gums will heal and your overall physical health will be protected. If you are experiencing bleeding gums, bad breath or gum recession then book an diagnostic appointment with your dental professional today to keep your smile for years to come.