Before your dental hygienist begins the cleaning, they will perform an oral cancer screening, consisting of checking all oral tissue for any signs of abnormalties and the lymph nodes of the head and neck. Then, they will complete an assessment, this may consist of updating the dental chart, perio charting (measuring the spaces between the gums and the teeth), and possibly x-rays, depending on the patients needs at the time of the appointment.
The dental hygienist will then combine all of the information gathered from the assessment to determine the patient's condition of their teeth, the bone level and structures supporting the teeth, as well as their gums in order to decide which form of treatment will best suit the patients needs to give them the greatest chance at maintaining or reaching their optimal oral health.
Dental prophylaxis is what most people consider to be a regular "teeth cleaning". This consists of removing plaque and tartar/calculus (hardened plaque that can't be removed by a toothbrush or floss) from the teeth. Followed by polishing and flossing the teeth.
Periodontal debridements are typically necessary when a patient has a lot of plaque and tartar (hardened plaque) built up on their teeth and/or really inflammed gums. The debridement involves removing all the buildup that can be reached at the inital appointment, but then scheduling a follow-up appointment to determine how well the gums heal. This allows us to determine if the swollen gums were due to the inflammatory response to the infection caused by the plauqe/tartar buildup, and not a result of another sytemic issue that would need to be addressed. If the tissues begin to heal, then we proceed with treatment of a prophylaxis or scaling and root planing, depending on the severity and what will give the patient the greatest opportunity to avoid progression of periodontal disease.
Scaling and Root Planing
Scaling and root planing is a very effective way to prevent periodontal (gum) disease from getting worse. At a scaling and root planing appointment, we clean below the gumline, on the roots of the teeth, to the base of the periodontal pocket (space between where the gum attaches to the root of the tooth). To allow us to be as thorough as we need to be, we often recommend our patient gets numb to make it more comfortable for them, however this is not always necessary and varies from patient to patient. Depending on the extent of the periodontal disease and amount of buildup, this could potentionally take multiple appointments.