Why Do I Need a Deep Cleaning, and How Does it Differ From a Regular Dental Prophylaxis?

Educating patients and getting them to understand the importance of treating their periodontal disease has always been a challenge for dentists simply because patients can neither see nor feel the condition. In a healthy mouth the gums fit snuggly around each tooth, and the distance between the top of the gum and the area where the gums attach to the tooth should be 1-3mm in depth. This space is often referred to as the gum pocket. Pocket depths of 4 mm are marginal, and pockets that are 5mm or greater are considered to have periodontal disease with accompanying bone loss. Once pockets reach 5 mm bone loss has started to occur. Once the bone is lost it will not re-grow.

For a typical prophylaxis (regular cleaning) patients will get their teeth cleaned every 6 months on average, and exhibit the following characteristics:

• Good home-care habits that include regular flossing
• Healthy gums that don’t bleed
• Pockets under 4mm

 When a patient has periodontal disease (gum disease) the supporting bone and tissue around the teeth are destroyed by bacteria and the toxins the bacteria produce. Tartar also adheres to the root surfaces deep under the gums and causes bacteria to accumulate. As bone loss continues the teeth eventually become loose and will require extraction. It is impossible to treat gum disease with a regular prophylaxis because the infected areas are found below the levels at which a regular cleaning can reach. Signs of Periodontal Disease include: Bleeding gums, bad breath, red/swollen gums, gums pulling away from the teeth, 5+mm pockets, puss, and bone loss.

Treatment Options for Treating Periodontal Disease

•  Scaling and Root Planing  (i.e. deep cleaning). This non-surgical procedure is designed to remove bacteria, calculus (tartar), and their accompanying toxins from below the gum line. Typically local anesthesia is used for patient comfort.

•  Sometimes laser treatment may be used to detoxify and kill bacteria deep in the pockets. This is done with a local anesthetic and has no post-operative pain associated with it.

•  Gum surgery. This procedure includes flapping the gums back, removing and re-shaping the bone, bone grafting, and tissue regeneration.

Most patients can avoid gum surgery, which costs thousands of dollars, if they follow our deep cleaning and periodontal maintenance programs. If left untreated gum disease will progress to the point where teeth will be lost. The number one cause of tooth loss today is from gum disease.

 As dental care providers, one of our roles is to educate our patients about their dental conditions, but the difficulty is that some conditions such as gum disease have little to no obvious signs or symptoms that the patient can recognize. Don’t wait until you have symptoms because by then it is often too late.

About the Author: Dr. Anthony Dailley is a practicing general dentist in Berkeley California. He has been practicing since 1981 and graduated from San Francisco State University with a degree in Cell & Molecular Biology, and obtained his dental degree from the Pacific School of Dentistry. Dr. Dailley also holds a fellowship position with the International Congress of Oral Implantologist (ICOI). Dr. Dailley has also been a founder in a biotech company called NovaBay Pharmaceuticals and was a member of their board of directors from 1997-2014.