Not Everyone Needs a Deep Teeth Cleaning
Don't Be This Guy
I was talking to this guy, we will call him Rich, and during conversation
I revealed I was a dental hygienist. This always makes things
interesting; either people immediately stop smiling or go on to share a
couple dental experiences, traumas or problems. Rich went on to state
that it was time for a"deep cleaning", it had been a while. Since that
statement struck me as odd, I asked what he meant, how did he know.
Periodontal disease is defined as a chronic bacterial infection that
results in the loss of connective tissue and bone, depleting attachment to
According to www.Perio.org, "Toxins produced by the bacteria in plaque
irritate the gums. The toxins stimulate a chronic inflammatory response in
which the body in essence turns on itself, and the tissues and bone that
support the teeth are broken down and destroyed. Gums separate from the
teeth, forming pockets (spaces between the teeth and gums) that become
infected. As the disease progresses, the pockets deepen and more gum
tissue and bone are destroyed. Often, this destructive process has very
mild symptoms. Eventually, teeth can become loose and may have to be
It's this loss of attachment and inflammation of the gums that help
dictate a need for deep cleanings. Nothing else. If you don't have
pockets, gum infections or periodontal problems, then there is nothing to
He went on to say, that a few years back, he hadn't used up any of his
dental insurance and that the dentist thought it was a good idea to get a
"deep cleaning". I asked him if he had a history of gum infections or
periodontal disease and he said no.
A typical deep cleaning aka scaling and root planning aka quadrant therapy
aka non-surgical periodontal therapy procedure is indicated when a patient
presents with gingivitis, deep pocket depths exceeding 4-5mm, neglected
hygiene, and, sub and supragingival bacterial deposits. Multiple
appointments are usually needed accompanied with the use of local
anesthetic for comfort.
Any area with pocket depths of 5mm and higher cannot be accessed with a
toothbrush or floss. As a result, deep cleanings are done to remove
plaque, tartar and bacteria from the pocket where the patient can't get.
This helps arrest the progression of the disease. When the deposits are
removed and the tooth structure is clean it promotes tissue reattachment
and reduces the inflammation. This allows the patient a better chance at
keeping the disease at bay. Periodontal disease is not curable, just
maintainable. If it goes untreated, the patient risks loosing their teeth
and other complications.
Anyway, as his story continued and not to my surprise, after enduring
needless treatment the insurance denied his claim. Apparently there was no
evidence of a need for the "deep cleaning" and paid about $1000.00 out of
pocket. Hopefully after my explanation he realized that a "deep cleaning"
is a specific procedure to help people with periodontal problems, not just
a really thorough cleaning.