Deep Cleaning
In this section, we will cover:
- What is a deep clean?
- Why would I need a deep clean?
- What does the procedure involve?
- What should I expect after?
What is a deep clean?
This is a procedure where your dentist or hygienist will clean above and below the gum to remove bacteria and plaque/calculus deposits. It is often referred to as "root surface debridement" because it cleans the roots of your teeth (see tooth anatomy).
Why would I need a deep clean?
A deep clean is only needed for patients who have advanced gum disease, or "periodontitis".
If you have periodontitis, it is impossible for you to clean the bacteria out from underneath the gum yourself as your toothbrush can't reach here. A deep clean removes this bacteria and gives you the chance to keep your teeth and gums clean by brushing thoroughly twice a day and cleaning in between the teeth at least once a day.
After you have been diagnosed with periodontitis, you will have your first cycle of treatment. This will involve deep cleaning and oral hygiene instruction.
What does the procedure involve?
Gum disease can affect anywhere from a few teeth to your whole mouth. The number of visits you need to complete a deep clean depends on how many teeth are affected and how severe your gum disease is.
If only a few teeth are affected, one visit is normally enough for your first cycle of treatment. If your gum disease is widespread, your treatment will likely be carried out over 2 to 4 visits. Each appointment can last up to 1 hour.
So what are the stages?
- Local anaesthetic
The decision to give local anaesthetic will depend on the extent of gum disease and what you are comfortable with as the patient. Many patients would rather avoid the local anaesthetic, especially if only a few teeth need to be cleaned. Others would prefer to have their teeth and gums numbed.
I personally find that if the gum disease is widespread, I can provide a much more thorough clean if I give local anaesthetic. - Removal of plaque and calculus deposits
This is where the plaque and calculus (tartar) deposits above and below the gumline are scraped off the teeth with an ultrasonic scaler and/or hand instruments. The sound of the ultrasonic scaler and hand instruments can be quite grating as it scrapes off the deposits on your teeth - you may wish to listen to music to drown out these noises whilst having the procedure done.
What should I expect after?
If your dentist has used local anaesthetic, you should expect your teeth and gums to feel numb for 2-3 hours. Once the local anaesthetic has worn off, you may find your teeth are sensitive and your gums feel slightly tender. These are temporary symptoms which will pass within a few days. It is also common for the gums to bleed following the procedure. If you stick to a good daily oral hygiene routine at home, you should find your bleeding and tender gums will heal.
Following your first cycle of treatment, your dentist or hygienist will then review the health of your gums after 3 months. Sometimes one cycle of treatment is enough. Sometimes you may need to undergo a second cycle of deep cleaning and oral hygiene instruction.
Do not be disheartened if you need a deep clean more than once - it often takes a few cycles (every three months) before your gum disease stabilises. After this, you will likely only need "top up" hygiene visits to maintain healthy gums.