When Do My Teeth Need a Deep Cleaning?

Dental deep cleaning is another term for a procedure called scaling and root planing. The two-step process involves removing plaque and tartar from above and below the gum line (scaling) and then smoothing the root surfaces of the teeth (planing). Your dentist or hygienist may recommend deep cleaning if you have advanced periodontal (gum) disease, also referred to as periodontitis.

Your regular, twice-yearly dental cleaning removes plaque and tartar from the crowns of your teeth – the parts that are normally visible above the gum line. Your dentist or hygienist will use a manual or ultrasonic tool to scale away visible plaque and tartar that have built up since your last visit, and will finish by polishing any surface stains from your teeth. This is all part of your routine preventative dental care, and can help to reduce your risk of early gum disease (gingivitis) and tooth decay. 

A dental deep cleaning, on the other hand, is something that is done to treat gum disease that has reached an advanced stage (periodontitis). It goes deep below the gums and treats the root surfaces of the teeth, too. Let’s discuss how periodontitis develops and why scaling and root cleaning treats it in more detail...

Deep cleaning is used to treat advanced gum disease, a bacterial infection of the gums, bone and other tissues that hold the teeth in place. 

In the early stages, gum disease is known as gingivitis, and is caused by a build-up of plaque around the gum line. At this stage, a standard dental cleaning (scale and polish) and oral hygiene improvements are typically enough to resolve the problem. 

However, untreated gingivitis can eventually turn into periodontitis. This is when plaque and tartar (hardened plaque) build up on the root surfaces of the teeth that sit below the gum line. Bacteria can then infect the ligaments and bone, breaking them down and loosening the teeth. 

This “subgingival” plaque and tartar can’t be removed with home hygiene or even a regular dental cleaning, so your dental professional will likely recommend a scaling and root planing treatment as a first-line approach.

Gingivitis is characterized by sore, inflamed, red gums that might bleed when you brush and floss. If you notice these symptoms, a prompt visit to the dentist may prevent periodontitis from developing. The following symptoms suggest that periodontitis has already set in, and a dental deep cleaning may be necessary:

• Persistent bad breath or a bad taste in your mouth.
• Receding gums that look like they’re shrinking.
• Areas of visible tooth root at the gum line.
• Sensitivity, especially around the gum line.
• Loose teeth.
• Shifting teeth.
• Changes in your bite.
• Changes in the fit of your dentures or other appliances.
• Pain when chewing.

Your dentist or hygienist may do something called a comprehensive periodontal evaluation (CPE) to see how far gum disease has progressed. As part of the CPE, they will use a probe tool to check for periodontal pockets between your teeth and gums. Pockets form when the gum tissue starts to separate from the root surface of the teeth, and that’s when plaque and tartar start to build up on the roots. So if you have periodontal pockets deeper than 3mm, that indicates that you could benefit from a scaling and root planing.

A CPE is usually done as standard during your routine twice-annual dental check-ups, as recommended by the American Academy of Periodontology (AAP). That’s one more reason to keep to those regular appointments! If you haven’t had a check-up in a while, book in soon; the earlier you catch gum disease, the easier it is to treat.

Dental deep cleaning happens in two stages. 

1. Scaling. 

Your dental professional will use a manual scaler or an ultrasonic scaler (or both) to remove plaque, tartar and bacteria from above and below the gum line. Some specially trained professionals might even use laser scalers, which can cause less swelling and discomfort than traditional tools. 

2. Root planing. 

Your dental professional will then smooth out the root surfaces of the teeth. It’s harder for plaque to adhere to smooth surfaces, so this reduces the risk of further plaque build-up after your procedure. Smoothing the roots also allows your gums to reattach to the teeth as they heal, reducing the depth of periodontal pockets. 

Scaling and root planing takes 1-2 hours if done in a single session, but may be split into two appointments. Your dental professional may also administer antimicrobials below the gum line or give you antimicrobial products to use at home, which will help to kill bacteria and prevent infection.

Deep cleaning the teeth can be an effective treatment for gum disease. It’s a short, minimally invasive procedure that can help your gums to heal and reattach to the teeth. By preventing further plaque and tartar build-up, it can prevent any further loss of periodontal tissues and eliminate the need for more advanced and invasive treatments. And as your gums heal, it can also help to ease some of the discomfort and sensitivity associated with gum disease.

Of course, every solution has its drawbacks, and dental deep cleaning is no exception. There is a small risk of infection afterwards, along with some other post-procedure side effects we’ll discuss below. And if you have very advanced gum disease with heavy plaque and tartar, for example, scaling and root planing might not be suitable at all. In this case, your dental professional will discuss more advanced solutions with you.

Be aware that you might experience soreness, tooth sensitivity, or bleeding for a few days after scaling and root planing. Your dental professional may recommend the following to manage swelling, discomfort and infection risk: 

• Anti-inflammatory medicines. 

• Cold compresses.

• Antimicrobial rinses.

• Salt water rinses.

Your dental professional will encourage you to schedule a follow-up appointment to check that your gums are healing and any periodontal pockets are reducing in depth. If necessary, they may recommend further treatments or antimicrobial therapies.  

To keep your gums healthy and prevent the need for future deep cleaning, build these healthy oral hygiene, diet and lifestyle habits into your daily routine:

• Brush twice daily with an antimicrobial fluoride toothpaste.
• Clean between your teeth daily to remove plaque using floss or another interdental tool.
• Rinse daily with a mouthwash or mouth rinse designed to prevent plaque.
• Limit sugary or starchy foods and eat a balanced, nutrient-rich diet.
• Avoid tobacco products.
• Visit your dentist regularly for professional cleanings and check–ups.

Even though deep cleaning is a relatively minor dental procedure, we hope you can avoid it with proper oral hygiene. But if you must undergo deep cleaning, know that it's for the best to keep your teeth and gums healthy!

Is dental deep cleaning painful? 

Due to tooth sensitivity and gum inflammation, some people find having their teeth deep-cleaned to be uncomfortable or even painful. Your dental professional can manage this with local anesthesia to numb your mouth during the procedure. Any post-procedure pain or discomfort can usually be managed at home with anti-inflammatory medicines like ibuprofen. 

How often is dental deep cleaning needed?

With a thorough daily oral hygiene routine and frequent dental check-ups, you may never need a deep cleaning again! This is only done to treat gum disease, so provided you stay on top of your oral health and hygiene, you can usually avoid the need for future cleanings. 

How much does dental deep cleaning cost? 

Scaling and root planing is usually covered by insurance as it’s necessary for your oral health. If you’re paying yourself, the out-of-pocket cost starts at around $200-300. The total price will depend on factors like the severity of your gum problems, your location, and the experience of the individual provider. Be sure to speak with your dental professional and your insurance company before committing to a treatment plan.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.