Dental cleanings involve removing plaque (soft, sticky, bacteria infested film) and tartar (calculus) deposits that have built up on the teeth over time.
Your teeth are continually bathed in saliva. Your saliva contains calcium and other substances which help strengthen and protect the teeth. While this is a good thing, it also means that we tend to get a build-up of calcium deposits on the teeth. This chalky substance will eventually build up over time, like limescale in a pipe or kettle.
Usually, it is tooth coloured and can easily be mistaken as part of the teeth, but it also can vary from brown to black in colour.
If the scale (also known as calculus or tartar) is allowed to accumulate on the teeth, it will, unfortunately, provide the right conditions for bacteria to thrive next to the gums. The purpose of the cleaning and polishing is basically to leave the surfaces of the teeth clean and smooth so that bacteria are unable to stick to them. This gives you a better chance of keeping the teeth clean during your regular home care.
Also, it leaves your teeth feeling lovely and smooth and clean, which is nice when you run your tongue around them. Actually, come to think of it, there’s nothing worse than someone you fancy running their tongue around your teeth and finding a piece of spinach or something! Still, if they’re hungry…
The professional cleaning of teeth is sometimes referred to as prophylaxis (or prophy for short). It’s a Greek word which means “to prevent beforehand” – in this case, it helps prevent gum disease.
How are dental cleanings done?
The dental hygienist or dentist uses specialized instruments to gently remove these deposits without harming the teeth. The instruments which may be used during your cleaning, and what they feel like, are described below.
Commonly used first is an ultrasonic instrument which uses tickling vibrations to knock larger pieces of tartar loose. It also sprays a cooling mist of water while it works to wash away debris. The device typically emits a humming or high pitched whistling sound.
The ultrasonic instrument tips are curved and rounded and are always kept in motion around the teeth. They are by no means sharp since their purpose is to knock tartar loose and not to cut into the teeth. You should inform the operator if the sensations are too strong or ticklish so they can adjust the setting on the device or modify the pressure applied.
With larger deposits that have hardened on, it can take some time to remove these, just like trying to remove baked-on grime on a stove that has been left over a long time. So your cleaning may take longer than future cleanings. Imagine not cleaning a house for six months versus cleaning it every week. The six-month job is going to take longer than doing smaller weekly jobs.
Fine hand tools
Once the larger pieces of tartar are gone, the dental worker will switch to finer hand tools (called scalers and curettes) to remove smaller deposits and smoothen the tooth surfaces. These tools are curved and shaped to match the curves of the teeth. They allow smaller tartar deposits to be removed by carefully scraping them off with a gentle to moderate amount of pressure. Just like taking a scrubbing brush to a soiled pot, the dental worker has to get the areas clean and smooth.
Once all the surfaces are smooth, the dental worker may polish your teeth. Polishing is done using a slow speed handpiece with a soft rubber cup that spins on the end. Prophylaxis (short for prophy) paste – a special gritty toothpaste-like material – is scooped up like ice cream into the cup and spun around on the teeth to make them shiny smooth.
Your dentist may also apply fluoride. This is the final, and my favorite part of the dental cleaning! Fluoride comes in many different flavours such as chocolate, mint, strawberry, cherry, watermelon, pina colada and can be mixed and matched just like ice cream at a parlour for a great taste sensation!
Make no mistake though, this in-office fluoride treatment is meant for topical use only on the surfaces of the teeth and swallowing excessive amounts can give a person a tummy ache as it is not meant to be ingested.
Fluoride foam or gel is then placed into small, flexible foam trays and placed over the teeth for 30 seconds. Afterwards the patient is directed to spit as much out as possible into a saliva ejector. The fluoride helps to strengthen the teeth since the acids from bacteria in dental tartar and plaque will have weakened the surfaces. It is best not to eat, drink or rinse for 30 minutes after the fluoride has been applied.
Is it going to be painful?
Most people find that cleanings are painless, and find the sensations described above – tickling vibrations, the cooling mist of water, and the feeling of pressure during “scraping” – don’t cause discomfort. A lot of people even report that they enjoy cleanings and the lovely smooth feel of their teeth afterwards. There may be some zingy sensations at times, but a cleaning shouldn’t normally be painful.
Several things can cause a cleaning to be painful: exposed dentine, sore gum tissues, or a rough or overzealous dentist or hygienist.
Be sure to let your dentist/hygienist know if you find things are getting too uncomfortable for your liking!
A spot of nitrous oxide can often make a huge difference. You could also choose to be numbed. If you find the scaling a bit uncomfortable because the gum tissues (rather than the teeth themselves) are sensitive, topical numbing gels can be used.
In case you may have had painful cleaning experiences in the past, switching to a gentle hygienist/dentist can sometimes make all the difference. In the UK, you can visit dental hygienists directly, without going through a dentist. So if you like your dentist but not their hygienist, you can see someone of your own choice. However, if you have gum disease (BPE scores of 3 or above), you should really discuss this with your dentist first.
This article was originally written by Zzzdentist, a Canadian dentist who wishes to remain anonymous.
Do you find dental cleanings to be a white-knuckle ride? Visit our dental phobia support forum for help!