How does the dentist or dental hygienist decide how often I need a cleaning?
A cleaning has several purposes. Most people dutifully get their teeth cleaned and the reasons to do it are kind of foggy for them. While a cleaning does make your teeth feel smooth and slippery, it is the prevention of disease that is the most compelling reason to get a cleaning. You can remove the soft white material from your teeth yourself at home with a toothbrush and floss. However, the hard material (calculus—also called tartar) cannot be removed at home with normal tools like a toothbrush and floss. The dentist or hygienist can remove these hard deposits for you at the dental office. When calculus is left on your teeth for months or years, it causes bone loss. This bone loss is usually permanent, and if the conditions that caused it are not changed will eventually cause the teeth to be lost.
You might wonder how the dentist or dental hygienist figures out how often to get you back for a cleaning. There are several systems that are well known in the profession to help the dentist with this determination. The goal is to have calculus removed when the calculus is just starting to form. Once it starts to form in small deposits on the teeth, it adds to itself quite rapidly and covers a large area of the teeth. “Stain” on the teeth is often simply calculus that has picked up dark colours from the things we eat or drink. If your teeth have a dark stuff on the edges of them, this is a good indicator that a dentist or hygienist needs to clean them to avoid bone loss due to calculus accumulation. There can also be stains that are actually inside the tooth, but these are much less common than stained calculus on the outside of the teeth. If the patient has been out of the cleaning at the dental office habit, the dentist or hygienist will have to make an educated guess at the interval that would be best. Often they will choose six months and when the patient returns six months later, the interval will be reevaluated to see if it is too long or too short by checking how much calculus is on the teeth after six months. The fancy systems for making a more accurate “guess” after that first visit have to do with the depth of the gums around the teeth and the level of inflammation encountered when the depths are measured and the teeth are cleaned. To arrive at the correct interval, the patient has to return at the interval decided upon at the first cleaning for the dentist or dental hygienist to reevaluate the situation.
Many people end up with a six month interval. Some need a professional cleaning more often because the calculus builds up quicker than on other people. Some people have so little accumulation after six months that a longer interval is the best for them. One thing you should watch out for is that you don’t rely on your insurance company to choose your cleaning interval. The insurance company chooses your cleaning interval based on decisions made by the person in charge of your pay cheque at work totally without regard to your individual health. For the insurance company to dictate that you need a cleaning once every nine months or once a year is as ridiculous as for your dentist to tell you that everyone needs a cleaning every six months. The decision of when is the best interval for your cleanings has to be decided on an individual basis taking into account how much previous bone loss you have, and how much calculus you build up in a given period of time. It cannot be an arbitrary decision and be expected to be effective for everyone.
There are some things you can do at home that can easily lengthen the interval you can use effectively to maintain the best level of health in your mouth. Remember that the cleaning interval is decided largely on how fast you form calculus. While people form calculus at different rates, you can make your calculus formation rate slower by keeping your teeth very clean. This means floss is mandatory every day—maybe even twice a day. It also means that no matter what, you cannot go to bed without brushing and flossing your teeth. Remember that plaque forms very quickly on the surface of existing calculus. This means that once calculus has started to form in your mouth, it will add more calculus much faster than if the calculus was forming on a clean tooth surface. Scrupulous cleaning of your teeth at home every day or even a couple of times a day will make it so you will need fewer cleanings at the dental office. This is the logical way to cope with an insurance plan at work that has lengthened its cleaning interval and still maintain the best health in your mouth. Ask your dentist if you would like to know what to do to make your cleanings easier or less frequent.
- This article was written by Dr. Mike Christensen and published in the Daily Miner and News, and Enterprise. Local Kenora News Publicatons (1998-2006)