I want to have my teeth cleaned. How many times does the doctor say I should have my teeth cleaned?

Patient: Doctor, last time I went to have my teeth cleaned, they said I have periodontal disease and I need to have my teeth cleaned several times?! They said that in addition to cleaning the dirt on the surface, you also need to clean under the gums, which is the area that cannot be seen by the naked eye, and you have to turn the gums over to clean? Isn’t that scary and painful?

Periodontal mucosa doctor: You are talking about subgingival scaling. Subgingival scaling refers to the use of special and fine periodontal ultrasound or manual instruments to enter the periodontal pocket after routine teeth cleaning to clean the tartar hidden under the gums. Generally, there is no need to open the gums. Of course, whether subgingival scaling is necessary requires detailed and professional examination and diagnosis by a periodontal mucosa doctor.

01 What is deep "teeth cleaning"

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When it comes to teeth cleaning, we must first understand dental calculus. It is formed by the calcification of "food residue + bacteria + oral saliva". Long-term accumulation of dental calculus will irritate the gums, causing redness, swelling and bleeding of the gums. In severe cases, bad breath, alveolar bone absorption, periodontal pockets, etc. may occur. Periodontal pockets can easily accumulate food residues and bacteria, causing a vicious cycle, and eventually leading to loose teeth or even tooth loss.

Teeth cleaning is the most effective way to deal with dental calculus. The ultrasonic vibration breaks up the dental calculus, achieving the effect of removing dental calculus and reducing the burden on the gums. However, simple teeth cleaning cannot completely solve the problem of dental calculus, because some people's dental calculus grows under the gums, that is, in the periodontal pocket. Conventional teeth cleaning can only remove the surface dental calculus and cannot achieve the effect of cleaning teeth. If you want to completely remove the irritant, you need to do a deep "teeth cleaning", also called "subgingival scaling".

02 Is subgingival scraping painful?

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This depends on the depth of the periodontal pockets and whether the tooth roots are flat. If the periodontal pockets are deep or the tooth roots are uneven, anesthesia may be required to make the process more comfortable.

If the pockets are not very deep, you may experience only a small amount of discomfort during scaling. You may not even feel any pain or a little soreness while your dentist performs scaling and root planing. After the tartar is removed, root planing gives the gum tissue a good chance to heal and regenerate, so some deep pockets may become shallower after scaling.

03 How many times is subgingival scaling treatment needed?

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The duration of a single subgingival scraping treatment is generally about 30 minutes to 1 hour, and the treatment cycle depends on the patient's condition. If the condition is not serious, it can be removed in one go.

If the condition is serious, such as deep periodontal pockets and rough tooth root surfaces, deep scaling will require medication and necessary periodontal surgery. The doctor will arrange 2 to 6 treatments depending on the severity of the condition.

04 Precautions after subgingival curettage

1. You can eat about 2 to 4 hours after subgingival scraping (that is, the anesthetic effect wears off, but not everyone needs anesthesia);

2. Maintain good oral hygiene after subgingival scaling. You can use chlorhexidine mouthwash for 1 to 2 weeks, 3 times a day, 1 to 2 minutes each time;

3. After subgingival scaling, the teeth may be sore, sensitive and loose for a short period of time. These are normal phenomena. Please avoid excessive cold or heat and avoid stimulation by hard food. Usually the symptoms can be relieved in about a week.

4. Eat warm or cool food within 1 to 3 days after subgingival scraping to avoid eating too hot food which may cause bleeding gums.

5. There may be slight gingival bleeding within 1 to 3 days after subgingival scaling, which is a normal phenomenon. If there is heavy bleeding, please contact the attending physician in time.

The following is a case of severe periodontitis in our hospital.

A middle-aged woman came to our hospital for treatment and said that her upper and lower front teeth had been loose for several years. The gaps between her teeth had also gradually widened, affecting her eating and greatly affecting her appearance! She had been treated at another dental clinic two years ago. At that time, it was diagnosed that the periodontitis was too severe, and there was no other good way to solve it except for teeth cleaning. She would wait until the teeth fell out and then get dentures. As a result, she recently found that her front teeth were getting looser and looser, and she felt that they would fall out at any time, so she hurried to our hospital for treatment.

After a detailed periodontal examination, we found that the patient's upper and lower front teeth were very loose. Taking into account the patient's concerns about the long-term impact on his appearance after tooth extraction, the periodontal mucosal doctor of our hospital diagnosed that conservative treatment could be given first, and then extraction if the teeth could no longer be saved.

The first step was teeth cleaning, the second step was deep subgingival scaling (completed twice under anesthesia), and the third step was temporary fixation of the loose teeth.

Through careful periodontal treatment and good oral hygiene maintenance (for example, the patient insisted on using interdental brushes and brushing teeth correctly), six months later, the patient found that the upper and lower front teeth were no longer loose, the gaps between the teeth became smaller, and the gums in other parts of the mouth recovered a lot! Such good results made her more confident in the subsequent periodontal treatment.

She said with deep emotion: I used to worry that deep periodontal scaling would be very painful, but after the treatment I found it was not as scary as I had imagined. The pain from the anesthesia during the treatment was mild and completely acceptable.

(The picture comes from Dongguan Jianli Dental Hospital, the copyright belongs to Dongguan Jianli Dental Hospital)

Subgingival scaling is the most effective way to treat periodontal disease. If you find early symptoms of periodontitis such as bleeding gums, please go to a regular dental medical institution for examination and treatment! Seriously remind you that developing good hygiene habits such as brushing teeth correctly, using dental floss, interdental brushes, and regular teeth cleaning is the simplest and most effective way to prevent periodontal disease, which is equivalent to saving you money!

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