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Why do I need a "Deep Cleaning"? Can I just get my teeth cleaned?

The question often comes up as to why just a "normal cleaning" cannot be done now and why does a "deep" cleaning even need to be done.  The difference between the two types of cleanings is the state of periodontal health, which is the health of the bone and gums that support the teeth.  The health of the bone and gums is directly linked to the amount of plaque (soft) and calculus/tartar (hard) that is depositing on your teeth.  It is fairly common for most people to develop some calculus (same thing as tartar) between their recall cleaning visits.  The most common place for calculus to develop is the tongue side of the lower front and the cheek side of the upper back teeth.  This occurs to various degrees to those who are routine with their dental cleanings, but the longer you go without removal of the deposits the larger the calculus grows.  This calculus starts to develop usually right at the gumline.  When the deposits are not removed, they start to increase in size and start to move under the gums.  This causes an inflammatory response much like when you get a splinter in your skin.  This response or localized infection causes the bone to move away from the irritant (calculus).  This ultimately causes bone loss and subsequently what we call a periodontal pocket.  This is a deep pocket around your tooth that is even more prone to entrapment of food and debri and the bone loss continues......  

A normal cleaning is for individuals that have deposits only at or above the gumline.  These individuals may have gingivitis due to lack of flossing or improper brushing technique (or other contributing factors such as crowded teeth, poor restorations, medications, hormones) but do not have bone loss.  A deep cleaning is necessary if calculus is detected under the gumline (subgingival) and there are signs of bone loss.  A deep cleaning removes the deposits that form on the surface of the tooth's root (upward).  Unfortunately once bone is lost it is not readily regenerated in the direction of the crown of the tooth.  What our goal is to stop further loss and maintain healthy gingiva free of periodontal pockets (and bleeding).  This helps with the health and the stability of the teeth.  After the inital deep cleaning (also called scaling and root planing), these patients are seen for periodontal maintance visits which generally occur every 3-4 months due to their risk of developing subgingival calculus once again.  Proper brushing (at least twice daily) and daily flossing are a necessity to help fight build up.

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