I just had a regular cleaning. Why do I need a deep one now?
The short answer
A regular cleaning is for healthy gums or mild inflammation. A deep cleaning is for gum disease that has caused pockets and bone loss below the gum line, where a regular cleaning can't reach. Gum disease usually doesn't hurt, so it's common to find out at a routine visit.
What's different about a deep cleaning
A regular cleaning removes plaque and tartar from the teeth, mostly above the gum line. A deep cleaning (also called scaling and root planing) goes down to the bottom of the pockets between the gums and teeth, cleans the roots, and smooths them so the gums can tighten back up. It usually takes longer, is often done one or two sections of the mouth at a time, and is often done with numbing.
Why it can change from one visit to the next
- Gum disease is slow and quiet. It can build for years with little more than some bleeding when you brush.
- New X-rays or measurements may show bone loss or deeper pockets that weren't there, or weren't measured, before.
- Offices can approach early gum disease differently. Thinking about gum disease has changed over the years. Some dentists prefer to watch borderline areas and re-measure over time. Others treat sooner, while the disease is easier to stop and before more bone is lost. Both are reasonable, so a new office recommending treatment for something your last office was watching isn't unusual.
- Health changes such as diabetes, pregnancy, smoking, or some medications can make gum disease more likely.
How to check it for yourself
Ask to see your pocket measurements and the bone level on your X-rays. If you've changed offices, you can ask your previous office for a copy of your records and X-rays to compare. See What do my gum pocket numbers mean?
Questions to ask
- Can you show me my pocket measurements and where you see bone loss on the X-ray?
- Which sections of my mouth need it, and why?
- What changed since my last cleaning?
- Could we watch this and re-measure, or do you recommend treating it now? Why?
- Before we schedule, can I get my cost in writing? (A predetermination if I'm using insurance, or a good faith estimate if I'm paying myself.)
When a second opinion makes sense
Reasonable if you were told you had healthy gums recently and nothing has changed, if you can't see bone loss on the X-ray, or if every section is recommended with mostly shallow pockets.