Why do I need a deep cleaning?

It starts as gingivitis: red, puffy gums that bleed easily. That stage can be reversed with a regular cleaning and good home care. If it goes on, it can become periodontitis: the gums pull away from the teeth, pockets form, and the bone holding the teeth slowly wears away. Bone lost to gum disease usually doesn't grow back on its own.

The hygienist or dentist cleans down to the bottom of each pocket and smooths the root so the gums can heal and tighten. It's usually done one or two sections of your mouth at a time, often with numbing. A follow-up visit a few weeks later checks how the gums healed.

Your dentist looks at:

• Pocket depths (see What do my gum pocket numbers mean?)
• Bone loss on X-rays
• Bleeding, recession, and loose teeth
• Risk factors such as smoking and diabetes

The mouth is usually split into four sections. Each section is treated (and billed) separately, so you may need it in some sections and not others. See an example

For borderline areas, some dentists prefer to watch and re-measure, and others treat sooner. See I just had a regular cleaning. Why do I need a deep one now?

Deep cleanings are a common recommendation, and a fair one to ask about, especially at a new office. They're also one of the easier ones to check, because the evidence is in your chart: your pocket measurements and X-rays. Ask to see both. See also I just had a regular cleaning. Why do I need a deep one now?

One thing worth knowing: tartar (hardened plaque) on its own doesn't mean you need a deep cleaning, even when it shows up on an X-ray. A deep cleaning treats gum disease that has caused bone loss. Tartar without bone loss is usually handled with a regular cleaning, or with a cleaning for inflamed gums if they're swollen. See Are there alternatives to a deep cleaning?

Your plan can also be a helpful second look. See how plans review deep cleanings.

Gum disease usually keeps going slowly and quietly. Over time it can loosen teeth. Here's what can happen if you skip it →