Dental cleaning (also known as scaling) is the most common procedure done in a dental office by a dentist or dental hygienist. Everybody needs to have their teeth checked out every few months for signs of gum disease, plaque accumulation and tartar build up. Regardless of how strict their oral hygiene regimen is, most people start to develop tartar (also known as calculus) every 6 to 12 months, and would need a consultation from their dentist for its removal.
Tartar is the yellowish or grayish deposits that is seen on the surface of the teeth, especially the inner surface of the lower front teeth and the outer surface of the upper back teeth, and can be felt by passing your tongue against these parts as rough areas, or as if your teeth are now somehow joined together and no spaces exist between them. The reason for this feeling is that tartar occupies the tiny spaces between the teeth, and builds up by time so that these spaces are completely filled. Not only that, but by time, the compiled tartar starts to press down on the gums that are normally present between the teeth, and that is the reason for the rough sensation.
Calculus is hardened dental plaque. Dental plaque is the thin film of food debris and remnants that is formed on the surface of the teeth when you skip cleaning and brushing them for more than 2 days. This film is a playground for bacteria, which infests the plaque and starts the inflammation process. By time, Calcium and other hard minerals from saliva and from the food and drinks you consume begin to be deposited into this plaque, and calculus is formed. Due to the nature of calculus and the action of the bacteria, the calculus sticks hard to the teeth surface and can only be removed by the hands of a professional.
The reason that calculus is mainly formed on the inner surface of the lower front teeth and the outer surface of the upper back teeth is because these areas are directly opposite to the opening of major salivary glands, so the concentration of the minerals in these areas are quite high. In addition, these 2 areas are the most difficult to clean and are often missed during the normal brushing process.
Calculus formation is the first step in sustaining gum disease. It is hard, quite stuck to the tooth surface, and full of bacteria. These bacteria release chemicals and toxins into the gums, and gum disease starts.
The stages of gum disease progress as follows:
This is called gingivitis, or inflammation of the gums. The initiation of this condition happens only 3 days after plaque formation. In this stage, the gums are inflamed, red and easily bleed on touch and even during brushing and cleaning, but there is no recession, no bone loss and no pocket formation.
The condition has now progressed into periodontitis, with the inflammation increasing and food getting trapped even more especially between the teeth, making it very difficult to clean.
The bone loss and pocket formation continues. The inflammation does not decrease, and more severe symptoms start to appear, such as pain and sensitivity, and mobility of the teeth. Eventually, if the condition is not contained, these teeth could be extracted later.
So gum disease is the direct consequence of leaving calculus to build up, and could eventually lead to loss of the teeth. In some cases, the calculus build up is so severe that it has already eaten away all the bone holding the tooth in place, and the only thing actually keeping the tooth in your mouth is the calculus itself. In that case, unfortunately, there is no cure but to remove the tooth, a situation that can be easily avoided if tooth cleaning is done every few months.
Another hidden danger of calculus build up is that it obliterates the spaces between the teeth making them impossible to clean. These spaces are now filled with bacteria which use the food remnants to release acids and toxins not only into the gums, but into the teeth as well. Your teeth may be decaying underneath the calculus deposits and you wouldn’t even know it. When this calculus is removed eventually, you could find the tooth completely ravaged by decay that it would need advanced therapy to restore it. Again this could be easily avoided if you seek teeth cleaning every few months.
Tooth cleaning is all about removal of the plaque and calculus stuck to your teeth. It is a very routine procedure done many times daily in our practice. According to the severity of the condition, dental cleaning can be categorized into 3 main categories:
This is for people who have their teeth cleaned on a regular basis, and their calculus build up is minimal. In this situation, the dentist would use a specialized hand piece with a metallic tip attached to it. This tip vibrates at supersonic speed, loosening the hardened calculus deposits that are then cleared away. Expect some loud noises, a continuous flow of water for cooling purposes, and nearly no pain at all except the occasional sensitivity feeling if a sensitive area is touched. No anesthesia is needed in this type of treatment. In some cases, where the sensitivity is high, the dentist would use hand instruments instead of the supersonic hand piece to decrease the sensitivity.
This is when the gum disease advanced into periodontitis, and pockets have started to form. The main bulk of the calculus is cleaned with the supersonic instrument as before, but the deeper lying deposits on the root surface will have to be cleaned by other specialized hand tools, designed to reach the depth of the pockets without causing harm to the tooth or gums. This procedure is called curettage. Mostly it does not require anesthesia, but in cases of severe pain and sensitivity, a small dose of anesthetic solution is given.
These are the cases where the gum disease is so advanced, and the pockets are so deep that even curettage is not enough to thoroughly clean the deposits away. In these cases, surgery is probably needed, where the surgeon would open up the gums next to the tooth in question to reveal the entire surface, and start the cleaning procedure. This procedure is quite advanced, and would need the hands of a skilled professional periodontist, but is easier than you think and could be done under local anesthesia with only a few sutures, and minimal pain and swelling afterwards.
In all cases, you should seek at least a consultation or a follow up appointment with your dentist every 6 to 12 months, regardless of the presence or absence of symptoms; However, there are early stages of gum disease that you can detect, and seek help immediately such as:
New York Total Dental offers cosmetic dentistry and general dentistry services including full mouth rehabilitation, Invisalign, dental implants, orthodontics, veneers, periodontics gum treatment, teeth whitening, crowns and bridges, teeth fillings, and dental cleaning to Midtown Manhattan, Upper Manhattan, Lower Manhattan, and Downtown Manhattan in New York City.
