What happens at a dental cleaning?

Who does the cleaning

A routine cleaning, often called a "scale and polish", can be done by a dentist or a dental hygienist.⁸ In Ontario, dental hygienists are regulated health professionals who focus on preventing oral disease, overseen by the College of Dental Hygienists of Ontario.¹ Only people registered with that college can call themselves a dental hygienist, and you can look up any hygienist on the college's public register.^1,2

Our team at Kreher Dental Clinic includes a registered dental hygienist.

Step by step

1. A quick health update

The visit starts with your chart, your medical history and how you're feeling now, because some health issues affect dental care.³ Mention any new medications. Side effects can include dry mouth and overgrown gums.⁴

2. A look at your mouth, head and neck

The hygienist checks your mouth and the surrounding tissues of your head and neck,⁵ and the visit can include a screening for oral cancer.⁶

3. Measuring your gums

To check gum health, a small measuring tool (a periodontal probe) is usually placed between each tooth and the gum to measure the depth of the "pocket" there. This helps show how healthy your gums are.^3,7,9

4. Scaling: removing plaque and tartar

Scaling scrapes plaque and tartar off the surface of your teeth, using hand instruments or a vibrating ultrasonic instrument.⁸ This is the part of the cleaning you can't do at home. Plaque that isn't removed every day hardens into tartar (also called calculus), and tartar can't be removed by brushing and flossing.⁹ No matter how well you clean your teeth, some areas are always hard to reach.⁸

5. Polishing and fluoride

If you have stains, your teeth may be polished. A fluoride treatment may be applied to strengthen your teeth.^3,8

6. X-rays, if needed

Not every visit needs X-rays. How often you need them depends on your oral health. Dental X-rays use very little radiation.¹⁰

7. Advice for home

You'll get advice on keeping your teeth and gums healthy at home.³

8. The dentist's exam

The dentist's exam is a separate step. It isn't the dentist checking the hygienist's work; it's an exam of its own.⁴

If you're nervous or your teeth are sensitive

Many people feel some anxiety about dental visits.¹¹ A few things help:

• Tell us if your teeth are sensitive. Sensitivity often comes from gums pulling back and exposing the tooth roots, and it can be a sign of gum disease.¹²
• Raise your hand any time you need a break.¹¹
• Tell us if you have a low tolerance for pain, or about any bad experiences you've had before, so we can adjust.¹¹
• Ask questions. Knowing what to expect can calm your nerves.¹¹

For patients who are anxious, we also offer mild sedation. See sedation for anxious patients.

Why regular cleanings matter: gum disease

Gingivitis is inflammation of the gums. Its warning signs are puffy gums, blood on your toothbrush, or a change in the colour of your gums, and it usually doesn't hurt.¹³ Because it isn't painful, it can go unnoticed until a hygiene visit.¹⁴ Caught early, gingivitis can be reversed.¹³

Left untreated, gingivitis can lead to pockets forming between the teeth and gums. This more serious stage, called periodontitis, can't be reversed and can lead to tooth loss.⁷ According to the Canadian Dental Association, seven out of ten Canadians will develop gum disease at some point in their lives.¹⁵

How often should you go?

It depends on your mouth. For many people the Canadian Dental Association says that means an exam every six months,¹⁰ while the Ontario Dental Association recommends seeing your dentist at least once a year.¹⁶ People with periodontitis may need hygiene appointments every three to four months.¹⁷ The Canadian Dental Association also advises not to base how often you go on what your dental plan covers.¹⁰