Dental Education Lecture: Regular Cleaning: Skin Deep

There are generally two types of cleaning: regular and deep.  Regular cleaning is indicated when we do not have gum disease (prevention), whereas deep cleaning is done when we have gum disease (treatment).  Regular cleaning is to remove tartar from the area we can see (above gum line, usually the crown, skin deep, making surface shiny).  By contrast, deep cleaning is get rid of tartar underneath the gums.

What will happen if regular cleaning or no cleaning is done for several years where deep cleaning is necessary?  The answer is that we will lose our teeth.  Mrs. Jones is in her late forties.  She has had gum diseases for quite a while and refused deep cleaning.  Last week she returned to dental office for extraction because of severe toothache and tooth mobility.  In fact, she had a regular cleaning done in her home country recently.  Fig.1 shows three extracted teeth.  The portion of the tooth above the white arrows is the crown, which is pretty clean and nice.  Everything below the white arrows is the root, which is usually covered by the gums.  The black arrow points to heavy nasty tartars well below gum lines, which regular cleaning cannot remove.  It is these tartars that cause our bad odor, gum bleeding, and loose teeth.  Fig.2 and 3 are X-ray taken before extraction.  The bone around the labeled teeth (*) is not as dense as the bone below these teeth, the basis of mobile teeth.  Reduced density of the bone around the loose teeth is due to the presence of deeply-seated nasty tartar.  Do we need to do deep cleaning remove them as early as possible or just skin deep regular cleaning?

Xin Wei, DDS, PhD, MS 1st edition 09/02/2009, last revision 09/03/2009