Our patients sometimes ask:
“What is the difference between a regular cleaning, i.e. prophylaxis, and deep dental cleaning, i.e. scaling and root planning? And why do I need periodontal maintenance? It feels just like a regular cleaning.”
Those are good questions!
Here’s what you need to know about dental cleaning and maintenance to keep your oral health at its best.
A dental prophylaxis (D1110) “is performed on transitional or permanent dentition, which includes scaling and polishing procedures to remove coronal plaque, calculus, and stains.”
Coronal means above the gumline.
Although many times during prophylaxis a hygienist may clean below the gums, or subgingival, it is not meant to be done when there is significant calculus or pockets with inflammation.
Periodontal scaling and root planing (D4341) “involves instrumentation of the crown and root surfaces or the teeth to remove deposit and/or roughness and is therapeutic, not prophylactic, in nature.
Root planning is the definitive procedure designed to remove plaque and calculus from these surfaces. It is indicated for patients with periodontal disease and is for removal of cementum and dentin that is rough, and/or permeated by calculus or contaminated with toxins or microorganisms. Some soft tissue removal occurs.”
Periodontal disease is episodic; destructive episodes can be triggered by stress, disease, or other systemic problems. It is not curable but can be controlled much like diabetes.
Periodontal maintenance (D4910) is for “patients who have completed periodontal treatment (surgical or nonsurgical) and includes removal of the bacterial flora from crevicular and pocket areas, scaling and polishing of teeth, periodontal evaluation and a review of the patient’s plaque control efficiency. Typically in intervals of three months, but varies depending on clinical judgement.”
Periodic maintenance following periodontal therapy is not prophylaxis. If the hygienist is thorough and the patient has been following their homecare hygiene regimen; there should not be much calculus at the three-month interval.
The purpose of periodontal maintenance is to control the disease. Ideally, if the patient can tolerate the use of the ultrasonic piezo, it is best if used for at least 75% of scaling at low power. This will be the most effective way to debride pathogens. The reason for the intervals being shorter is to reduce the build-up of the pathogens that cause the disease to become destructive. Usually, 1 year of stability is needed to lengthen the interval visits to 6 months.
Keeping your regularly scheduled dental cleaning appointments is vital for the health of your teeth and gums.
Are you past due for a cleaning?
We will be happy to schedule you an appointment at a time convenient for you!