Deep cleaning teeth: what it is and when you need it

Deep cleaning teeth usually means cleaning below the gum line to treat gum disease, also called root surface debridement. It is different from a routine scale and polish, which removes tartar above the gum. At Toothi London in Edgware, a scale and polish is £70 and a comprehensive clean with Airflow is £125. Deeper cleaning is quoted in writing after assessment. Your dentist will tell you which type of clean your gums actually need.

Plaque is a soft, sticky film of bacteria that builds up on your teeth every day. Brushing and cleaning between your teeth removes most of it. Plaque that is left behind absorbs minerals from saliva and hardens into tartar (also called calculus) within days.

Tartar is rough and firmly attached, so it cannot be brushed off. It gives plaque more places to collect and irritates the gums, which causes inflammation and bleeding. Tartar that forms below the gum line can contribute to gum disease. Only a dental professional can remove it, which is what tartar removal at a hygiene appointment is for.

There are three main levels of professional teeth cleaning. They are often confused, but they do different jobs.

A scale and polish and an Airflow clean are maintenance treatments. Deeper cleaning is a treatment for gum disease, and is only recommended after your gums have been measured and assessed. Read more about Airflow and our hygiene appointments.

You can’t tell for certain at home. The decision is based on a gum assessment at your check-up (£55), where the dentist measures the depth of the pocket between each tooth and the gum. X-rays (£15 each) may be taken to check the bone. Signs that suggest it is worth booking include:

• ✓  Gums that bleed when you brush or floss.
• ✓  Persistent bad breath or a bad taste.
• ✓  Gums pulling away from the teeth, or teeth looking longer.
• ✓  Teeth that feel loose or have started to move.

If deep pockets and bone loss are found, a deeper clean is usually part of a wider plan. Our page on gum disease treatment explains the full process.

For deeper cleaning below the gum, the area is numbed with local anaesthetic first. The root surfaces in each pocket are cleaned carefully, often one part of the mouth at a time over more than one visit. The gums are re-measured after healing to check how they have responded.

Most people find a scale and polish comfortable. If your gums are inflamed or your teeth are sensitive, you may feel some tenderness, and we can adjust the water temperature and pressure or numb sensitive areas.

Deeper cleaning below the gum is usually done under local anaesthetic, so most people feel vibration and pressure rather than pain. Afterwards, gums can feel sore and teeth more sensitive for a few days. This typically settles. Your usual painkiller, following the packet instructions, can help; ask a pharmacist if unsure.

There is no single right interval. It depends on your gums, how quickly tartar builds up and your risk factors, such as smoking or diabetes.

• ✓  Healthy gums. Many people have a hygiene appointment every six to twelve months.
• ✓  Gingivitis or heavy tartar. More frequent visits may be suggested until the gums settle.
• ✓  Treated periodontitis. Regular maintenance, often every three to six months, helps keep gum disease stable.

Your dentist will recommend an interval that suits you at your check-up.

• ✓  Brush twice a day for two minutes with a fluoride toothpaste, angling the bristles towards the gum line. Spit, don’t rinse.
• ✓  Clean between your teeth every day with interdental brushes or floss. This reaches the areas a toothbrush misses.
• ✓  Expect some bleeding at first when you clean more thoroughly. It usually reduces within a week or two as gums heal. If it doesn’t, tell us.
• ✓  Limit sugary snacks and drinks between meals, and stop smoking if you smoke.
• ✓  Keep your next appointment so tartar is removed before it causes problems.

When to get urgent help: a painful swelling on the gum needs a prompt dental appointment – call 020 3148 2444. Swelling spreading across the face or neck, swelling affecting breathing, swallowing or the eye, or a high temperature needs A&E or 999. Out of hours, call NHS 111.