How a tooth cleaning works

A professional tooth cleaning follows almost the same order everywhere. It does not begin with the device but with the findings — what is cleaned is decided after that.

1. Findings and staining

First the member of staff looks at where plaque lies and how the gums look. The plaque is often made visible with a staining solution. That is less a ritual of inspection than a map: it shows you and the practice which places are regularly missed during daily brushing. Usually they are the same three or four.

The condition of the gums is also recorded — whether they bleed on light contact and how deep the groove between tooth and gum is.

2. Removing hard deposits

Tartar is loosened with ultrasound, worked over with hand instruments, or both. The ultrasound transfers fine vibrations to the tip of an instrument and breaks off the hard layer; at the same time a jet of water cools. For many people the noise is more unpleasant than the treatment itself.

3. Below the gum line

After that the groove between tooth and gum is cleaned, usually with fine hand instruments. This step is the most important and at the same time the one most likely to be sensitive — above all if the gums are already inflamed. Where pockets are deeper, this is no longer done as part of a cleaning but planned as a separate periodontal treatment.

4. Interdental spaces and soft plaque

The surfaces between the teeth make up about a third of the entire tooth surface. They are cleaned with dental floss, interdental brushes or the air-polishing jet. Discolouration on the outer surfaces comes off in the same operation.

5. Polishing

All reachable surfaces are smoothed with a soft rubber cup and a polishing paste. The paste is made for this purpose: coarse enough to remove residues, fine enough not to attack the enamel. The result is a surface to which new plaque adheres less well.

6. Fluoride and advice

At the end a fluoride varnish or a gel is applied to the teeth. After the cleaning the enamel is briefly more receptive; the fluoride hardens it and eases the sensitivity that some people feel in the first few hours.

Then comes the part with the longest after-effect: the discussion. Which places are being missed, which brush size fits your interdental spaces, which technique really changes something. Anyone who skips this part pays for a cleaning and takes the same gaps home again.

Does it hurt?

With healthy gums, as a rule not. It can become unpleasant in three places: at exposed tooth necks, at inflamed gums and where there is a lot of tartar below the margin. A local anaesthetic is possible and with sensitive patients it is also usual — it is worth raising that beforehand and not only in the middle of the session.

How long does it take?

Forty-five to sixty minutes is usual. Less than half an hour is rarely enough for all six steps. Anyone with a lot of tartar, deep pockets or extensive dentures needs longer; some practices then split the session over two appointments.

What applies afterwards

• Eat and drink nothing for about an hour so that the fluoride can take effect. Some varnishes need longer — the practice will say what applies to the preparation used.
• On the first day, avoid strongly colouring foods: coffee, black tea, red wine, curry, beetroot. The freshly polished surface takes up colour more easily.
• Sensitive teeth are normal and usually subside after one or two days. A toothpaste for sensitive teeth helps during that time.
• Slight bleeding of the gums can occur in the first few hours, especially if they were inflamed beforehand. Keep brushing — do not stop. Stopping prolongs the inflammation.