Advanced Dentistry by Design
Deep Cleanings San Jose | Advanced Dentistry by Design

Deep Cleanings and Me

July 14, 2019
Posted By: Dr. Michelle Khouri
Teeth Cleaning San Jose | Advanced Dentistry by Design

We’re all familiar with dental cleanings.  You go in to the dentist’s office and lay back in the dental chair while your teeth are cleaned and polished.  However, some of you may have been told that you need a “deep cleaning.”  What exactly is a deep cleaning, and how does it differ from a regular one?  How will you know which option is the best one for you?  Below, we will discuss everything you need to know about deep cleanings and how they are diagnosed.  But first, to understand the treatment, you must understand the main culprit: calculus.


The Biology of Calculus


Calculus (not to be confused with the dreaded math class) is the term used to describe plaque that has been sitting on the surface of the teeth for long enough that it calcifies.  As calculus builds up over time, it can lead to gingivitis, which is inflammation of the gums, and periodontitis, which is the breakdown of the bone surrounding your teeth.

One of the main factors that contributes to calculus formation is improper oral hygiene habits.  Remember, calculus forms when plaque sits on your teeth for too long.  By brushing your teeth 2x daily, and flossing to get those surfaces in between, you remove that film of plaque, giving it no chance to harden into calculus.


Once plaque becomes calculus, it is virtually impossible for you to remove with a toothbrush and floss alone and requires the use of special dental instruments to clean off thoroughly.


What is a deep cleaning?


A deep cleaning, as the name implies, is a cleaning that goes “deep.”  This means it is not just limited to the surfaces at or above the level of the gums, but goes beneath them to remove calculus hidden below the gumline.


Deep cleanings are usually split into two appointments, and half the mouth is done at a time.  Because deep cleanings require calculus removal from beneath the gumline, the patient is numbed up so that the experience is as comfortable as possible.  After all the calculus is removed, the gums are then irrigated with a special antibacterial, anti-inflammatory mouth rinse.   


How do I know if I need a deep cleaning?


Now, not everyone with calculus needs a deep cleaning.  Your dentist or hygienist will conduct an extensive oral exam to determine whether or not a deep cleaning is in your best interest.  Below are a few of the factors we consider when evaluating a patient’s oral health:


  1. The calculus can be seen on your x-rays.

This means that the calculus has gotten to the point where it is about the same density and hardness as bone.That’s clearly a lot of calculus!


  1. Your gums are puffy, red, and bleed easily.

As mentioned earlier, calculus buildup causes inflammation of the gums, or gingivitis.Healthy gums are tight, pinkish in color, and do not bleed, even when probed.Inflamed gums are puffy and red from increased blood flow to the area, and they bleed much more easily when agitated, like during brushing and flossing.


  1. The level of the bone around your teeth has gone down.

In a healthy mouth, your bone level should be just below where the crown of your tooth fuses with the root.As calculus builds up, bone is lost and falls below this level.This is called periodontitis and can range from mild to severe depending on how much bone is lost.

4. You have deep pockets of gum around your teeth.

Your teeth poke out through a pocket of gum surrounding them.When gums are healthy, these pockets should be 2-3 mm deep.A combination of bone loss and gum inflammation causes these pockets to be much deeper.Measurements of ≥5 mm are a clear indication of poor gum and bone health and heavy calculus buildup.


What are the consequences of leaving the calculus there?


If you are recommended a deep cleaning, it is because your mouth checks off all the criteria listed above.  Not removing the calculus can cause these conditions to worsen significantly.  Gums will continue to swell and become increasingly sensitive.  The bone around your teeth will continue to break down, and unfortunately bone that is lost cannot be regained without surgical intervention.  In severe cases, the teeth can even become mobile, putting them at risk for developing infections and needing to be removed.



Proper home care and regular visits to the dentist can help prevent any of this from happening.  However, if you do find yourself in a situation where your mouth is in the condition described above, it is not too late to get it back into a healthy state and avoid further issues.  Oral care is a team effort, so let’s work together to make sure your gums and teeth stay their healthiest!

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