Is the cleaning a full cleaning, or a polish? On one Groupon offer in the the past, the offer offer said, "cleaning" but when you go to them they say, "You need additional deep cleaning....which we can do for $150." Naturally, I was put-off and never went back. That defeats the puruspose of the special offer, would you say? I'm used to getting a full cleaning, scraping the tartar and getting under the gum line, tooth by tooth, topped off with a quick polish. That used to be called a "cleaning." Can you clarify your process and procedure? Thank you!
Robert S. asked on May 31, 2013
Dear Robert , Thank you for bringing up this matter into attention. There is widespreads confusion in this area. I believe the solution lies in your own understanding of the difference between prophy/polish and scaling and root planing/deep cleaning. First, let's establish that prophy are for healthy mouths. Definition of dental prophylaxis by American Dental Association is performed on transtitional or permanent dentition which includes scaling and polishing procedures to remove coronal plaques, calculus, and stains. The key word is "coronal".All hygienists and dentists do subgingival scaling on many patients who have not been classified as periodontal patients. The reality is that patients who accumulates supragingiva calculus deposits invariably will have subgingival deposits as well.However, in the strickest sense of definition, a prophy/polish is a simple procedure on a patient that does not have significant subgingival deposits or periodontal pocketing.The typical prophy patient comes every six months exhibits excellent homecare, has healthy gingival tissues, does not bleed on gentle probing and has no pockets over 4 mm. Now let's examine the definition of scaling and root planing or deep cleaning. This is defined as a procedure involves instrumentation of the crown and root surfaces of the teeth to remove deposits and is therapeutic, not prophylactic, in nature. Root planing is the definitive procedure designed to remove plaque and calculus from these surfaces. It is indicated for patients with periodontal disease and is for the removal of the cementum and dentin that is rough and/or permeated by calculus or contaminated with toxins or microorganism. Some soft tissue removal occurs. Periodontal procedure for the most part ,subgingival in nature.Periodontal scaling requires more skill and expertise than prophylaxis procedures.Patients with periodontal disease, either active or inactive, bears the scars of the disease process - such as bone loss and pocketing - which is rarely generalized through out the mouth.Periodontal disease is a bacterial and/or viral proliferation of pathogens that overwhelms the host defenses and spurs the host's own immune system to initiate a breakdown of supporting tooth structures. Periodontal disease also is episodic in nature.Destructive episodes can occur unbeknownst to the patient and can be triggered by stress, disease or other systemic problems. We also know that periodontal disease is not "curable" disease, but it is controllable in most patients.Therefore when a patient has experienced periodontal disease in the past,we must be ever - vigilant to monitor for signs of active disease long after the disease has been brought under controlled through good periodontal therapy. Now there is another term called " periodontal maintenance". This is a procedure for patients who have completed periodontal treatment ( surgical and/ or non surgical periodontal therapies ) and in needs of removal of the bacterial flora from crevicular and pocket areas, scaling and polishing of the teeth, periodontal evaluation, and a review of the patient's plaque control efficiency.Typically an interval of three months between appointments results in an effective treatment schedule, bu this can vary depending upon the clinical judgement of the dentist. When new or recuring periodontal disease appear, additional diagnostic and treatment procedures must be considered. Periodic maintenance treatment following periodontal therapy is not synanomous with a prophylaxis. The goal of Scaling root planing or deep cleaning is to remove as much subgingival debris as possible and disrupt/destroy the bacterial proliferation.The goal in periodontal maintenance is to debride the sulcular areas of attached and non attached plaque pathogens.That being said, you are controlling the periodontal disease. I hope this information helps. Sincerely, Neni Shriver,DDS
neni s. from Merchant replied on May 31, 2013