The Whole Tooth: Two Types of Dental Cleanings – Which One Is For You?

By Michelle Aldrich, DMD, For The West Side

We have all seen the advertisements running specials for a "Free Teeth Cleaning." It sounds like a great deal, but sometimes "free" isn’t really free. You go in for your appointment, only to be told that you don't qualify for a standard cleaning and will have to pay. It can easily feel like a bait-and-switch.

While the ethics of healthcare providers running "specials" is a soapbox for another day, there is a legitimate medical reason for this distinction. Dentistry categorizes cleanings into two entirely different types based on the health of your mouth.

Adult Prophylaxis:  The Preventive Approach

The first type of cleaning is an Adult Prophylaxis. This is a strictly preventive service. It is designed exclusively for people with healthy gums, no bone loss, and no deep "pocketing."

What exactly is pocketing? When dental hygienists evaluate your mouth, they measure the tiny space between your tooth and gum.  This is the exact spot where popcorn hulls always seem to get stuck.

• The Health Standard:  A healthy measurement is 3 millimeters or less, accompanied by zero bleeding. The gums should look pink and firm.
• The Objective:  Because there is no active disease, this cleaning simply prevents future problems by removing routine surface plaque.

Periodontal Maintenance:  The Therapeutic Approach

If your dental exam reveals deeper pockets, bleeding, and bone loss visible on your X-rays, you no longer fit the criteria for a prophylaxis. Instead, you require Periodontal Maintenance Therapy (abbreviated to PMT).

Think of it this way: if a patient already exhibits signs and symptoms of gum disease, it is too late to prevent it. You cannot prevent a condition that is already present. This is where hygienists sometimes face indecision when a patient has a mixture of healthy areas and diseased areas. 

However, providing a superficial preventive cleaning to active disease just doesn't work. Periodontal maintenance is a therapeutic service.  This means it relates to the treatment or management of a disease. The focus shifts from prevention to defending your mouth against an unseen microbial enemy.

• Achieving Stability:  Some patients have great success after a year or two of definitive maintenance. They reach a point where bleeding stops and bone loss halts. These patients typically don't smoke, maintain excellent home care, and stable overall health.
• A Lifelong Fight:  Other patients, especially those who smoke, have uncontrolled diabetes, or struggle with oral hygiene may never achieve total stability. They will require periodontal maintenance for the rest of their lives to prevent tooth loss.

Customization is Key

Ultimately, managing gum disease requires a highly customized daily routine. When you receive high-quality therapeutic care and commit to excellent home habits, you establish a healthy point of reference that protects your smile for years to come.