A comprehensive dental exam will be performed by your dentist at your initial dental visit. At regular check-up exams, your dentist and hygienist will include the following:
Professional dental cleanings are usually performed by Registered Dental Hygienists. Cleanings can be one of six different types:
A prophylaxis, sometimes called a “regular cleaning,” is considered a preventive procedure where the dentist or hygienist removes plaque (bacterial film), calculus (tarter), and stains from the teeth. The dentist may recommend this procedure at regular intervals, possibly once or twice a year, for patients whose gum health is generally good (healthy gum color and texture, minimal plaque and debris, and shallow gum pockets around the teeth). A prophylaxis may also be appropriate for patients with gum conditions limited to gingivitis, or gum inflammation. However, if a patient has active gum disease a prophylaxis is not the appropriate procedure and your healthcare professional will recommend 4341/4342 (see below) as the first step to control the infection
On occasion, when there has been significant buildup of plaque and calculus that makes it difficult or impossible to complete a thorough examination, the dentist may recommend a full mouth debridement (FMD). FMD is the gross removal of plaque and calculus buildup from the teeth and gums. This procedure is considered a preliminary procedure that is generally performed prior to completion of an oral examination and diagnosis, and does not prevent the need for additional scaling and teeth cleaning procedures.
Periodontal scaling and root planing is often called a “deep cleaning”. A dentist will recommend scaling and root planning (SRP) when a patient shows signs of gum disease. These signs may include the finding of deeper gum pockets, loss of bone support for the teeth that are visible on x-rays, bleeding gums, and accumulation of plaque and calculus below the gums. DSRP procedures are generally completed in quadrants (or sections of the mouth), and usually require the dentist or hygienist to numb the treatment area so that all surfaces of the teeth, including the root below the gum, can be thoroughly scaled and cleaned. Usually, DSRP is accompanied by the use of antimicrobials and/or antibiotics. Follow up periodontal maintenance cleanings are necessary.
Scaling, in the presence of generalized moderate or severe gingival inflammation-full mouth after oral evaluation, is a code used for the removal of plaque, calculus and stains from above and below the gums. It is indicated for patients that have swollen, inflamed gums, pockets without bone loss, and moderate to severe bleeding on probing. This may be necessary in an individual that has not had adequate home care and no professional care for long periods of time.
A periodontal maintenance (PM) is a procedure that is recommended “following periodontal treatment (such as scaling and root planing) and continues at varying intervals, determined by the clinical evaluation of the dentist.” PM is important because gum disease will get worse without adequate follow up. PM includes removal of plaque and calculus above and below the gums, polishing and is frequently accompanied by the use of antimicrobials and/or antibiotics. PM is always performed following active periodontal treatment such as scaling and root planing or more extensive gum surgery.
