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Dr. Katz
Dr. Katz, Dentist - DDS
Category: Dental
Satisfied Customers: 3019
Experience:  Dentist and Anesthesiologist for 35 years.Anesthesiology Fellow-Johns Hopkins School of Medicine.Evaluator for Maryland State Board of Dental Examiners.
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I have tartar buildup behind my two bottom front teeth.

Customer Question

Hi, I have tartar buildup behind my two bottom front teeth. Every time I go to get it removed, they always want to do a deep cleaning (scaling and root planing). I've been reading in some places that scaling and root planing are reserved for bleeding gums, severely damaged teeth etc, none of which I have. Also, prior to the deep cleanings, my gums were in fine shape. However, after the gum scraping I endured during my deep cleaning, I suddenly need a gum treatment, according to the dentist. Is deep cleaning damaging my gums? Is this the usual treatment required for minimal tartar buildup? I fear my dentist is trying to make money off of me.
Submitted: 1 year ago.
Category: Dental
Expert:  Dr. Katz replied 1 year ago.
Welcome .I will do my best to answer your question.I am not a great typist,be patient and feel free to ask if anything is unclear.Without seeing your xrays and knowing your age,I cannot tell the severity of your gum problems accurately.I will tell you though that the area behind the lower front teeth is an extremely common area to build up calculus in almost all patients.Deep scaling and root planing is reserved for the more severe cases of periodontal disease where there has been documented and visible bone loss creating pocket areas between the teeth.Unless there has been this type of bone loss,periodontal deep scaling is the incorrect coding for your cleaning and yes,many dentists will use this coding to make more money on a standard cleaning.Deep cleaning is not damaging to the gums.The questions is do you actually need a deep cleaning and are they actually doing a deep cleaning..Everyone builds up tartar.The big question is ,do you have bone loss from the tartar buildup and can they document pocket formation.How old are you? Do you have xrays of your teeth to upload? I would be happy to look at them for you.
Expert:  Dr. Katz replied 1 year ago.

Do you have any other questions or is anything unclear?

Customer: replied 1 year ago.

Sorry for the late reply, and yes. I am 21 y/o and am going to the dentist soon so I will try to upload my x rays later.

You mentioned changing coding to get to get more money- when I had my cleanings done, the hygienist went under my gums and there was a lot of bleeding and pain, although my gums never bled before nor have I ever had tooth pain or sensitivity issues, except when I had a few cavities. Does this sound like the periodontal deep scaling? Also, what are typically used, less invasive methods for mild tartar buildup?

Thank you for the detailed response.

Expert:  Dr. Katz replied 1 year ago.
The only way to remove the tartar or hard calculus that forms behind the backs of the lower teeth is to have a professional cleaning.This stuff attaches on the teeth like concrete.You can minimize its accumulation by using dental floss ,brushing regularly and having your teeth cleaned,a regular cleaning twice a year.Some people just build this stuff up more readily than others.The dentist can use an ultrasonic scaler which also helps remove tartar quickly.Periodontal deep scaling coding indicates that there is substantial bone loss between the teeth.If you do not have this bone loss,they cannot use this code.I doubt that at 21, your xrays would show this.Daily brushing ,flossing and rinsing with 3% hydrogen peroxide can help keep this tartar from building up.
Expert:  Dr. Katz replied 1 year ago.
Is there any other information that you need?
Customer: replied 1 year ago.

Hello, thanks again for the reply. I was wondering if you would be willing to wait a day or two so that I can get my x rays and get your opinion on them..thank you.

Expert:  Dr. Katz replied 1 year ago.
I would be happy to look at the xrays for you.