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Ask Lara Coseo Your Own Question
Lara Coseo
Lara Coseo, Dentist (DDS or equivalent)
Category: Dental
Satisfied Customers: 211
Experience:  Awarded, licensed dentist with over 13 years experience
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How does a dentist determine if a deep cleaning is ncessary?

Customer Question

thank you. How does a dentist determine if a deep cleaning is ncessary?
JA: Have you seen a dentist about this yet?
Customer: Yes,only x-rays were taken and the dentist told me I needed deep cleaning. I thought the measurement of gum tissue was necessary.
JA: Please give me a bit more information, so the dentist can help you best.
Customer: This was my first visit to a new dentist. I have always had the dentist use a probe and measure the tissue around the teeth. This dentist only looked at the x=rays.
JA: Have you noticed any swelling in the gums? When was your last visit to the dentist?
Customer: No. There is no bleeding or swelling to the gums.
Submitted: 2 months ago.
Category: Dental
Expert:  Lara Coseo replied 2 months ago.

That's a really great question and one that can cause some concern for patients who are hearing that they need a deep cleaning for the first time.
A deep cleaning is necessary when the accumulation of tartar on the teeth is below the gums and some periodontal disease is present. This is typically determine by a combination of the two things you already mentioned: the x-rays PLUS the probing measurements.
Tartar buildup does show up on x-rays once it is big enough. If if is visible on an x-ray in between the teeth, it's almost always below the gumline.
The probing measurements are to determine how deep underneath the gums the cleaning will need to go.
I'm going to continue with more. Just want to send this off so you know I'm here typing.....
Dr. Lara

Expert:  Lara Coseo replied 2 months ago.

A generally accepted rule by most dentists and almost all dental insurance companies is that a deep cleaning is necessary when there is tartar (or calculus) visible on the bitewing x-rays, and there are probing measurements of 4mm or greater. Anything 4mm or greater is considered a "pocket" of periodontal disease. These can be localized to just one area, or generalized over the whole mouth.

The purpose of the deep cleaning is to allow the dentist or dental hygienist to adequately access and remove ALL of the calculus/tartar buildup in your mouth, which requires cleaning underneath the gums.
Does that make sense?

Dr. Lara

Expert:  Lara Coseo replied 2 months ago.

In answer to your question, though, yes, a dentist can diagnose the need for a deep cleaning just from x-rays if the findings are obvious enough.