Back when I was practicing in Austin, I had a dental hygienist pull me to the side one afternoon.
“My patient would like to talk to the doctor,” she said.
I walked into the operatory, wondering what the problem might be.
“My cleaning was very comfortable. It did not hurt. She must not have done a very good job. I’d like you to do it again,” the patient said.
I tactfully picked my jaw from the floor and explained that I aimed to please, but that inflicting pain was not the type of customer service I liked to provide. The patient was persistent and re‐scheduled another cleaning with me, as opposed to the “gentle” hygienist.
When the appointment arrived, I stepped into the room hesitantly. Cleaning teeth is not something I had done since my days in dental school. I gingerly started to simulate removing plaque and calculus from the teeth, as the hygienist had already removed it all a week earlier. After a few minutes, the patient exclaimed, “Put your back into it. You are doing no better than she did.”
I reluctantly began to scrape the teeth harder and harder. There was little to actually clean, but I poked and scraped every surface of every tooth. I cannot imagine it was even a bit comfortable. When I was through, the patient thanked me for a thorough job and set up her next cleaning appointment, with me, six months later.
According to the ADA, a dental prophylaxis consists of removing plaque, calculus, and stain above the gums from all of the teeth in a healthy mouth. Prophylaxis by definition means to guard or prevent, therefore no gum disease can be present to start with. There is also a number of procedure codes used to classify treatment for the various stages of gum disease. Let us save that discussion for another day and discuss strictly healthy mouth cleaning or prophylaxis.
There are a number of ways to do a good job cleaning teeth. The old standby hand instruments work great when they are kept sharp and used correctly. A skilled hygienist can clean teeth this way as well as any other. Some professionals and patients prefer an ultrasonic cleaning. This is a metal tipped instrument that vibrates at high speeds to clean teeth. They do a great job, but can be wet and whistle loudly. There are even “sandblasters” that use air, grit, and water to blast build‐up off of teeth. These too work great, but can be a bit messy. Flossing, fluoride application, and the final polishing of the teeth are also commonly performed at a healthy mouth cleaning.
The comfort level of a healthy mouth cleaning can change from visit to visit. Stress, hormones, hygiene, and diet can all affect the amount of gum inflammation and therefore, sensitivity, during a healthy mouth cleaning. If things get uncomfortable, ask your hygienist or dentist to let up a bit. If a thorough job cannot be done comfortably, further treatment with anesthesia (numbing) may be necessary. Communication is the key.
‐Please send comments to Drs. Parrish at www.ParrishDental.com.
