Do I Need Deep Cleanings?

Have you been told that you need deep cleanings?  We’ve been getting a lot of calls recently about clients that have been told they need “deep cleanings”. 

While deep cleanings CAN be effective, if you don’t know how to take care of your mouth you will need them again in the future!  Instead, what I like to recommend is first learn how to take care of your mouth, and then what was deep inside the pocket will be much easier to get to…often times you don’t even NEED deep cleanings, and instead, just a “cleaning”! 

Listen to a hygienist’s perspective on insurance and the current trend of everyone needing “deep cleanings”.  I’d love to hear your thoughts. 

Video Transcription

Hi, it’s Carrie with Natural Gumption.  And I just had a question come in from a client and I just wanted to kind of read this question and address it because it’s really part of what fuels my frustration with the way that patients are treated in the dental office.So the question that came in was, Dear Carrie, So I have a dental question and of course you came to mind.  I am somewhat leery of my new dentist since I had to switch to an HMO.  Prior to the switch I loved my dentist and had no issues.  Fast forward.  My new place tested my pockets and said I have 4-, 5-, and 6 mm pockets that I needed ‘deep cleaning.’  Is this customary?  Also will it do anything?  Any input will be greatly appreciated.So, here’s my thing about HMO offices.  They don’t make money by you just coming in and just having regular cleanings.  I have temped in a few – quite a few – HMO offices and I have also interviewed at a few HMO offices.  And each time what they kind of do is bring you in and do a quick dental screening on you and recommend deep cleanings because it’s a billable service.Again, we’re at the place in dentistry where if something is a billable service sometimes they’re going to figure out a way how to do it.  So they will come in and they will do these quick little probe readings.  Probe readings are really subjective.  It’s just somebody taking a little ruler basically and putting it in between your gums and measuring.  There’s no – let me say this carefully – it’s a great tool but you would also want to see x-rays.  You would also want, and when you see x-rays you can ask them – okay, show me where the bone loss is because on x-rays you can see bone loss.  You can also ask them to let them see your mouth with an intraoral camera.  Because when you can see with an intraoral camera you can look at the healthy areas and notice if your gums are pink, like mine are, or if you have infected areas.  Infected areas are going to be bright red in color.  They’re also going to sometimes gray in color.  Those are some of the key factors that you’re looking for.But this is a really big issue.  The last HMO office that I worked at  -- which I will never name names but – they said, oh make sure that you irrigate on whatever patient that you can because that’s the only way we make money off of them.  And I’m like well do you have toothbrushes that you give them?  And they’re like no we don’t  give them toothbrushes because that costs us money.  So that’s kind of the current trend in dentistry.  I’m not saying that all HMO offices are bad.  There are some great HMO offices, I’m sure.  But it is something that you have to be careful with.  Again if you are told that you need deep cleanings make sure that you ask for x-rays.  Make sure that you ask to see the bone loss.  Make sure that you get an intraoral camera in your mouth so that you can see the areas that the buildup is or the areas that the infection is.  Once you have a deep cleaning your insurance company categorizes you differently and they pay for a different portion of your cleaning, not with an HMO, but with a PPO or indemnity play they just pay differently.  So your deductible applies, they pay 80% of your cleanings instead of 100%.  And what I recommend is that you have been told that you have deep cleanings go ahead and get that initial cleaning, that initial debridement because they kind of do have to do that, then and then go home and really focus on your home care.  Do what you can do in order to clear the infection.  It might be that you have a lot of bacteria underneath your gums and so your gums are – similar to if you get a splinter in your finger.  If you get a splinter in your finger it gets pussy and it tries to work itself out.  That’s what happens in your mouth.  So if you are able to effectively clean at your gum line, in between your teeth, under your gums, with the right products and the right tools you’re going to get in there and you’re going to get things to be looking more healthy.  That way when you do have to have a cleaning then what’s there is usually kind of just below the gum line or above the gum lines because the gums will kind of pull back and shrink because that inflammation will go away.So sometimes deep cleaning as necessary, absolutely, but one of the most important things that you can do inside or outside of deep cleanings is be really aware of what areas in your mouth you’re missing.  Really focus on your home care.  Use the right products to kill the bacteria and keep the good bacteria going and then go back and see if you still need a deep cleaning.  I know a lot of my patients that I’ve seen initially, if I would have first recommended deep cleanings for them when I first saw them, it would have been a valid thing to do.  But, the way that I kind of like to work with patients is determine the ones that are interested in getting healthy on their own and then the ones that are interested in getting healthy on their own I’m going to walk them through a whole step.  I’m going to show them the inside of their mouth with an intraoral camera.  I’m going to show them how to use specific products so that they can get to those areas.  Most people kind of have the hardest time getting into the inside.  So focus in those areas. Focus on “flossing” surfaces, not necessarily with floss but with products that do really help.  Tooth and Gums Tonic is the way to go.  Actually, this isn’t a post about products so.Yeah, deep cleanings sometimes necessary, sometimes not.  The biggest factor is what you’re doing and what you’re not doing at home and how to be effective with it.  So I hope that helps.  Thanks for the question and keep them coming because I love to answer them. Talk to you soon.  Bye.