What are the advantages and disadvantages of professional teeth-cleaning?

In Germany, statutory health insurers cover the costs of having tartar removed. Children and teenagers below the age of 18 – and people who are in need of nursing care or have a disability – can also have free patient education to learn how to clean their teeth and gums properly.

It’s currently not possible to say whether professional teeth-cleaning prevents tooth decay, gingivitis and periodontitis more effectively than the standard scaling (tartar removal) does. There are no suitable studies in this area.

Tartar removal and good oral hygiene are very important in the treatment of periodontitis. Before the actual treatment is started, dentists often recommend combining professional teeth-cleaning and patient education to ensure good oral hygiene and reduce very severe inflammations somewhat. After the treatment, this combination is recommended in order to prevent the inflammation from coming back.

But there’s no suitable research on the potential advantages of professional teeth-cleaning in the treatment of periodontitis. So it’s not possible to say whether the combination of professional teeth-cleaning and patient education before or after periodontitis treatment can prevent the progression of the disease any better than the standard tartar removal can.

Some people think that professional teeth-cleaning will give them brighter teeth and keep the necks of their teeth (the part closest to the gums) cleaner. But if you carry on drinking coffee or black tea, or if you continue smoking, your teeth might be stained again within a few weeks.

It's sometimes claimed that professional teeth-cleaning fights bad breath too. Only a few studies have looked into this, though, and they are of poor quality. So their results aren’t reliable enough to prove that professional teeth-cleaning can prevent bad breath.

There’s no research on potential long-term side effects of professional teeth-cleaning. So it’s not clear whether, for instance, it makes the teeth more sensitive over time, or damages the gums or the surfaces of the teeth.

Like the removal of tartar, professional teeth-cleaning can be unpleasant – especially if the necks of the teeth are exposed. If the gums are already irritated or inflamed, they are likely to bleed during the procedure. Because of this, it’s important to let the dentist know beforehand whether you are taking blood-thinning medication such as acetylsalicylic acid (the drug in medicines like Aspirin).

Professional teeth-cleaning can include several steps: cleaning, polishing and a fluoride treatment. The dentist or dental hygienist might also offer to show you how to clean your teeth properly yourself.

The first step is scaling, where plaque and tartar are removed – also from hard-to-reach areas between the teeth and at the edges of the gums. This is done using things like ultrasound devices and hand-held instruments (called scalers or curettes). The gaps between the teeth are cleaned using dental floss, special dental sandpaper or small brushes. Some dental practices also use a jet of water and powder to clean the teeth and remove stains too.

After the teeth have been cleaned, they are polished. This is done using a special paste on the rotating head of a hand-held instrument. The head is made out of rubber or a small brush. The polishing smooths the surface of the teeth, making it harder for bacteria to stick to them.

At the end, the teeth are usually covered in a fluoride gel or varnish to protect and strengthen the enamel.

Professional teeth-cleaning can take about 45 to 60 minutes. It is carried out by a dentist or a specially trained dental professional (dental hygienist). Dental hygienists are allowed to remove visible and easy-to-reach tooth deposits. If someone has particularly sensitive teeth, they can be given a numbing injection before having their teeth cleaned professionally.

This procedure isn’t generally covered by statutory health insurers in Germany. It usually costs between about 80 and 120 euros.

A number of statutory health insurers cover a part of the costs, though, and some even cover all of the costs. Most additional dental insurances (Zahnzusatzversicherungen) that supplement statutory health insurances cover some or all of the costs, too.