Tooth cleaning and bleaching

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What are dental cleanings (scale and polish) and why have them?

Dental cleanings involve removing plaque (soft, sticky, bacteria infested film) and tartar (calculus) deposits that have built up on the teeth over time. Your teeth are continually bathed in saliva which contains calcium and other substances which help strengthen and protect the teeth. While this is a good thing, it also means that we tend to get a build-up of calcium deposits on the teeth (tartar).  Usually it is tooth coloured and can easily be mistaken as part of the teeth, but it also can vary from brown to black in colour.

If the tartar is allowed to accumulate on the teeth it will unfortunately provide the right conditions for bacteria to thrive next to the gums. The purpose of the cleaning and polishing is basically to leave the surfaces of the teeth clean and smooth so that bacteria are unable to stick to them and you have a better chance of keeping the teeth clean during your regular home care.

How are dental cleanings done?

The dental hygienist or dentist uses specialized instruments to gently remove these deposits without harming the teeth. The instruments which are usually used during your cleaning are: ultrasonic instrument, fine hand tools, polishing and sometimes fluoride. 

Ultrasonic instrument

Commonly used first is an ultrasonic instrument which uses tickling vibrations to knock larger pieces of tartar loose. It also sprays a cooling mist of water while it works to wash away debris and keep the area at a proper temperature. The device typically emits a humming or high pitched whistling sound. This may seem louder than it actually is because the sound may get amplified inside your head, just like when you put an electric toothbrush into your mouth.

The ultrasonic instrument tips are curved and rounded and are always kept in motion around the teeth. They are by no means sharp since their purpose is to knock tartar loose and not to cut into the teeth. It is best to inform the operator if the sensations are too strong or ticklish so that they can adjust the setting appropriately on the device or modify the pressure applied.

Fine hand tools

Once the larger pieces of tartar are gone, the dental worker will switch to finer hand tools (scalers and curettes) to remove smaller deposits and smoothen the tooth surfaces. These tools are curved and shaped to match the curves of the teeth. They allow smaller tartar deposits to be removed by carefully scraping them off with a gentle to moderate amount of pressure.

Polishing

Once all the surfaces are smooth, the dental worker may polish your teeth. Polishing is done using a slow speed handpiece with a soft rubber cup that spins on the end. Prophylaxis paste – a special gritty toothpaste-like material – is scooped up like ice cream into the cup and spun around on the teeth to make them shiny smooth. Instead of the polishing the dental worker may ask you if you agree with using sodium bicarbonate; this happens when the colour of your teeth is turned to being darker than its natural colour is. Sodium bicarbonate helps in whitening your teeth (for tooth whitening see below). 

Fluoride

Your dentist may also suggest yuo fluoride applications. The fluoride helps to strengthen the teeth since the acids from bacteria in dental tartar and plaque will have weakened the surfaces. It comes in many different flavours such as mint, strawberry, cherry; this in-office fluoride treatment is meant for topical use only on the surfaces of the teeth and swallowing excessive amounts can give a person a tummy ache as it is not meant to be ingested.

Fluoride foam or gel is then placed into small, flexible foam trays and placed over the teeth for 7 minutes. Afterwards the patient is directed to spit as much out as possible into a saliva ejector.  It is best not to eat, drink or rinse for 30 minutes after the fluoride has been applied.

Tooth whitening

Your smile creates an immediate, subconscious, visual impact on people you meet. A brighter smile gives the impression of youth, vitality, radiant health, happiness, and warmth. A bright smile is perceived as a healthy smile. If you don't see brightness in your smile and you find your teeth have lost in colour you can ask your dentist for tooth whitening.

Causes of tooth discoloration

Deciduous (baby) teeth are typically whiter than the adult teeth that appear later. As we age, our adult teeth often become darker, yellower, or stained. Internal tooth discoloration is caused by changes in the enamel of the tooth and the dentin. The main causes of internal tooth discoloration are exposure to high levels of fluoride, tetracycline, use of antibiotics as a child, developmental disorders, tooth decay, restorations, root canal issues, and trauma. External tooth discoloration is caused by factors outside the body, mainly foods and tobacco. The main causes of external tooth yellowing are smoking, foods with tannins, coffee, tea, carrots, oranges, liquorice and other foods.

Types of teeth whitening

There are various ways to whiten your teeth, but the two most common are in-office treatment and the home tooth whitening system. We prefer home tooth whitening system because it's easy to use and your teeth will be whiter longer than with the in-office treatment. Your dentist will give you mouth trays with whitening toothpaste that you can apply for 4 hours during the day, or for the entire night long, for  10 days. From the beginning to the end of the treatment you will be supervised: the dentist will check that the tooth whitening tray fits properly, and he will handle any issues that may arise from whitening treatment, such as tooth sensitivity. Today most tooth sensitivity cases are easily managed.

With the home tooth whitening system you will be able to follow up regurarly with a home whitening product for maintenance.

Is it going to be painful?

Most people find that cleanings are painless, and find the sensations described above – tickling vibrations, the cooling mist of water, and the feeling of pressure during “scraping” – do not cause discomfort. A lot of people even report that they enjoy cleanings and the lovely smooth feel of their teeth afterwards!

Be sure to let your dentist/hygienist know if you find things are getting too uncomfortable for your liking. They can recommend various options to make the cleaning more enjoyable. Painful cleaning experiences can be caused by a number of things: exposed dentine (not dangerous, but can make cleanings unpleasant), or sore gum tissues.

In case you may have had painful cleaning experiences in the past, switching to a gentle hygienist/dentist and perhaps a spot of nitrous oxide can often make all the difference. You could also  ask for a topical numbing gel or you can choose to be numbed.


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