Today, we received a question from a reader concerning whether she needed a full mouth debridement. Though we wrote a previous article on this subject matter, which can be found here, we wanted to explore an easy way to tell if you need a regular cleaning, or a full mouth debridement, or a scaling and root planing.
I am told I need a full mouth debridement and a perio scaling root planning on only 1/4 of my mouth. My husband was also told he needs a full mouth debridement. Neither one of us have any pain or have red gums. When they did measurements we got around 5 4′s and 3 5′s the rest were under 3. I just don’t understand why this is necessary and have had issues with dentist not being honest in the past. How can I know for sure if I need this done?
Now a scaling/root planning and a full mouth debridement are two separate procedures. We’ll start by discussing the full mouth debridement.
Why Do I Need a Full Mouth Debridement
A full mouth debridement is needed when there is too much plaque and calculus buildup for the dentist to perform a thorough evaluation. When you rub your tongue over your teeth, how does it feel? Do your teeth feel grainy and hard? Or do they feel smooth? If your teeth feel grainy, rough, and hard, then you probably have a layer of buildup or calculus on your teeth. Unfortunately, the only way to remove the calculus is with the “debridement” performed by the dentist or hygienist. If it feels smooth, this is perfectly normal and how your teeth should feel, this indicates there is no buildup present and you are feeling only enamel.
Why Do I Need a Scaling and Root Planing
A scaling is performed when the dentist takes measurements around your teeth to determine the level of attachment of your gum tissue. If you have enough 5’s and 6’s and sometimes even 4’s (measurement of 4 is at the dentist’s discretion as to whether to perform scaling, a 4 is borderline), then the dentist will decide to do a Scaling in that area. It’s actually more likely, as in your case, to have deeper pockets associated with your back teeth. Higher numbers mean that your gum tissue is slightly inflamed. This usually indicates that you have slight buildup underneath the gums, that’s not visible.
Honestly, in your situation, I would trust a dentist telling me I only need a scaling in 1/4th of my mouth versus a dentist telling me I need a full mouth scaling.
Full Mouth Debridement vs Regular Dental Cleaning
Now a debridement is only recommended when there is a significant amount of buildup on the teeth. This buildup is preventing the dentist from diagnosing as to whether you need a scaling, fillings, or other dental procedures. If this is NOT THE CASE, then you should only have a normal cleaning, also known as oral prophylaxis. It’s perfectly normal if you have a scaling on 1/4th of your mouth and a normal cleaning on the other areas.
How To Check Your Teeth for Buildup and Calculus
Many stores sell a small kit, on the dental aisle, that has a mirror and a probe. This kit isn’t normally more than $10.00. I would recommend purchasing this kit, and taking a good look at the backs of your teeth. Do you see a grainy substance near the gumline? Take the probe and insert it slightly underneath your gums (as in the picture above) in different areas around the tooth. Does this make your gums bleed? Is the probe going down deeper in certain areas and shallow in yet other areas? If you do notice buildup on the backs of your teeth, or bleeding, then your dentist may be justified in his/her recommendation.
If you have any doubt in your mind, please do not hesitate to seek a second opinion. Many dentists offer no-charge second opinions.
Save My Smile Team
In June 2009 a dentist performed the advanced cleaning procedure they
identified as a full mouth debridement. The dentist also measured the
distance between the bottom of the enamel and the top of the gum. This was
painful as the measurement device pressed into what I assume was soft enamel
The reason for my concern and my question here follows. Before the cleaning,
my gums completely filled the gaps between my maxilla 7, 8, 9 and 10(top front teeth). After
the cleaning, between 9 and 10, a 1.5 millimeter gap exists. And, between 9
and 8, and between 8 and 7, a 0.5 mm gap exists. In other words it appears
that the dentist created gaps during the cleaning process. I definitely had
a lot of blood when I rinses after the cleaning. Did the dentist make a
The dentist recommended that I come back for the second part of the cleaning
including having the undersides of my gums cleaned. Another dentist during
another previous appointment recommended the same. Based on the apparent
damage to my gums, I have ignored this. I have not had my teeth cleaning
Wow, your ability to relay the information in dental terminology is quite impressive
So first we will explain exactly what happened and then we will explain the reaction of your gums to the procedure.
Full Mouth Debridement
A full mouth debridement is an extensive cleaning procedure that involves cleaning the surfaces of your teeth including the tooth surfaces (root) located under the gums. A dentist performs a periodontal probing to determine if a patient needs a debridement. Based off of your information, it looks like the dentist recorded your probing depths, meaning he used a probe to measure the depths of the pockets around your teeth. This information tells us whether or not your gums are inflamed, meaning that you are experiencing gingivitis (please see our article here for more information on gingivitis).
Signs of Gingivitis
It looks like you had inflammation of your gums. The major factors in your situation that point us in this direction are the following:
- Bleeding during a cleaning or probing indicates inflammation of gums/gingivitis
- Shrinkage of the gums after the cleaning was performed indicates that the gums were inflamed and are now healing
Healing After Full Mouth Debridement
So now, the dentist performed the debridement and you see spaces that didn’t exist before. Let’s explain fully why this occurred.
- There is a possibility that you had calculus deposits. Calculus is a hardened buildup that can accumulate, over time, on teeth. Sometimes, it appears as tooth structure, but is actually harmful to the teeth. Calculus usually accumulates around the gumline. If the dentist removed calculus, spaces can now appear in those newly cleaned areas.
- Your gums are now healing. Before your gums were inflamed. Gums become inflamed when there are bacteria, food deposits, plaque, or calculus that remains on the teeth near the gums. The body’s defense system attempts to fight the foreign invaders resulting in inflammation and tenderness of the gums. Some signs of inflammation include the following:
- Red gums
- Puffy gums
- Gums that bleed when flossing
Healthy gums should appear coral pink (or slightly pigmented based on ethnicity), firm and tight.
So don’t worry, the dentist definitely didn’t mess up. Your gums are now healing after the extensive cleaning was performed. If the spaces in your teeth concern you, return to your dentist and he/she will be able to better assess the situation from this point. More than likely, once the gums return to full health, the spaces will resolve. Or, if you had periodontitis, meaning bone loss accompanied the gum inflammation, there are procedures the dentist can use to solve the problem.
Hope this helps and good luck,
Save My Smile Team