My dentist recommended that I get a full mouth debridement.  What does this mean and will it hurt?

Answer:

A full mouth debridement is a very thorough deep cleaning procedure performed by the dentist or hygienist.  In order to fully explain this procedure let’s examine three areas:

• Why a full mouth debridement is needed
• What a full mouth debridement consists of
• Instructions for what to do after a full mouth debridement

Why a full mouth debridement is needed

This procedure is needed if you have an excessive buildup of calculus or have some form of gingivitis or periodontitis  (Please read more about these conditions here).  But to offer a brief recap, gingivitis and periodontitis are caused by bacteria that are left around our teeth and gums when we are not brushing and flossing adequately.  As a result, the gums become red, swollen, and inflamed.  If left untreated, this can progress to periodontitis, which consists of losing the bone around the teeth.  This leads to loose teeth and eventually the teeth falling out.

What a Full Mouth Debridement Consists Of

Before this procedure is performed, the dentist or hygienist records a series of numbers called periodontal probings.  The hygienist will stick this small probe beside your tooth and slightly under the gum in order to obtain the pocket or sulcus depth.   The pocket depth is an indication as to whether the gum tissue is healthy.  A healthy pocket ranges from 1-3mm.  An unhealthy pocket is 3 mm and above.

The next step is to use a Cavitron (electric scaler) or hand instruments to clean the teeth.  The hygienist places the tip of the scaler on the tooth and manually scrapes off the calculus, bacteria, and other debris.  The scaler also reaches under the gum tissue to remove deep down debris and bacteria.  Sometimes anesthesia is used so that you won’t feel the scaler reaching under your gum tissues.

The procedure itself does not hurt.  It you feel some discomfort, ask your hygienist to administer some anesthetic.  This should take away all pain.  The only thing you will feel are some vibrations on your teeth.

Instructions for what to do after a full mouth debridement

After a full mouth debridement, your teeth may be somewhat sensitive.  Here are some possible steps than can be taken to avoid sensitivity:

• Ask your dentist to polish your teeth with a densitizing agent (BEST OPTION)
• Avoid cold drinks or food for a few hours after the procedure.
• Use a toothpaste or mouthwash for sensitive teeth (although this measure sometimes take up to 1-2 weeks to have an effect)

All in all, the health of your gum tissue should be restored and healthy before getting any other work done.

And most importantly, remember to brush and floss daily to maintain your dental work and nicely cleaned tooth surfaces.

Sincerely,

SaveMySmile 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
or dentin.

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
mistake?

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
since.

Answer:

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