Often times, new patients call our office so the can schedule a cleaning. The appointment is made and when the doctor completes an examination, we find that the conditions we see require something different. Treatment plans are presented and confusion sets in. Why? Because there are several types of procedures that hygienists provide and the word “cleaning” is being used for a number of situations. We all have unique situations, varied habits, diets, medical and dental histories, so wouldn’t it make sense that we all have different needs from our dental hygienists?
Here’s the five basic types of cleanings and why you might need each.
1110 The Prophy 
This type of cleaning is for those that have no bone loss and generally no infection. It means that when we measured your bone level with that tiny little probe, we didn’t find pocketing, and that your gums are in good shape overall. Tartar levels may vary but the hygienist will remove all of the deposits and try to find the best time frame for you to come back for another cleaning.
4346 Scaling with Gingivitis
If you have an active infection and tissue that bleeds when we measure the bone level, you are going to need a little more attention to
detail. The doctor and/or hygienist will need to carefully document all bleeding sites as well as removing all of the tartar and bacteria that are wreaking havoc on your mouth. If you fall into this category, it’s important to understand that uncontrolled gingivitis usually leads to permanent bone loss. Work with your caregivers to find out what you can do to manage your bacteria and tartar levels and ask how often you should have your teeth cleaned. If all goes well, you will soon be able
to eliminate the infection and go back to a normal cleaning.
*This is a new procedure code for 2017. Click here to Watch the video for details
4341/4342 Root Planing “Deep Cleanings”
When you have true bone loss, heavy tartar and an infection, the hygienist will need to carefully scale all surfaces of your teeth to eradicate the active infection and remove the tartar that is built up below your gums. The number of appointments you will need depends on how many areas of your mouth qualify for this procedure. A full periodontal screening needs to show that there are pockets of at least 5mm and x-rays mu
st also demonstrate the damage. Although this is one of the most invasive procedures we hygienists perform, be assured that we will use local anesthetic as needed to keep you comfortable. (Many of my patients only need topical gels!) If all goes well, you will then be put on a 3-4 month schedule with your hygienist for perio maintenance.
4355 Gross Debridement
So this procedure should only be performed when there is so much tartar on the teeth the doctor can’t get an accurate periodontal screening and examination done correctly. In order to find decay and measure how much bone is holding your teeth in, we need to first remove the build up and clear the path if you will. Usually these patients haven’t been to the dentist in a very long time and will be treatment planned for multiple visits with they hygienist. No one would expect to have a “cleaning” done right after this!
4910 Perio Maintenance
This procedure is only performed after a patient has undergone treatment for periodontal disease. It means that “gum disease” has progressed into permanent loss of bone in the jaw. The purpose of the perio maintenance cleaning is to remove tartar and bacteria on a 3-4 month schedule to prevent further damage. The benefit of being under this umbrella is that your hygienist can do some isolated root planing as needed during your visit. Each time you come in, he/she will carefully measure your bone levels to make sure your condition is maintained. Just like any medical condition such as high blood pressure or diabetes, it’s important to understand that you cannot rid yourself of the disease completely, but you can manage your symptoms effectively for a very long time.
(photo credits: ADA.org)