Is Scaling & Polishing supposed to be a painless procedure?

This is the most confusing and debatable question I’ve seen in my 14 years of experience as a dentist or even before I became a dentist. Patients judge their dentists by evaluating the scaling and polishing treatment experience (because this is the most common and regular service that everyone needs). So, to the patients -> Painful experience = No Good; Painless = Excellent.

Well, is that really true? Is the dentist who rendered painless service to you definitely the best dentist? And the dentist who caused you some pain surely a bad guy? Are you sure?

I have been practising as a qualified dentist for 14 years. Until today, I will still have two extreme types of patients at my clinic. Some praised me sky high for being the most gentle dentist that they’ve ever seen, some complained to my nurses or even dropped bad review to comment that my service was rough and caused pain. At the end of the day, the pair of hands working on the patients are the same. Being a professional dentist as much as I wanted to be, consistency and improvement at work are my goals and pride. So what could have gone wrong for a dentist to receive two extreme feedback from his patients?

Let’s have a look with a simple briefing on the scaling & polishing procedure before walking you through the expectations of experience.

What is Scaling & Polishing?

It is a common and regular dental procedure served to keep one’s teeth clean and healthy. It is also known as “teeth cleaning” among some patients.

So, why do you need a ‘scale and polish?’

It is a recommended dental procedure for all individuals with permanent teeth every 6-12 months along with twice daily tooth brushing, flossing, mouthwashes and healthy eating to reduce the risk of gum disease and tooth decay.

Your teeth come under constant attack from the starches and sugars present in our food which are released as we eat. When this combines with plaque – the sticky bacterial film that forms on the teeth over time, it produces an acid which is harmful to our teeth.

This plaque forms on the surface of and between our teeth and can also affect the gum line. If is not removed then it will harden and form calculus or ‘tartar’ – a yellow or brown mineral deposit which causes the teeth to have a rough or ‘crusty’ appearance. This makes them vulnerable to further plaque attacks.

Plaque can corrode the teeth over time which causes cavities and tooth decay as well as bad breath. If it leads to tartar formation, especially around the gums then gingivitis can occur. The danger with this is that it can lead to the more serious periodontal gum disease.

A scale and polish can remove plaque and leave your teeth feeling nice and smooth. This will also prevent bacteria sticking to them (which they are able to on teeth with a rough surface) which can lead to the build up of tartar. And, it will help to prevent gum disease.

If any of these happen to your teeth then it could lead to you losing a tooth or even several teeth.

(Click into the link if you’d like to learn more about plaque, tartar and their impact to your gum health  —–> http://www.colgateprofessional.co.za/patienteducation/Plaque-and-Periodontal-Disease/article)

What does a scale and polish involve?

1. The dentist will start off with the ‘scale’ part using an ultrasound device which emits vibrations to loosen large areas of tartar. It will spray a cooling mist at the same time to wash away the debris.
2. Following this, the dentist will use a series of hand tools called scalers and curettes to scrape away the remaining small stubborn deposits left on the teeth. This step is important to smoothen out the surface of the teeth. (Remember what we mentioned on the top? The rough or crusty appearance of the teeth caused by tartar can invite plaque attacks which eventually results in cavities, tooth decay, bad breath or even more serious gum disease). The gum area previously covered by tartar will appear to be raw and involves some bleeding after the removal of tartar. The area of the affected gum determines the level of pain that one can get. In another words, if you have more tartar build up, you are more likely to have higher exposed gum area after the scaling (if your dentist did a good job) then you are more likely to feel some sensitivity and pain.  In addition to that, as I mentioned earlier, the more tartar build up you have, the higher the chance of gum disease. This simply means that your gum is now weaker than the others and it causes bleeding and soreness easily.
3. Lastly, the dentist will polish the beautifully smooth teeth using a soft spinning rubber cup with special paste. This step is to provide your teeth a shining appearance.

How often do we need to do Scaling and Polishing?

The usual recommended time period is every 6-12 months to avoid heavily build up of plaque and tartar. This is a preventive measure to reassure good oral health.  And of course, if you visit your dentist to carry out scaling and polishing procedure regular enough, the chances of you having bad after-procedure pain, bleeding and sensitivity is greatly reduced.

As the saying goes, “ Prevention is better than cure”. In dentistry, whatever preventive measure procedures are always cheaper than the treatments. Scaling and polishing in fact is the cheapest dental service that most clinics have.

If the tartar build up is bad, scaling and polishing itself is insufficient to carry out the cleaning work. There it comes the additional charges for Air polishing, deep scaling and even treatment cost for cavity, gum disease, bad breath etc due to the poor oral hygiene.

Does Scale and Polish hurt?

So, coming back to our main question à Is Scaling & Polishing supposed to be a painful or painless procedure?!

The answer is = IT DEPENDS!

A scale & polish tends to be painless with many patients reporting ‘tickling’ or ‘scraping’ sensations. It is likely to be painful if you have

1. sore gums due to large build up of tartar
2. badly worn teeth
3. or a dentist who is less than gentle.

However, there is a topical numbing gel available to be used if you have low pain threshold. It is a form of local anaesthetic and will freeze the area to be treated. Let your dentist know so both of you can enjoy the dental appointment.

In short, the key message that I would like to pass on is “Do not be afraid to see your dentist.”  The more regular you see your dentist, the more comfortable and pleasant your dental experience will become. Do not let the lack of dental awareness become a hurdle towards good oral health and  cause misjudgement over your poor dentist. =D

Happy, grinning, tooth

Sshhhh…. So whenever my own patients complain about other  dentist being rough and unpleasant during their scaling and polishing session , I would just keep quiet and have that awkward smile on my face ^^’’

At the end of the day, I cannot judge your dentists for you but I may provide you some dental education to keep your judgement fair. Stay tuned to my next blog!