10/28/2024
What Is Dental Prophylaxis?
Dental prophylaxis most commonly refers to cleaning, but it may include other prophylactic (preventative) procedures such as an exam or checkup. It refers to dental care to protect your teeth and prevent gum disease.
It includes a full examination of your mouth and teeth and a thorough cleaning using an ultrasonic scaler, pick, or other tools to remove tartar, plaque, and calcifications. The teeth are then polished, and a fluoride treatment or dental sealant is applied.
In addition to the above, X-rays may be taken if a cavity is suspected or it has been a while since you had images taken.
This article discusses dental prophylaxis and preventive oral care. It provides a detailed explanation of different types of dental prophylaxis and what to expect the next time you see your dentist for a check-up.
Dental Prophylaxis Services
Dental exams
X-rays
Cleaning
Scaling or root planing
Flossing and polishing
Fluoride treatments or sealants
Each service provides a different function for your teeth.
Dental exams: Check the mouth for cavities, gum disease, oral cancer, and more
X-rays: Check for any signs of tooth decay
Cleanings: Performed by a dental hygienist or dentist to remove plaque and calculus (also called tartar)
Scaling or root planing: A form of cleaning or scraping to remove tartar and other deposits from teeth
Flossing: Removes food and dental plaque between teeth
Polishing: Cleans teeth with a pumice-type paste that removes stains and dental plaque build-up
Fluoride treatments or sealants: A dental treatment (usually for kids) to prevent tooth decay
Pitfalls From Skipping Your Yearly Dental Cleanings
Dental Prophylaxis for Kids
Children have unique needs when it comes to dental care. They are extremely vulnerable to decay and other dental problems. One review published in the journal Pediatrics says, “Poor oral health is one of the most common health conditions of childhood in the United States.”1
The American Academy of Pediatric Dentistry recommends that kids have their first dental examination and prophylactic treatment at 12 months of age.2
Pediatric dentists specialize in helping children who experience fear and anxiety related to dental visits. The primary goal of early intervention of prophylaxis for young children is to get them accustomed to seeing the dentist early on.
This way, the dentist can administer preventative procedures when needed—such as sealants and fluoride treatments—to prevent tooth decay down the road.
Effectiveness of Prophylaxis Services
There are many recommendations about dental prophylactic measures, including how often each procedure should be done. How effective are these recommendations? Do they really help prevent tooth decay and gum disease? What does the scientific research say?
Do Regular Dentist Visits Prevent Problems?
A review of 36,000 kids from the Children’s Health Insurance Program (CHIP), found preventative visits were linked with fewer dental appointments for fillings and other restorative care in the future.1
Contrary to many dentists’ recommendations, however, the study authors reported that it was not actually cost-effective for children to see the dentist twice each year.
However, it could be that kids who visit the dentist regularly don’t have dental issues later on or that children who get sealants may be protected against other dental issues that would require more dentist visits.
Are Dental X-Rays Necessary?
Dental X-rays are a standard procedure at most annual dental prophylactic appointments. According to the American Dental Association (ADA), not everyone needs to get yearly X-rays, especially those who have no apparent dental problems.
The ADA reports that adults who brush properly and take good care of their teeth (and have no cavities or gum/oral conditions) only need X-rays every two to three years.3
Although the ADA clearly states that annual bitewing X-rays are not necessary for everyone, most dentists still perform them yearly.
Do You Need a Yearly Dental Prophylaxis (Cleaning)?
The American Dental Association (ADA) recommends scheduling dental visits at intervals determined by your dentist.
Yearly cleanings may not always be necessary. A Cochrane Collaboration review of studies that measured the impact of routine dental cleaning intervals of six or twelve months found a small reduction of tartar and plaque with routine cleanings compared to no routine scaling and polishing, though the benefit is uncertain.4
One potential harm from dental scaling is called periprosthetic joint infection resulting from bacteremia (bacteria in the blood). This occurs as a result of the agitation of the gums, causing bacteria to travel from the mouth into the bloodstream.5
Treating dental patients with antibiotics before dental cleaning and/or restorative procedures is a preventative measure that can be used for people at risk of complications from bacteremia.6
Many studies have shown the presence of bacteremia immediately following gum agitation from dental procedures but this doesn’t indicate that regular dental cleaning shouldn't be done.
What Do Sealants and Fluoride Treatments Do?
Sealants. Sealants are a thin coating applied to a child’s molars to help protect against cavities (also called dental caries).
A guideline panel convened by the American Dental Association and the American Academy of Pediatric Dentistry didn’t find any data on the benefits of sealants for adults, though the panel “suggests that similar treatment effects may be expected for other age groups, particularly in adults with a recent history of dental caries.”7
Dental sealants can be applied by a dental hygienist—without an accompanying examination by a dentist—making it more cost-effective.
Fluoride treatments. Also known as fluoride varnishing, many research studies have shown fluoride varnish helps prevent tooth decay. In fact, the U.S. Preventive Services Task Force (USPSTF) recommends:
Fluoride supplementation—also known as dietary fluoride supplementation—in geographic areas of the country where the water is not fluoridated
Application of fluoride varnish to primary teeth (baby teeth) for moderate tooth decay prevention.8
Is Flossing Important?
Dental flossing is usually done by the dental hygienist after scaling and before polishing.
According to a review by the Cochrane Collaboration, flossing was found to lower the incidence of gingivitis (inflammation of the gums) when combined with brushing. It was unclear if flossing reduces plaque. None of the studies reviewed assessed the effect of flossing on tooth decay.9
How Much Does Dental Cleaning Cost?
A 2017 survey of dentists showed an average cleaning costs between about $88 and $135.10 The cost may vary depending on where you live and the charges may be more if you have excessive plaque and tartar build-up.
If your dental visit involves a consultation from the dentist that includes X-rays, a full-mouth exam, impressions, or other procedures there will be additional fees.
Dental insurance may lower your costs if it's provided by an employer and your monthly premiums are either free or inexpensive. Insurance typically covers the cost of dental cleanings twice per year and most or all of the cost of X-rays.
For other procedures, like fillings or crowns, there is usually a shared cost between you and the insurance provider. It is always best to talk with your insurance provider to understand your out-of-pocket expenses.
How to Prevent Dental Problems
One aspect of dental prophylaxis is to teach patients how to perform preventative measures at home, such as correct techniques for regular flossing and brushing.
Dental Brushing
The most impactful preventative action that dentists teach their patients is that regular brushing is advantageous to oral health, lending itself to lowering the incidence of dental cavities. According to one Cochrane review, it's important that fluoride toothpaste is used.11
Rotating power toothbrushes were found to do a better job at removing plaque and reducing gingivitis than traditional toothbrushes.
When it comes to how often a person should brush the teeth for optimal results, there haven't been a lot of studies conducted that provide reliable information. The studies that have been done, however, generally support brushing twice per day.
