A routine cleaning is called for when a patient has healthy gums or gingivitis. (Gingivitis is reversible changes in the gums and jaw bone. Periodontitis is when there are irreversible changes.) The focus in a routine cleaning is to remove plaque and tartar accumulations on and in between the teeth, at or above the gum line. It is recommended to get a cleaning every six months, and the process takes one visit in most circumstances.
A deep cleaning is needed where there is active gum disease present. In a deep cleaning, the focus on doing everything that is done in a routine cleaning, plus removing the tartar below the gum line. It is this tartar that is causing the inflammation in the gums, which in turn causes the loss of bone that holds the teeth in, as shown in the picture below.
Sometimes, the surfaces of the tooth below the gum become rough, and this attracts more plaque and tartar to the area, so in these cases the teeth are also smoothed to help minimize future build up. To ensure maximum patient comfort during the procedure, and to allow the dentist or hygienist to do a thorough job, the mouth is usually numbed during the procedure. Because of this, a deep cleaning of the whole mouth is usually spread out over two visits, so that the right side can be numbed on one visit and the left side on the second visit. It can be a very odd feeling to have your whole mouth numbed at once!
If your body responds well to the deep cleaning and you maintain good brushing and flossing habits, it does not need to be repeated. You will need to get more frequent cleanings in order to maintain the results, usually every 3 or 4 months. At these visits, your gums will be reevaluated to make sure that the gum disease is under control. As your gum disease shows evidence of stabilizing, you can gradually move back to getting a cleaning every 6 months.
If your body does not respond well, you and your dentist may consider a second round of deep cleaning. Or if you had a deep cleaning years ago but relapsed with your flossing habits and/or your recommended cleaning schedule, the gum disease can return. In this case, a second deep cleaning may be necessary.