Dental prophylaxis most commonly refers to cleaning, but may include other prophylactic (preventive) procedures such as examination or screening. It refers to dental care to protect your teeth and prevent gum disease.
It includes a complete examination of your mouth and teeth and a thorough cleaning using an ultrasonic cleaner, pick or other tools to remove tartar, plaque and calculus. 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 images were taken.
This article discusses dental prophylaxis and preventive oral care. It provides a detailed explanation of the different types of dental prophylaxis and what to expect the next time you see your dentist for a check-up.
Prophylactic Dental Services
Dental services considered prophylactic (or preventative) include:
- Dental exams
- x-rays
- Cleaning
- Scale or root planing
- Thread and polish
- Treatments with fluoride or sealants
Each service provides a different function for your teeth.
- Dental examinations: Check the mouth for cavities, gum disease, oral cancer and more
- Radiographs: Check for any signs of tooth decay
- Cleanings: Performed by a dental hygienist or dentist to remove plaque and calculus (also called calculus)
- Scale or root planing: A form of cleaning or scraping to remove tartar and other deposits from the teeth
- thread: Removes food and plaque from between teeth
- Polishing: Cleans teeth with a pumice-like paste that removes stains and plaque build-up
- Fluorine treatments or sealants: A dental treatment (usually for children) to prevent tooth decay
Dental prophylaxis for children
Children have unique needs when it comes to dental care. They are extremely vulnerable to tooth decay and other dental problems. A review published in the magazine Pediatrics says, “Poor oral health is one of the most common childhood health conditions in the United States.”
The American Academy of Pediatric Dentistry recommends that children have their first dental exam and preventive treatment at 12 months of age.
Pediatric dentists specialize in helping children who experience fear and anxiety associated with visits to the dentist. The primary goal of early intervention prevention for young children is to get them used to visiting the dentist early.
That way, the dentist can administer preventative procedures when needed—such as sealants and fluoride treatments—to prevent tooth decay down the road.
Effectiveness of Preventive Services
There are many recommendations regarding dental prophylactic measures, including how often each procedure should be performed. How effective are these recommendations? Do they really help prevent tooth decay and gum disease? What does the scientific research say?
Do regular visits to the dentist prevent problems?
A review of 36,000 children from the Children’s Health Insurance Program (CHIP) found that preventive visits were associated with fewer appointments for fillings and other restorative care in the future.
Contrary to the recommendations of many dentists, however, the study authors reported that it was not actually cost-effective for children to see the dentist twice a year.
However, it may be that children who see the dentist regularly do not have dental problems later, or children who get sealants may be protected from other dental problems that would require more visits to the dentist.
Are dental x-rays necessary?
Dental x-rays are a standard procedure at most annual preventive dental appointments. According to the American Dental Association (ADA), not everyone needs annual x-rays, especially those with no obvious dental problems.
The ADA states that adults who brush properly and take good care of their teeth (and do not have cavities or gum disease/mouth disease) only need x-rays every two to three years.
Although the ADA clearly states that annual bitewing x-rays are not necessary for everyone, most dentists still perform them annually.
Do you need an annual dental prophylaxis (cleaning)?
The American Dental Association (ADA) recommends scheduling dental visits at intervals determined by your dentist.
Annual cleaning may not always be necessary. A Cochrane Collaboration review of studies that measured the impact of regular dental cleaning intervals of six or twelve months found a small reduction in calculus and plaque with regular cleanings compared with non-routine scaling and polishing, although the benefit is uncertain.
A possible damage from tooth scaling is called periprosthetic joint infection resulting from bacteremia (bacteria in the blood). This happens as a result of gum recession, causing bacteria to travel from the mouth into the bloodstream.
Treating dental patients with antibiotics prior to dental cleaning and/or restorative procedures is a preventive measure that can be used for individuals at risk of complications from bacteremia.
Many studies have shown the presence of bacteremia immediately after gum recession from dental procedures, but this does not indicate that regular dental cleanings should not be performed.
What do sealants and fluoride treatments do?
Sealants. Sealants are a thin coating applied to a child’s molars to help protect against tooth decay (also called tooth decay).
A guidelines committee convened by the American Dental Association and the American Academy of Pediatric Dentistry found no data on the benefits of sealants for adults, although the group “suggests that similar treatment outcomes may be expected for other age groups, particularly in adults with a recent history of dental caries’.
Dental sealants can be applied by a dental hygienist—without an accompanying dental exam—making it more economical.
Fluoride treatments. Also known as fluoride varnish, many research studies have shown that fluoride varnish helps prevent tooth decay. In fact, the US Preventive Services Task Force (USPSTF) recommends:
- Fluoride supplements—also known as dietary fluoride supplements—in geographic areas of the country where the water is not fluoridated
- Application of fluoride varnish to primary teeth (baby teeth) for moderate caries prevention.
Is the thread important?
Flossing is usually done by the dental hygienist after scaling and before polishing.
According to a Cochrane Collaboration review, flossing was found to reduce the incidence of gingivitis (inflammation of the gums) when combined with brushing. It was unclear whether the thread reduces plaque. None of the studies reviewed evaluated the effect of dental floss on tooth decay.
How much does dental cleaning cost?
A 2017 survey of dentists showed an average cleaning cost between about $88 and $135. Costs may vary depending on where you live, and charges may be higher if you have excessive slab and stone buildup.
If your dental visit includes a dental consultation that includes x-rays, a full mouth exam, impressions or other procedures, there will be additional charges.
Dental insurance can lower your costs if it is provided by an employer and your monthly premiums are either free or cheap. Insurance usually covers the cost of twice-yearly dental cleanings and most or all of the cost of x-rays.
For other procedures, such as fillings or crowns, there is usually a shared cost between you and the insurance provider. It’s always best to talk to your insurance provider to understand your out-of-pocket expenses.
How to prevent dental problems
One aspect of preventive dentistry is teaching patients how to perform preventive measures at home, such as proper techniques for regular flossing and brushing.
Tooth brushing
The most effective preventative action dentists teach their patients is that regular brushing is beneficial to oral health, offering the potential to reduce the incidence of cavities. According to a Cochrane review, it is important to use fluoride toothpaste.
Rotating power toothbrushes have been found to do a better job of removing plaque and reducing gingivitis than traditional toothbrushes.
As for how often a person should brush their teeth for optimal results, not many studies have been conducted that provide reliable information. The studies that have been done, however, generally support brushing twice a day.
A word from Verywell
It is important to recognize that research on dental prophylaxis is at odds with some of the current standards of dental care. Several studies and reviews support the idea of brushing twice a day with fluoride toothpaste for good oral health. For children, the evidence strongly supports the use of fluoride varnish or sealants. However, whether other recommended preventive dental procedures are 100 percent necessary for oral health requires further research.
