What is dental scaling

So how do dentists remove tartar? Well, there are two parts to this common tartar removal and teeth cleaning procedure, which may be carried out by a dentist or hygienist.

1. Teeth scaling: The first task is to clean by scraping plaque off of teeth. Various tartar removal tools are used for teeth scaling, which we describe in more detail below.

2. Teeth polishing: Once teeth are clean, they are polished to make the surface really smooth. Not only does this improve the cosmetic appearance of the teeth; it also removes rough patches which are more susceptible to plaque buildup.

Depending on the state of your oral health, your dentist or hygienist will either conduct a regular tooth cleaning, potentially with a scale and polish as and when is needed, or they may recommend a deep cleaning (more on that later.)

Now let's look in detail at what a dentist or hygienist does when scaling teeth during dental cleaning.

Ask a dentist: What is root planing and scaling?

After the tooth surface has been completely cleaned above and below the gum line, the root of the tooth undergoes a process called planing. This is a process of smoothing the root of the tooth so that any remaining tartar is removed. This clears away any rough areas that bacteria below the gum line thrive in. And, it makes it much easier for the gum tissue to re-attach itself to the tooth, reducing the size of the pockets that the plaque and bacteria hide in.

Scaling occurs above or below the gum line and involves the scraping and removal of plaque and calculus (tartar) from the tooth. Scaling done at regular teeth cleanings usually involves the crown of the tooth. However, in more extreme circumstances, it is necessary to go further below the gum line to thoroughly remove disease-causing bacteria and its by-products on the root surface. The goal of root planing and scaling is to prevent or treat gum disease and to keep your mouth as healthy as it can be.

Dental cleaning procedure

The final stage of teeth cleaning is to smooth teeth by polishing them

When scaling teeth, dentists normally use an electric scaling instrument, sometimes called an ultrasonic scaler. This vibrates at high speeds to loosen tartar on the teeth. It also sprays water to wash the debris away, so you might be asked to spit from time to time.

Once the electronic scaler has removed larger pieces of tartar on teeth, the dentist will use hand scaling tools in a variety of shapes and sizes. They scrape away any remaining tartar, with the different shaped tools making it possible to reach between the teeth and into gum pockets.

Any newly exposed areas of tooth enamel can be quite rough, but the final polish takes care of this. The dental polishing tool looks a bit like a rotating electric toothbrush head, and the dentist might use a special toothpaste to finish the dental cleaning.

Heavy tartar removal

If you haven't taken the best care of your teeth and have avoided the dentist for years, you may have quite heavy tartar buildup. In extreme cases, tartar on teeth can spread to the point where it completely covers the teeth. Even if heavy tartar removal is required, it's possible to save the teeth underneath once the tartar removal is complete.

The process is much the same as described above, but will take longer the more calculus on teeth has built up.

What is a deep cleaning?

Many people get confused with the various types of teeth cleaning out there. We just finished talking about scaling and polishing, which is a pretty routine procedure that many dentists encourage their patients get once or twice a year in order to prevent periodontal disease. 

A deep cleaning of the teeth, however, is a bit more involved and is meant for those patients who already have periodontal disease. If you already have periodontal disease and deep gum pockets, your dentist may recommend not only scaling teeth but a deep cleaning that includes root planing as well.

How long does a dental cleaning take?

A scale and polish for someone who has generally good oral hygiene might take around 15-30 minutes, with the entire hygienist appointment lasting 30-45 minutes.

When more extensive tartar removal is required, it can take a lot longer—even hours—and may be spread over more than one appointment. Patients who are nervous about the procedure can request for it to be done under IV sedation. With this, the patient is awake throughout but very relaxed, and won't remember much of the teeth cleaning experience. However, IV sedation usually has to be paid for privately.

Does dental cleaning hurt?

Scaling teeth during a routine cleaning can be uncomfortable, but it shouldn't be painful if you have done a good job of removing plaque by cleaning your teeth daily.

If, however, calculus on teeth has built up around your gums and below the gumline, the calculus removal will probably hurt a bit. This is partly because of the effort required to scrape tartar away, and partly because the gums underneath will be sore anyway. Your dentist might apply an anesthetic gel to your gums to help with the pain, or may even use a local anesthetic if the procedure is going to be quite invasive.

After a scale and polish, you might experience some tooth sensitivity while your teeth adjust to being fully exposed again, but they shouldn't be painful for more than a couple of days.

Does a scale and polish whiten your teeth?

Dental scaling and polishing removes surface stains from teeth, so it can make them appear brighter and whiter even though there is no teeth whitening involved. You should also notice that they feel much cleaner.

Tooth scaling before and after

The gums are sore after calculus removal by a hygienist

This image shows teeth before and after a scale and polish with a hygienist. As you can see, a lot of tartar buildup has been removed and the teeth have a brighter appearance after a dental scaling and polishing.

However, the gums which were covered with calculus have become red and inflamed, so this patient will experience some soreness while the gums recover.

What else to expect at a dental cleaning visit

A hygienist appointment isn't just about removing tartar from your teeth. Dental hygienists will also check your general oral hygiene and show you the best way to clean your teeth, as well as addressing any concerns you have.

They may finish by applying a fluoride varnish to protect your teeth, as the video below explains.

Your dentist may also recommend a dental sealant, which can help keep molars with deep fissures free from cavities. You can read more about sealants for children in our full guide.

How much does a dental cleaning cost?

Now that you're ready for a professionally clean mouth, you're probably wondering just how much is teeth cleaning at the dentist anyway? Teeth cleaning costs vary depending on whether you have insurance or not, who your dentist is, and where they are located. Additionally, teeth cleaning costs more if extensive dental scaling is needed. 

Cost of dental cleaning with insurance

How much does it cost to get teeth cleaned on insurance? If you purchase a dental insurance plan, it's likely that your plan will cover 100% of dental cleaning costs for preventative visits once a year. If you have Medicaid, dental coverage is decided by state, so it's possible that in your state Medicaid will not cover your dental expenses. 

Dental cleaning cost without insurance

Teeth cleaning costs will vary depending on if you have insurance. 

So how much does a teeth cleaning cost without insurance? The cost of dental cleaning that includes a basic scale and polish with a private dental hygienist costs between $75 and $200, but expect hygienist prices to be higher for more advanced or complex treatments. Some hygienists offer stain removal treatments, for example. Dental deep cleaning might be charged per quadrant, meaning you only pay for it in the areas where it's needed.

Some dental insurance policies and private dental plans include preventative care like teeth cleaning as standard. This can be a helpful way to spread the cost of basic dental care if you know you'll need regular hygiene appointments.

Additionally, there are quite a few charitable organizations and dental schools that offer reduced cost or free teeth cleanings.

How often should you get your teeth cleaned?

First of all, check with your dentist how often you should receive a scale and polish. You don't necessarily need to visit a hygienist as often as you get regular checkups, unless you have particular oral health problems that need special attention.

 

Research from Cochrane studied adults with healthy gums who got a scale and polish every six months, every 12 months, and not at all over a period of three years. The conclusion was that there was almost no difference in bleeding gums (one of the signs of gum disease) between the three groups, suggesting that there is little benefit to routine scaling and polishing. However, this study didn't include adults who already had bleeding gums or some other sign of gum disease, so this doesn't negate the need to get checked regularly.