Why some people need their teeth cleaned four times a year

Why does your dentist, hygienist or periodontist recommend that you get your teeth cleaned three or four times a year?

The well-known advice: ‘’brush and floss your teeth and see your dentist twice a year‘’ actually started with a toothpaste commercial about sixty years ago. A direct result of that advice was that when employers started offering dental insurance as a benefit, the insurance companies allowed two cleanings a year. This was before the causes of periodontal (gum) disease were well known.

There have been hundreds of university studies done since then that have identified the bacteria involved in various types of periodontal disease. Sophisticated treatments have been developed, and individual risk factors have been identified. For example, smoking and diabetes greatly increase and individual’s risk of having progressive gum disease. Home care and genetics are also major factors. Conversely, having periodontal disease has been linked to heart problems, as the inflamation of the gums may cause an increase in arterial blockage.

Patients still have twice a year “prophylaxis” cleanings when they have no periodontal problems. The word “prophylaxis” by definition is a cleaning to prevent gum disease. For people who have existing periodontal pockets and bone loss, it is too late for preventive care. Deep cleanings and a three month schedule for maintenance cleanings are based on scientific evidence that these treatments are necessary to control periodontal disease. Surgical treatments may also be necessary.
Do insurance companies always pay for the treatment? Of course not.

Insurance companies pay according to the contract that an employer signs with them. Some will pay for periodontal maintenance cleanings only after scaling and root planing (deep cleaning) has been done. Other insurances may pay for prophylaxis twice a year, alternating with periodontal maintenance twice a year. You can call your insurance company for clarification, or ask your dental office to check for you. Optimal care is not always covered, but is still recommended for you to keep your teeth as long as possible.