Introduction
A so-called professional tooth cleaning (short: PZR) is one of the standard measures in the treatment process of various diseases of the periodontium. In addition, professional tooth cleaning can also be used for the prevention (prophylaxis) of gum inflammation or periodontitis. Professional teeth cleaning is primarily used to remove soft (plaque) and hard (tartar) deposits on the tooth surface.
Plaque is a biofilm, which consists of both food residues and waste products of bacterial metabolism. If these deposits remain on the tooth surface over a longer period of time without being thoroughly removed, they can spread to areas below the gum line. As a result, deep gum pockets form there, which are ideal breeding grounds for bacteria and other pathogens that are present in the oral cavity.
The organism reacts to stimuli emanating from these pathogens by releasing various inflammatory mediators and increasing tissue perfusion. It should also be noted that plaque hardens to solid tartar after some time. The consequence of these processes is in most cases the development of inflammatory processes in the gum area (gingivitis), which sooner or later can spread to the jawbone and other structures of the periodontium if appropriate treatment is not carried out.
In the worst case, this can result in the loss of bone substance and the loss of teeth that are actually perfectly healthy. The complete procedure of a professional tooth cleaning is usually not covered by the statutory health insurance companies, so the patient has to pay at least a part of the costs himself. The costs for a professional dental cleaning amount to approximately 35 to 150 Euros, depending on the type of work and the effort involved.
Procedure
A professional tooth cleaning can be carried out either by the dentist himself or by trained specialists (prophylaxis assistant; dental assistant; ZMF; dental hygienist; DH). Before the actual tooth cleaning, the treatment process begins with the staining of the teeth. For this purpose, special solutions or tablets are used to make visible dental plaque that was not properly removed during brushing.
In addition, most stains are able to distinguish between fresh (younger than 48 hours) and older (older than 48 hours) plaque. Most of the products used in dental offices have a bluish dye to show older plaque and a red dye to make new plaque visible. This measure makes sense because the stained areas can be used to train a brushing technique that is individually adapted to each patient.
Especially patients suffering from pronounced malocclusion or very narrow interdental spaces usually have areas that are difficult to access. These areas can hardly or not at all be reached by the bristles of a toothbrush. For this reason, dentists recommend using an interdental brush or floss at least once a day.
After learning adequate oral hygiene, the second part of the treatment process is followed by professional tooth cleaning. In this step the actual tooth cleaning begins. The treating dentist or the responsible dental assistant cleans all tooth surfaces with the help of a flexible, rotating cleaning attachment.
Even during this partial unit, coarse deposits can be effectively removed from the tooth surface. So-called scalers, ground, sterilizable hand instruments are then used. With the help of these scalers, food residues and plaque, which are located in the interdental spaces or near the gumline, can be completely removed.
In addition, hardened plaque, so-called tartar, can be removed relatively easily above the gum line with the scalers and below the gum line with the help of curettes. During this step in the treatment process of professional tooth cleaning, several of these sterilizable hand instruments are used. The individual curettes and scalers differ in the individual grinding of their ends, which allows a specific tooth surface to be optimally cleaned.
Alternatively, professional tooth cleaning can also be carried out using an ultrasonic or air-scaler device.The next part of the treatment process of professional teeth cleaning is the removal of stains with the help of rotating devices or a powder jet. Patients who already have a disease of the periodontium must repeat this treatment procedure at regular intervals. Most dental practices integrate the affected patients into so-called recall systems, in which a professional tooth cleaning is performed every 3 to 6 months. Depending on the jaw situation and the patient’s own efforts with regard to the thoroughness of daily oral hygiene, the intervals between cleaning appointments may be shorter or longer.