Does scaling damage the teeth? How often should it be done?

What is calculus, and why does it form?

A soft layer called bacterial plaque forms on the teeth every day. Plaque not removed by brush and floss begins to harden with the minerals in saliva within 24–72 hours and turns into calculus (tartar). Its rough surface makes it easier for new plaque to attach; it irritates the gum, causing bleeding, recession and, in time, loss of the bone holding the tooth (periodontitis). It cannot be removed with a brush — only in the clinic.

Does scaling damage the tooth?

The ultrasonic scaler breaks the calculus by vibration and washes it away with water; hand instruments smooth the remaining roughness. These instruments are designed to remove hard calculus without harming enamel. The beliefs that it "thins the teeth", "loosens the teeth" or "opens gaps" are not true:

• The feeling of gaps: The calculus had filled the spaces between the teeth and pushed the gum away. Once it is gone the space becomes visible; the gum recovers within a few weeks.
• The feeling of looseness: In teeth that the calculus had "splinted" together but which had already lost bone support, mobility is noticed after cleaning; the cause is not the cleaning but pre-existing gum disease.
• Sensitivity: Exposed root surfaces are sensitive to cold; it eases in 1–2 weeks and desensitising toothpaste helps.
• Bleeding: Inflamed gums bleed during cleaning; this shows the cleaning was needed. It stops within a few days.

How is it done?

1. Examination and X-rays if needed; measurement of gum pockets.
2. Removal of calculus above and at the gum line with the ultrasonic tip.
3. Fine cleaning with hand instruments; in deep pockets, root planing under local anaesthesia, usually at a separate visit.
4. Polishing: the surface is smoothed so new plaque attaches less easily.
5. Advice on brushing and interdental cleaning.

A simple cleaning takes 20–40 minutes; no anaesthetic is needed. In sensitive patients a topical or local anaesthetic can be used.

How often?

• Healthy gums: A check every 6 months and cleaning if needed.
• History of gum disease, smoking, diabetes, rapid tartar formation: Every 3–4 months.
• Orthodontic patients, pregnant women: At intervals set by the dentist, usually more often.

Reducing tartar at home

• Brush twice a day for 2 minutes at 45° to the gum margin
• Floss or use an interdental brush every day — calculus collects most between the teeth and behind the lower front teeth
• Tartar-control toothpastes slow formation but do not dissolve what is there
• Cut down on smoking and sugary or acidic drinks

Is scaling done in pregnancy?

Yes, it is safe and recommended; pregnancy hormones increase gum inflammation. It is preferably planned for the second trimester. More: Dental health during pregnancy.

For the stages and treatment of gum disease see Gum treatment.