{{Short description|Oral hygiene practice}} [[File:"An Elephant Never Forgets" (15866594818).jpg|thumb|Poster encouraging tooth brushing with an elephant, (New Zealand, 1950s).]]
'''Teeth cleaning''' is part of oral hygiene and involves the removal of dental plaque from teeth with the intention of preventing cavities (dental caries), gingivitis, and periodontal disease.
People routinely clean their own teeth by brushing and interdental cleaning, and dental hygienists can remove hardened deposits (tartar) not removed by routine cleaning. Those with dentures and natural teeth may supplement their cleaning with a denture cleaner.
Home care teeth cleaning refers to the daily oral hygiene habits practised by patients. It can be performed by tooth brushing and interdental cleaning, to disrupt the maturation of dental plaque to calculus (tartar).
Professional tooth cleaning refers to treatment that is conducted by dental professionals like the dental hygienist, therapist, and dentist. Processes like scaling and prophylaxis aim to remove plaque, calculus, and stain that cannot be removed through routine home care.<ref>Newman, M. G., Takei, H., Klokkevold, P. R., & Carranza, F. A. (2018). Newman and Carranza's Clinical Periodontology E-Book: Newman and Carranza's Clinical Periodontology E-Book. Elsevier Health Sciences</ref>
== Brushing, scrubbing and flossing == {{main|Tooth brushing|Dental floss}}
=== Brushing === Careful and frequent brushing with a toothbrush helps to prevent build-up of plaque bacteria on the teeth.<ref>{{cite web |last=Curtis |first=J. |date=13 November 2007 |title=Effective Tooth Brushing and Flossing. |url=http://www.webmd.com/oral-health/effective-tooth-brushing-and-flossing |access-date=2007-12-24 |website=WebMD}}</ref> Toothbrushing is the gold standard of removing plaque & preventing plaque formation, which would otherwise lead to gum disease and tooth decay.<ref>{{Cite journal |last=Claydon |first=Nicholas C. |date=2008 |title=Current concepts in toothbrushing and interdental cleaning |url=https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1600-0757.2008.00273.x |journal=Periodontology 2000 |language=en |volume=48 |issue=1 |pages=10–22 |doi=10.1111/j.1600-0757.2008.00273.x |pmid=18715352 |issn=1600-0757}}</ref> Electric toothbrushes were developed, and initially recommended for people with strength or dexterity problems in their hands, but they have come into widespread general use. The effectiveness of electric toothbrushes at reducing plaque formation and gingivitis is superior to conventional manual toothbrushes.<ref>{{cite journal | vauthors = Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, Glenny AM | title = Powered versus manual toothbrushing for oral health | journal = The Cochrane Database of Systematic Reviews | issue = 6 | article-number = CD002281 | date = June 2014 | volume = 2014 | pmid = 24934383 | pmc = 7133541 | doi = 10.1002/14651858.CD002281.pub3 }}</ref>
'''Instructions'''<br /> Source:<ref>{{Cite web |title=Brushing Your Teeth |url=https://www.mouthhealthy.org/all-topics-a-z/brushing-your-teeth |access-date=2026-05-25 |website=www.mouthhealthy.org |language=en}}</ref>
* Step 1: For the amount of toothpaste, place a smear (rice-grain size) of fluoride toothpaste for children <3 years and a pea-sized amount for ≥3 years and adults when brushing. * Step 2: Place your toothbrush at a 45-degree angle to the gums.. * Step 3: Gently move the brush back and forth in short (tooth-wide) strokes. * Step 4: Brush the outer surfaces, the inner surfaces, and the chewing surfaces of the teeth. * Step 5: To clean the inside surfaces of the front teeth, tilt the brush vertically and make several up-and-down strokes. * Step 6: Brush the tongue
* Tip: It is recommended to use a 2/2 strategy, which includes brushing for two minutes in the morning and two minutes at night, which is the main standard for healthy gums and teeth.
=== Flossing === thumb|Dental floss In addition to brushing, cleaning between teeth may help to prevent build-up of plaque bacteria on the teeth. This may be done with dental floss or interdental brushes.
80% of cavities occur in the grooves, or pits and fissures, of the chewing surfaces of the teeth,<ref name="pmid2179337">{{cite journal |vauthors=Groeneveld A, Van Eck AA, Backer Dirks O |date=February 1990 |title=Fluoride in caries prevention: is the effect pre- or post-eruptive? |journal=Journal of Dental Research |volume=69 Spec No |issue=2_suppl |pages=751–755; discussion 820–823 |doi=10.1177/00220345900690S145 |pmid=2179337 |s2cid=32601535}}
* {{cite web |date=January 1, 2007 |title=Questions & Answers |url=http://www.healthyteeth.us/Questions___Answers/questions___answers.html#DoesWaterFluoridationAffect |archive-url=https://web.archive.org/web/20070730170432/http://www.healthyteeth.us/Questions___Answers/questions___answers.html#DoesWaterFluoridationAffect |archive-date=2007-07-30 |website=Healthy Teeth for a Lifetime}}</ref> however, there is no evidence currently showing that normal at-home flossing reduces the risk of cavities in these areas.<ref>{{cite journal | vauthors = Hujoel PP, Cunha-Cruz J, Banting DW, Loesche WJ | title = Dental flossing and interproximal caries: a systematic review | journal = Journal of Dental Research | volume = 85 | issue = 4 | pages = 298–305 | date = April 2006 | pmid = 16567548 | doi = 10.1177/154405910608500404 | s2cid = 53789465 }}</ref> Special appliances or tools may be used to supplement toothbrushing and interdental cleaning. These include special toothpicks, oral irrigators, and other devices. A 2015 Cochrane review found insufficient evidence to determine whether the interdental brushing decreases the levels of plaque when compared to flossing.<ref>{{cite journal | vauthors = Poklepovic T, Worthington HV, Johnson TM, Sambunjak D, Imai P, Clarkson JE, Tugwell P | title = Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults | journal = The Cochrane Database of Systematic Reviews | issue = 12 | article-number = CD009857 | date = December 2013 | pmid = 24353078 | doi = 10.1002/14651858.CD009857.pub2 | doi-access = free | pmc = 6481275 }}</ref>
== Professional teeth cleaning == [[Image:Tooth polishing 9332.JPG|thumb|Dental hygienist polishing a person's teeth]]
Professional teeth cleaning (also known as '''''Professional Mechanical Plaque Removal (PMPR)''''') is a procedure for the removal of tartar (mineralized plaque) that may develop even with careful brushing and flossing, especially in areas that are difficult to reach in routine toothbrushing. It is often done by a dental hygienist. Professional cleaning includes tooth scaling, tooth polishing, and debridement if too much tartar has accumulated. This involves the use of various instruments or devices to loosen and remove deposits from the teeth.<ref>{{Citation |title=Gingivitis and periodontitis: Learn More – What are the advantages and disadvantages of professional teeth-cleaning? |date=2023-08-23 |work=InformedHealth.org [Internet] |url=https://www.ncbi.nlm.nih.gov/books/NBK554695/ |access-date=2026-05-25 |publisher=Institute for Quality and Efficiency in Health Care (IQWiG) |language=en}}</ref>
As to the frequency of cleaning, research on this matter is inconclusive. That is, it has ''neither'' been shown that more frequent cleaning leads to better outcomes ''nor'' that it does not. A review of the research literature on the question concluded "[t]he research evidence is not of sufficient quality to reach any conclusions regarding the beneficial and adverse effects of routine scaling and polishing for periodontal health and regarding the effects of providing this intervention at different time intervals".<ref>{{cite journal | vauthors = Bader J | title = Insufficient evidence to understand effect of routine scaling and polishing | journal = Evidence-Based Dentistry | volume = 6 | issue = 1 | pages = 5–6 | year = 2005 | pmid = 15789039 | doi = 10.1038/sj.ebd.6400317 | doi-access = free }}</ref> Thus, any general recommendation for a frequency of routine cleaning (e.g. every six months, every year) has no empirical basis.<ref>{{cite web|url=http://askthedentist.com/how-often-should-i-go-to-the-dentist-for-a-teeth-cleaning/|title=How Often Should I Go to the Dentist for a Teeth Cleaning?| vauthors = Burhenne M |work=Ask the Dentist|date=19 August 2010 }}</ref><ref>{{Cite journal|last1=Lamont|first1=Thomas|last2=Worthington|first2=Helen V.|last3=Clarkson|first3=Janet E.|last4=Beirne|first4=Paul V.|date=2018-12-27|title=Routine scale and polish for periodontal health in adults|journal=The Cochrane Database of Systematic Reviews|volume=12|issue=4 |article-number=CD004625|doi=10.1002/14651858.CD004625.pub5|issn=1469-493X|pmc=6516960|pmid=30590875}}</ref> Professional dental cleaning reduces systemic inflammatory markers such as TNF-α, IL-6 and CRP, supporting a beneficial link between periodontal treatment and cardiovascular risk reduction.<ref>{{Cite journal |last1=Cardisciani |first1=Martina |last2=Di Nicolantonio |first2=Sara |last3=Altamura |first3=Serena |last4=Ortu |first4=Eleonora |last5=Del Pinto |first5=Rita |last6=Pietropaoli |first6=Davide |date=2025-08-28 |title=Temporal dynamics of early inflammatory markers after professional dental cleaning: a meta-analysis and spline-based meta-regression of TNF-α, IL-1β, IL-6, and (hs)CRP |journal=Frontiers in Immunology |language=English |volume=16 |article-number=1634622 |doi=10.3389/fimmu.2025.1634622 |doi-access=free |pmid=40948802 |pmc=12423065 |issn=1664-3224}}</ref>
Steps in professional teeth cleaning:
# Scaling ## Removal of plaque and tartar from tooth surfaces, including between teeth and near the gums, using ultrasonic and hand instruments. ## Dental floss, interdental brushes, or air polishing may be used to clean between teeth and remove stains. # Polishing ## Teeth are polished with a rotating rubber cup or brush and polishing paste to smooth the surface and reduce bacterial attachment. # Fluoride treatment ## Fluoride gel or varnish is applied to strengthen enamel and protect against decay.
Professional Mechanical Plaque Removal (PMPR) alone may not reduce gingivitis if the patient's oral hygiene continues to be poor. Evidence suggests better outcomes when PMPR is combined with Oral Hygiene Instruction (OHI) compared to OHI alone, especially in generalised gingivitis cases (Farina et al., 2026)<ref>{{Cite journal |last1=Farina |first1=Roberto |last2=Simonelli |first2=Anna |last3=Trombelli |first3=Leonardo |last4=Chew |first4=Ren Jie Jacob |last5=Tu |first5=Yu-Kang |last6=Preshaw |first6=Philip M. |date=April 2026 |title=Clinical Efficacy of Interventions Based on Professional Mechanical Plaque Removal in the Treatment of Dental Biofilm–Induced Gingivitis: A Systematic Review and Meta-Analysis |journal=Journal of Clinical Periodontology |language=en |volume=53 |issue=4 |pages=572–595 |doi=10.1111/jcpe.70083 |issn=0303-6979 |pmc=12972606 |pmid=41531192}}</ref>
== Complications ==
* Improper tooth cleaning may lead to ineffective removal of bacteria and food debris, allowing them to accumulate and potentially cause various oral health issues.<ref name=":0">{{Cite web |title=What Are the Risks of Using Improper Tooth Cleaning Instruments |url=https://dentalcarefree.com/blogs/What%20Are%20the%20Risks%20of%20Using%20Improper%20Tooth%20Cleaning%20Instruments.html |access-date=2026-05-25 |website=Dentalcarefree |language=en}}</ref>
* Using improper tools such as plastic toothpicks, hard-bristle toothbrushes, or even fingernails can harm both your gums and tooth enamel. These objects may cause small tears in the gum tissue, which can trigger inflammation and increase the risk of infection. Over time, this can escalate into more severe issues, like periodontal disease, which affects not only your mouth but your overall health.<ref name=":0" />
* Improper tooth cleaning increases the potential for gingival injury, especially if horizontal movements are performed.<ref>{{Cite journal |last1=Vogel |first1=Marc |last2=Sener |first2=Beatrice |last3=Roos |first3=M. |last4=Attin |first4=Thomas |last5=Schmidlin |first5=Patrick R. |date=2014-12-15 |title=Interdental cleaning and gingival injury potential of interdental toothbrushes. A laboratory investigation |url=https://www.swissdentaljournal.org/article/view/5549 |journal=SWISS DENTAL JOURNAL SSO – Science and Clinical Topics |language=en |volume=124 |issue=12 |pages=1290–1301 |doi=10.61872/sdj-2014-12-01 |pmid=25503477 |issn=2296-6501}}</ref> * Observational studies have shown that the use of simple, non-complex brushing techniques, such as the horizontal scrub method, and applying excessive brushing force are linked to the onset and progression of gingival recession. Additionally, brushing more frequently and using toothbrushes with harder bristles have also been associated with a higher risk of developing gingival recession.<ref>{{Cite journal |last1=Sanz |first1=Mariano |last2=Bäumer |first2=Amelie |last3=Buduneli |first3=Nurcan |last4=Dommisch |first4=Henrik |last5=Farina |first5=Roberto |last6=Kononen |first6=Eija |last7=Linden |first7=Gerard |last8=Meyle |first8=Joerg |last9=Preshaw |first9=Philip M. |last10=Quirynen |first10=Marc |last11=Roldan |first11=Silvia |last12=Sanchez |first12=Nerea |last13=Sculean |first13=Anton |last14=Slot |first14=Dagmar Else |last15=Trombelli |first15=Leonardo |date=April 2015 |title=Effect of professional mechanical plaque removal on secondary prevention of periodontitis and the complications of gingival and periodontal preventive measures: Consensus report of group 4 of the 11 th European Workshop on Periodontology on effective prevention of periodontal and peri-implant diseases |url=https://onlinelibrary.wiley.com/doi/10.1111/jcpe.12367 |journal=Journal of Clinical Periodontology |language=en |volume=42 |issue=S16 |pages=S214-20 |doi=10.1111/jcpe.12367 |pmid=25626357 |issn=0303-6979}}</ref>
== Disinfection == {{Expand section|date=June 2022}}
* Disinfection is important for the removal of microorganisms from surfaces and tools in a dental clinic/office for infection control in dental practices to prevent cross-contamination and the transmission of various diseases among patients and healthcare professionals. * The goals of infection control are: ** To minimize amount of infectious pathogens to a certain level where the body's immune system is capable of resisting the infection ** To disrupt the pathway of infection & stop cross-contamination ** To protect patients and practitioners from infections * It often involves the use/application of disinfectants on a surface or object (ex: dental instruments, dental chair). ** Disinfectants used in dental practices includes<ref name=":2">{{Cite journal |last1=Patiño-Marín |first1=Nuria |last2=Villa García |first2=Lorena Dafnee |last3=Aguirre López |first3=Eva Concepción |last4=Medina-Solís |first4=Carlo Eduardo |last5=Martínez Zumarán |first5=Alan |last6=Martínez Rider |first6=Ricardo |last7=Márquez Preciado |first7=Raúl |last8=Rosales García |first8=Pedro |last9=Salas Orozco |first9=Marco Felipe |date=February 2025 |title=Sterilization and Disinfection: Ensuring Infection Control in Dental Practices |journal=Cureus |volume=17 |issue=2 |article-number=e79041 |doi=10.7759/cureus.79041 |doi-access=free |issn=2168-8184 |pmc=11912515 |pmid=40099062}}</ref> : *** Aldehydes *** Chlorine products *** Alcohols *** Synthetic phenols *** Iodine products * Disinfection of dental instruments ** The disinfection & sterilization method used will depend on the dental instruments used<ref name=":2" /> : *** Critical - instruments that go into/pierce the mucosal tissue should be sterilized (ex: scalers, scalpels) *** Semi-critical - instruments that come in contact with mucosal tissue should be sterilized (ex: pliers) *** Least critical - instruments & surfaces that are touched during dental treatment should be disinfected (ex: dental chair light handles)
== Acidity and decay relationship ==
* Tooth decay, also known as dental caries, is the destruction of enamel and dentine caused by acids produced by bacteria when they break down sugars.
* Examples of bacteria which cause decay<ref>{{Citation |last=Loesche |first=Walter J. |title=Microbiology of Dental Decay and Periodontal Disease |date=1996 |work=Medical Microbiology |editor-last=Baron |editor-first=Samuel |url=http://www.ncbi.nlm.nih.gov/books/NBK8259/ |access-date=2026-05-25 |edition=4th |place=Galveston (TX) |publisher=University of Texas Medical Branch at Galveston |isbn=978-0-9631172-1-2 |pmid=21413316}}</ref> ** Streptococcus mutans ** Lactobacillus ** Actinomyces * When sugary foods are consumed, bacteria in dental plaque break down the sugars and produce acids. These acids lower the pH of the plaque and cause the loss of minerals from the tooth surface. If this process happens frequently, it leads to the development of tooth decay.<ref>{{Citation |last1=Wilson |first1=Michael |title=Tooth Decay |date=2021 |work=Close Encounters of the Microbial Kind: Everything You Need to Know About Common Infections |pages=273–291 |editor-last=Wilson |editor-first=Michael |place=Cham |publisher=Springer International Publishing |language=en |doi=10.1007/978-3-030-56978-5_20 |isbn=978-3-030-56978-5 |last2=Wilson |first2=Philippa J. K. |editor2-last=Wilson |editor2-first=Philippa J. K.}}</ref> * Saliva helps to protect teeth by: ** Washing away food particles and acids ** Neutralizing plaque acidity ** Providing calcium and phosphate ions for remineralization ** Controlling bacterial growth because it contains antibacterial substances * '''Demineralization vs Remineralization''' ** Demineralization *** Occurs when acids remove minerals from the enamel ** Remineralization *** Occurs when minerals are restored by saliva ** Tooth decay develops when demineralization exceeds remineralization over time. * '''Prevention and management'''<ref>{{Cite journal |last=Warreth |first=Abdulhadi |date=2023 |title=Dental Caries and Its Management |journal=International Journal of Dentistry |volume=2023 |article-number=9365845 |doi=10.1155/2023/9365845 |doi-access=free |issn=1687-8728 |pmc=9831703 |pmid=36636170}}</ref> ** Prevention of dental caries: *** Maintaining good oral hygiene *** Reducing sugar intake *** Using fluoride products to strengthen enamel. ** Management of dental caries: *** Removing decayed tooth structure *** Restoring the tooth with appropriate dental materials
==History==
=== 1. Early Methods of Teeth Cleaning ===
* Teeth cleaning practices date back thousands of years. * Early humans used '''toothpicks made from wood, bone, or quills''' to remove food particles between teeth. * Archaeological evidence from the '''Indus Valley civilization (around 7000 BCE)''' shows early dental procedures such as tooth drilling. * These findings suggest that '''oral hygiene and dental treatment were recognized even in prehistoric societies'''.<ref>{{Cite journal |last=Forshaw |first=Roger |date=December 2025 |title=Dentistry and dental care in antiquity: part 1 - prehistory, Mesopotamia, Israel, Etruria and the Far East |journal=British Dental Journal |volume=239 |issue=12 |pages=851–856 |doi=10.1038/s41415-025-8884-z |issn=1476-5373 |pmc=12716987 |pmid=41420034}}</ref>
=== 2. Teeth Cleaning in Ancient Civilizations ===
* Ancient Egyptians and Babylonians used '''"chew sticks"''', which were twigs with frayed ends acting as primitive toothbrushes. * Early '''tooth powders''' were made from abrasive materials such as crushed pumice, eggshells, and ashes. * These substances helped '''clean teeth, remove plaque, and improve breath'''. * Similar oral hygiene practices were later used by '''Greeks, Romans, Chinese, and Indians''', showing that dental care was common across many cultures.<ref>{{Citation |last=Lippert |first=Frank |title=An Introduction to Toothpaste - Its Purpose, History and Ingredients |date=2013 |volume=23 |pages=1–14 |editor-last=van Loveren |editor-first=C. |series=Monographs in Oral Science |url=https://karger.com/chapter/doi/10.1159/000350456 |access-date=2026-05-25 |publisher=S. Karger AG |language=en |doi=10.1159/000350456 |pmid=23817056 |isbn=978-3-318-02206-3}}</ref>
=== 3. Development of Modern Teeth Cleaning ===
* Modern professional teeth cleaning developed in the '''early 20th century''' with advances in dentistry. * In '''1906, Alfred C. Fones trained Irene Newman''' to perform dental prophylaxis (professional teeth cleaning). * This led to the '''first dental hygiene school in 1913''' in Bridgeport, Connecticut.
Professional teeth cleaning today involves '''scaling and polishing to remove plaque and calculus''', helping prevent cavities and periodontal disease.<ref>{{Cite book |last=Fones |first=Alfred C. (Alfred Civilion) |url=http://archive.org/details/mouthhygienetext00fone |title=Mouth hygiene; a text-book for dental hygienists |date=1921 |publisher=Philadelphia and New York, Lea & Febiger |others=Columbia University Libraries}}</ref><ref>Wilkins, E. M. (2017). ''Clinical practice of the dental hygienist'' (12th ed.). Wolters Kluwer.</ref>
== References == {{Reflist|30em}}
== External links == *[https://www.who.int/health-topics/oral-health/#tab=tab_1 World Health Organization site on oral health] *[https://www.cosmeticdentistryclinic.co.uk/dental-hygienist-london Cosmetic Dentistry Clinic site on Dental Hygienist] {{Dentistry}}
Category:Dentistry procedures Category:Oral hygiene