A basic periodontal examination is performed before cleaning is undertaken, if due. If scores of 3 or 4 are recorded, ‘full mouth pocket depth charting’ may be recorded, using 6 points around every tooth. This is important as it records a baseline, and allows treatment to be targeted at any particularly deep sites.
Under the current classification system, patients with Grade II, III , IV periodontal disease, or stage B or C, may be offered referral to a specialist periodontist. Additional factors taken into account are those predisposing to increased severity of gum disease, such as smoking or diabetes.
Cleaning may be peformed with ‘hand scalers’ or an ultrasonic cleaner may be used to gently remove calculus deposits. If the teeth are particularly sensitive, a desensitising agent may be applied prior to treatment. Occasionally cleaning may be performed using a local anaesthetic to numb them completely, but the teeth may be even more sensitive once the anaesthetic wears off.
Oral hygiene forms an important part of the cleaning appointment, and detailed instruction is given tailored to each patient.