How Often Should I Go to the Dentist for a Teeth Cleaning?

Q: How often do I need to get my teeth cleaned?

A: How often do you get your oil changed? Every 3,000 miles? Or is it every 6,000 miles? Thanks to computers, most cars today will make that determination for you based upon the type of driver and the temperature extremes the car has to endure.

So why is it that you have been told to see the dentist every 6 months (or every 3 months if you have gum disease)? How can it be so for every human, without the predictable variability of life styles and environmental triggers being a factor? Who says you have to see the dentist every 6 months?

Well, we do, us dentists. We, in our infinite wisdom have decided, as a group of health care professionals concerned for the health of our patients, that it is in your best interest to come see us every 6 months. Every person, whether you have good teeth or not, whether your gums are healthy or not, whether you build up a lot of plaque and tartar or not, whether you are the world’s best brusher and flosser, or not. That’s right, everyone needs to see the dentist every 6 months. And we certainly are not about to the reward the patients that brush and floss regularly because the rules are the rules…

Is this sounding ridiculous yet?

I hope so, because it is. Let’s first discuss the origin of this insanity, as risible as it may sound. Afterwards, we’ll arm you with the knowledge to make the right decision in your own case.

So are you a fast driver that drives in very cold weather or dusty conditions, or do you baby your car, warm it up every morning and drive like the owner of a Zamboni in an ice rink? How soon would your car’s onboard computer tell you to go in for service? And where (and when) did the profession of dentistry come up with that 6 month interval?

From Amos and Andy of course, a TV show from the 50s! I’m not joking. First a wildly popular radio show, a television adaptation ran on CBS-TV from 1951 until 1953, and continued in syndication though 1966. The show was sponsored by Pepsodent Tooth Powder. Toothpaste had not yet been invented (the procedure was to put some powder on the palm of your hand, wet your toothbrush, and touch the powder with your brush) and in those days going to see the dentist was not a routine activity. In fact, most people went to see a dentist when they needed an extraction or when they were in pain. The Pepsodent ad campaign was quite successful, and in an attempt to appease dentists and gain their recommendation, stated in the ad that in addition to brushing twice daily, that they see their dentist twice yearly (or every 6 months).

Yes, the ad men of Pepsodent (clearly “mad men”) are responsible for determining the frequency of your dental cleaning visits today!

Tartar and plaque form in the mouth at different rates. I can’t tell you how many times I’ve seen a patient for a recall cleaning visit only to see them two weeks later for a scheduled filling and already see tartar forming on the teeth. I also have some patients that need to come in for a cleaning only every 12 months. When dentists polish the teeth, the pellicle (skin of the tooth) is removed, but will reappear in 3 days. The sticky biofilm (plaque) will then stick to the pellicle.

Home care is vital in determining this rate of buildup of the product that is partially responsible for gum disease. Good brushers and flossers (determined by the frequency and quality of doing so) of course will fare better and last longer before needing another cleaning. It is extremely important to remember that gum disease is 100% preventable, but once seen in the mouth it is not 100% curable, and is less than 100% arrestable. So patients (and dentist) need to be armed with methods that properly address and pay for this degree of infection.

And the plot thickens: The insurance companies prefer the “Amos and Andy gig” by a wide margin. They like the steadiness of the 6 month recall concept. It means they have their providers, the dentists that have joined their plan, doing periodontal work for prophy fees! The insurance companies are then able to essentially reduce the utilization of the plan, which in turn increases profits. In the mean time the patient is being undertreated and the dentist is either committing malpractice or committing financial suicide.

The Amos and Andy rubber stamp of the 6 month recall has allowed the insurance carriers (their actuaries) to accurately predict their risk (the outlay of cash to provide for the utilization of the plan). By this quantifying of gum disease into absolute terms, they then know how much to add (to the bottom line) for profit.

The dentist is seeing something completely different. She is seeing a huge group of patients (80%) that need more than just 6 month recalls. Sure, the dentist can bill for SRP (scaling and root planing, otherwise known as “a deep cleaning”). However, it does not provide for the patient that is not yet inflicted with the disease but exhibits patterns that need more aggressive attention to prevent the disease.

Preventing the disease is the better model medically and financially. However, the insurance model is willing to wait for the disease to appear, as the actuaries have calculated exactly how many patients will and will not have treatment. And yes, even how many dentists will dutifully treat this disease at an inappropriate and inadequate pay structure.

How much more can I stress the importance of treating — no — preventing gum disease? If I were sitting at a table with Obama, the federal health commissioner and the health insurance commissioner, I’d point out that pregnant women who have periodontal disease may be seven times more likely to have a baby that is born too early and too small. I’d then hand them a pencil and paper and have them calculate the cost of supporting preemies in this country (26 Billion dollars per year). I’d also like to remind you of what President Obama said about flossing.

So what do I recommend you do?

  1. If you are a woman, get a clean bill of health before you conceive. Learn how to maintain that state of gum health. Your child’s health depends on it.
  2. Seek out a more individualized treatment modality from your dentist in regards to your own unique periodontal issues. Disregard what your insurance is willing to pay. You may spend more or less initially, but in the long run you will save more money.
  3. Write a letter to your personel/benefits department at work and copy them on this article. Force them to find a better plan before next year’s enrollment period that pays forward to reduce costs later.
  4. Find a dentist that understands and agrees with what is written here, and plan to live your life with perfect dental health so as to make other aspects of your health, both mental and physical, much improved.

If you take one message home with you after reading this, please remember this: Gum disease is like a cancer. In the earliest form (gingivitis) it is curable. After that, it’s only possible to achieve remission.

Let your dentist help you to prevent gingivitis so that you never have to face living with regret for the rest of your life.

Gum disease is 100% preventable.

After all, the number one cause of gum disease is the predictable nature of humans. Just go ask the insurance companies.

Mark Burhenne DDS

Comments

  1. says

    I m having cavities in some molars after get THEM fil i am having sensivity such as heat and cold in them n one of my molars wich i have get caping after rct it aches when i sleep at night due to compresion of jaws what are the reasons.

  2. Lyla Burns says

    Thank you so much for this article! I am currently trying to get pregnant, and I had no idea I should go see the dentist. I’m so glad I came across this article because I’m making an appointment today! Thanks again, this has been very helpful!

  3. t says

    I always have to go 6 months. I have veneers and bridge to be checked. That why I go get me teeth cleaned and checked. Good thing!

  4. mn says

    I always have to go 6 months. I have veneers and bridge to be checked. That why I go get my teeth cleaned and checked. Good thing!

  5. Jolene says

    This website is very informative.. if all dentists and healthcare professionals were as on-top of things and knowledgeable and caring about their patients well being as you are, we would all be better off. Thanks for sharing your knowledge!

  6. Lambert says

    My dentist wants to see me and my wife every 3 months for gen. cleaning. Yet, we have no periodontal disease. I brush my teeth 3-4 times daily, flosses 3-4 times a week and is very proud of my teeth. At age 70, I still have my original pearlie white teeth sans wisdom teeth. Having read this article, I will suggest to my dentist a 6 month visit.

    • Basha says

      It’s a scam and I think that dentists in this economy are doing this because they don’t make any money off of a 6 month visit. I like you can tell the same story. My teeth are in amazing condition, no gum disease, nothing wrong. Same with my boys yet my dentist has taken us from a 6 month cleaning to a 4 month, then 3 month cleaning. It was really subtle and they’ve given no explanation for it. I don’t want to embarrass Angie by asking. I respect her. She’s only doing what’s she’s told. I will do as you. I go in for yet another cleaning today (seems like I was just there!). I’m going back to 6 months.

  7. James says

    Hi Mark, Great article Mark! I love your recommendations at the end of the article. It is indeed important to schedule for teeth cleaning twice a year. I totally agree with you that teeth diseases are preventable, as long as you’re doing the right thing. Thanks for the information again! Regards, James

  8. malka says

    Toothpaste hadn’t been invented in the 50′s?? Odd, I was using it in the 50′s! You’re otherwise well-written piece is marred by this incredibly unbelievable statement, which brings everything else you wrote into question. *Fluoride* toothpaste was introduced in the early 50′s, for heaven’s sake!

  9. Carole Heath says

    I had two crowns break recently so i went to my dentist to try and have them put back. But unfortunately that wasn’t the case as the remaining teeth under the crowns were decayed. And he suggested that if i didn’t have them removed the teeth could become infected and lead to abscess which isn’t good. I hadn’t been for 3 years his records said he never found much wrong with the other teeth thankfully. But since having the teeth removed without much pain before or after i have had other problems very sore gums and swelling which is now beginning to improve after salty water mouthwashes. I am definitely going to keep up the every 6 months appoinment and check-ups for cleaning as i think if i had gone more regular the crowns could have been saved and also the treatment cost me over £200 as he is private only. And the 6 months checks can also tell your dentist if any problems may arise regarding your oral health etc.

  10. Basha says

    This article seriously needs to be updated. Who even HAS dental insurance anymore? This industry from a patients’ standpoint is that it is entirely self pay now and has been for some time. I have an HSA that pays both dental and medical. My frustration and concern is that I was following the 6 month rule. With myself and my two children. All of a sudden my dental hygeinist (sp?) wants to book us every three months. I don’t have gum disease and have not been told this. She’s doing the same thing to my boys. My oldest who is 23 is great gums and teeth yet, again, visits in 3 months. It was subtle. They “allowed” me to make the 6 month appointments and appeased me. They slowly slipped in, “Well, let’s just have you come in 4 months from now?” Eventually that whittled down to 3. These visits are eating up my HSA account to where I have a portion there for medical (I have insurance for that). Each visit for each of us is conservatively $100 IF we don’t have our annual bitewings OR an exam along with the cleaning every three months. $1200 a year in cleanings and that’s just MY family for just OUR cleanings. What? I’m beginning to think that I’m now paying for their vacation home in Palm Desert, their primary home with a pool, and their BMW that sits in the driveway. I can’t take this anymore.

    • says

      Speaking from the dentist’s view, you have right’s as a patient. In our office, we only occasionally recommend that a patient be seen more often than every 6 months. It’s probably 1 in 20 that we recommend do this. Even with that, only about half will do it because they don’t want to pay anything additional out of pocket. Tell your dentist how you feel. If they continue, I’d say, see someone else.

  11. Rick says

    If my gums don’t bleed when I brush or floss but my periodontist says they bleed during a cleaning, and recommends 3 month visits; why would I not believe that she/he is just saying that so that they can milk the insurance company for more money and make sure that they have a continued workload? If you poke any living tissue with a sharp metal object it’s going to bleed. Personally I think that this is exactly what happened and I’m going to cancel my future appointments with this dentist and go see a different one to see if they say the same thing after a perio visit. I may even get a third opinion. Human greed is becoming a serious problem. Since you compared this to oil changes…Those are a ripoff too. You don’t need to get your oil changed every 3000 miles. My owners manual says that I can go up to 7500 miles between changes depending on the driving conditions and that the 3000 mile mark is “recommended”.

    • says

      If it’s a periodontist that is recommending your more frequent cleanings, ask your general dentist what he/she thinks. Coming from the dentist’s point of view, we welcome the opportunity to give you that second opinion. A good periodontist should be having you see your regular dentist at least once per year anyway. And just so you know, tarter buildup is the real problem, not necessarily bleeding gums.

  12. Elle says

    That teeth be professionally cleaned twice a year is something INSURANCE COMPANIES have the determined. Technically, and if you could, people would go and should have it cleaned every 2 months. But since in this wonderful countires insurance companies make health care decisions for us and they make money by NOT paying claims, they decided on twice a year. It is nothing doctor recommended. It would be ideal to get your teeth cleaned 6 times a year just that ins companies dont want to pay for it so they set it at this minimum of once every 6 years. So, if you can afford it, go more. But dont think this is Dr. recommended.

  13. says

    Interesting. Several points are speculation without reference to proof though; poor dental hygiene may not be related to baby health at all but may just precipitate because of a persons standard of living or personal health ( an alcoholic is likely to have a poor baby and not brush their teeth but the brushing is not the cause). Seems like a sales pitch still.

  14. Ava says

    When my parents were growing up/as kids, they only went to the dentist when something was wrong. As they got older, now 40′s: 1 uncle has barely any teeth left. 1 Aunt had to have extensive work done. My mom, made it through OK, just fillings, and an emergency wisdom tooth removal (did not get them removed until infection was present). As I was growing up, the dental care got better, however I still did not see a dentist regularly until about 13 (when my mom got on insurance with new job). I had to have LOTS of fillings, I think all my molars are filled after that, (my bro had to have fillings) and seeing the dentist every 6 months I hadn’t had a cavity in over 12-13 years. My mom realized what we had to go through with all those fillings and also seen the importance, so whether we were on insurance at times or not she took us in for cleanings. I also had my wisdom teeth extracted and they were removed before there was any serious issue. I went to the dentist today and had to have a filling, I was really upset and disappointed in myself. The second filling I had to have this year. I decided I’m going to go every 3 months (in addition to flossing more). he dentist did not suggest it. I don’t have insurance at my job, so out of pocket I pay $85. I’m not rich by any means, but I want to keep all the teeth I have in my mouth, I don’t want root canals, etc. My brother, my mom calls him the 5K smile. He had braces, fillings only as a kid, and great oral hygiene—this guy really does the flossing/brushing at night. He also had lower wisdom teeth removal. My brother is having a baby, so now 3rd generation in, everyone is already talking about how important the teeth are. This kid has the possibility of being one of those people that never have a cavity. We’ve come to believe that today, being a good parent is getting your kid good dental care because they have to live with those teeth the rest of their lives. I’m very thankful for getting the cavities filled. I’m thankful for the teeth cleanings. I’m thankful for having all my teeth. I’m thankful for my mom taking us in for those appointments every 6 months (1 hour, 1 way). Thankful for my mom taking care of BOTH of us when we had our wisdom teeth taking out AT THE SAME TIME. There are so many parents that sometimes just don’t know any better or care enough to ensure these things get done and I’m thankful my mom did this for us. My dream is to continue education as a dentist. I don’t think the dentist is the enemy, I’m not rich, I don’t look it, if the dentist wants to make money I’m sure there are people who he/she can “milk,” they also do cosmetic work there. For the people that are asked to go every 3 months, are you really flossing every night? The last 2 cavities I had were in-between the teeth, I wasn’t flossing enough. Brushing isn’t enough, listerine isn’t enough, fluoride isn’t enough. I have the best tooth brush that’s on the market $100+ it still isn’t enough. If you’re not flossing, you can get a cavity within 6 months. Talk with your dentist, ask them to be upfront with WHY exactly they feel you should be coming in every 3. Tell them not to hold back, to be brutally honest, there’s probably something with your oral hygiene that’s not hitting the mark. It point blank terms, your mouth isn’t staying clean enough in-between visits to keep cavity bacteria at bay. Also be honest with yourself on how much time you invest in keeping those teeth clean. The dentist isn’t the enemy.

  15. Jam says

    But what if one wants to have more cleanings then recommended? I am scheduled for once every three months, but would like to have it done more often. I was told by the hygienist that it could be harmful to have too many cleanings, something to do with the roots. (?) Can you explain?

    • Dr. B says

      Yes, that’s true. Toxins build up on the roots of the teeth. We go in with sharp knives and we scrape — which is good to remove and lessen the immune response (which leads to inflammation) but on the other hand, if you scrape too much and too long, you damage the tooth by scalloping the sides of the roots of the teeth, which can lead to sensitivity to cold and hot, black triangles (little dark spaces in between your teeth), and you should really make sure that the dentist you’re seeing can really custom tailor the appropriate interval — not too much and not too little. Hope that helps. Dr. B

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Trackbacks

  1. [...] average, seeing a dentist twice a year works well for most people, although some people might require more or less frequent visits. Once [...]

  2. [...] Did you know that even 50 years ago, there were no set guidelines for how often you should visit your dentist? Many dentists focused simply on fixing existing problems rather than on preventive care. Dental and health organizations decided there was a need to set standards for preventative dentistry, and made a “guesstimate” of twice a year, or every six months. [...]

  3. [...] an appointment with your hygienist. During a dental cleaning, the hygienist removes the pellicle, a natural film that forms on top of your teeth. When the [...]

  4. […] When to see dentist? Once every 6 months, every 3 if you have gum disease. […]

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