Short answer
A regular cleaning removes plaque and tartar from the tooth surfaces above and just below the gumline in a healthy mouth. A deep cleaning, called scaling and root planing, goes further below the gums to clean the root surfaces inside periodontal pockets caused by gum disease. It is usually recommended when gum measurements show pockets deeper than about 4 millimetres, bleeding and bone loss on X-rays. Deep cleaning often takes more than one visit, may use local anesthetic and is followed by a re-evaluation and regular maintenance visits.
Key takeaways
- A regular cleaning is preventive; a deep cleaning treats existing gum disease.
- The decision is based on gum pocket measurements, bleeding and X-rays, not on how your teeth look.
- Deep cleaning is often done in sections over two or more visits, with freezing for comfort.
- After a deep cleaning, gums are re-measured and maintenance visits are usually more frequent.
If your hygienist has recommended a “deep cleaning”, you may wonder how it is different from the cleaning you usually get, and whether you really need it. The short answer is that a regular cleaning keeps healthy gums healthy, while a deep cleaning treats gum disease that has already formed pockets below the gumline. This guide explains the difference, how the decision is made, what to expect and how coverage usually works.
What happens in a regular cleaning?
A regular cleaning, sometimes called a prophylaxis or “prophy”, is preventive care for a mouth with healthy gums or mild gum inflammation (gingivitis). The hygienist:
- Removes plaque and tartar from the tooth surfaces above the gumline and just below it
- Polishes the teeth to remove surface stain
- May apply fluoride
- Checks the gums, measures pockets and reviews your home care
The gums in a healthy mouth fit snugly around the teeth, with shallow spaces of about 1 to 3 millimetres. A regular cleaning reaches these easily.
What is a deep cleaning?
A deep cleaning is the common name for scaling and root planing. It treats periodontitis, the stage of gum disease where inflammation has damaged the attachment between the gums and teeth and the bone around the roots.
When that happens, the shallow space between gum and tooth deepens into a pocket. Bacteria and hard tartar collect on the root surfaces inside the pocket, where a toothbrush, floss and a regular cleaning cannot reach. Deep cleaning removes them:
- Scaling removes plaque and tartar from the roots below the gumline, down to the bottom of the pocket.
- Root planing smooths the root surfaces so the gums can heal and reattach more closely.
Our article on what scaling and root planing involves walks through the procedure step by step.
Regular cleaning vs deep cleaning at a glance
| Regular cleaning | Deep cleaning | |
|---|---|---|
| Purpose | Prevent gum disease | Treat existing gum disease |
| Where it cleans | Above and just below the gumline | Deep below the gumline, on root surfaces |
| Typical pockets | About 1 to 3 mm | About 4 mm or deeper, with bleeding |
| Freezing | Usually not needed | Often used |
| Visits | Usually one | Often two or more, by section of the mouth |
| Follow-up | Routine recall | Re-evaluation, then periodontal maintenance |
Signs you may need a deep cleaning
You cannot always tell by looking in the mirror, because gum disease is often painless. Signs that suggest it include:
- Gums that bleed when you brush or floss
- Red, swollen or tender gums
- Gums pulling away from the teeth, making teeth look longer
- Persistent bad breath or a bad taste
- Teeth that feel loose or have shifted
- Food trapping in new places between teeth
The decision is made with measurements. Your hygienist uses a small probe to measure the depth of the space around each tooth, notes where there is bleeding, and looks for bone loss on X-rays. Pockets of about 4 millimetres or deeper with bleeding and bone loss usually mean a regular cleaning is not enough. Our article on early signs of gum disease explains what to watch for.
What to expect during a deep cleaning
- Planning. Your gums are measured and X-rays are reviewed. The hygienist or dentist explains which areas need treatment.
- Freezing. Local anesthetic is usually used, often one section of the mouth at a time.
- Cleaning. Ultrasonic and hand instruments remove tartar from the roots and smooth them.
- Home-care coaching. You learn how to clean the areas that need the most attention, often with interdental brushes.
- More visits. Deep cleaning is often split into two or more appointments, such as one for each side.
After a deep cleaning
It is normal for gums to feel tender and for teeth to be sensitive to cold for a few days. A soft toothbrush, warm salt-water rinses if your dental team recommends them and an over-the-counter pain reliever, used as directed, usually help. As inflammation settles, the gums may tighten and shrink slightly, which can make teeth look a little longer or leave small gaps between them.
Several weeks later, your gums are measured again. Many pockets become shallower. Areas that do not respond may need further treatment or a referral to a periodontist.
Is a deep cleaning the same as gum surgery?
No. Scaling and root planing is non-surgical: the gums are not cut or stitched. It is the first-line treatment for most gum disease and is often enough to bring it under control. Surgery or other advanced treatment by a periodontist is considered only for areas that do not respond, such as very deep pockets or complex bone defects.
Why maintenance matters afterwards
Gum disease can be controlled but tends to come back if bacteria are allowed to rebuild in the pockets. After a deep cleaning, most people need periodontal maintenance visits more often than a routine cleaning, often every three or four months. Our article on periodontal maintenance explains why.
Home care between visits
Professional cleaning removes what has built up, but daily home care decides how well the gums stay healthy:
- Brush twice a day with a soft brush or an electric toothbrush, angling the bristles toward the gumline.
- Clean between your teeth every day. Interdental brushes often work better than floss where gums have shrunk; your hygienist can show you which sizes fit.
- Use a water flosser if you find other tools difficult, especially around bridges or implants.
- Don’t smoke or vape. Smoking is one of the strongest risk factors for gum disease and slows healing.
- Manage diabetes with your physician, since high blood sugar and gum disease make each other worse.
Bleeding that persists after a couple of weeks of good home care is a sign to let your dental team know.
What affects the cost of a deep cleaning?
There is no single price. The fee depends on:
- How many areas need treatment and how deep the pockets are
- Time, since cleaning is usually billed in time units
- Freezing and X-rays
- Re-evaluation and maintenance visits afterwards
Ask for a written estimate that shows the number of units planned and what your insurance is expected to pay.
Insurance and CDCP
Most dental plans cover scaling and root planing, usually measured in time units with annual limits. Under the Canadian Dental Care Plan, adults 17 and over can have up to 4 units of scaling and root planing combined in any 12 months, and care beyond the limit needs preauthorization. Our CDCP coverage guide explains co-payments and limits.
What if you skip it?
Untreated periodontitis usually progresses slowly but steadily. Pockets deepen, more bone is lost, teeth can loosen and eventually may be lost. Gum disease is also associated with conditions such as diabetes and heart disease. Treating it early is simpler and less costly than treating advanced disease.
Gum care at Regal Heights
At our St. Clair West office, we measure your gums at each exam and show you the results, so you can see why a regular cleaning or a deep cleaning is recommended. Learn more about our dental hygiene and gum care, or book an appointment if your gums bleed when you brush.
Frequently asked questions
How do I know if I need a deep cleaning?
Only an examination can tell. Your hygienist or dentist measures the space between the gums and teeth with a small probe and checks for bleeding and bone loss on X-rays. Pockets deeper than about 4 millimetres with bleeding usually indicate gum disease that a regular cleaning cannot reach.
Does a deep cleaning hurt?
Most people are comfortable because the area is usually frozen with local anesthetic. Gums may feel tender and teeth may be sensitive to cold for a few days afterwards.
Can I just get a regular cleaning instead?
A regular cleaning does not reach deep pockets, so the bacteria and tartar causing gum disease would remain. Ask your hygienist to show you your measurements and explain what could happen if the pockets are not treated.
Is a deep cleaning covered by insurance or CDCP?
Most dental plans cover scaling and root planing as part of periodontal or basic services, usually measured in time units with annual limits. Under the Canadian Dental Care Plan, adults can have up to 4 units of scaling and root planing combined in 12 months, and more needs preauthorization.
How long does it take for gums to heal?
Gums usually feel better within a few days. Bleeding and swelling typically improve over the following weeks. Your dental team re-measures the gums several weeks later to see how they have responded.
