Preventive and general dentistry
What happens at a dental check-up and clean?
A check-up and clean is an examination of the teeth, gums and bite, radiographs where needed, and removal of plaque, tartar and stain. It finds problems while they are still small enough to treat conservatively.
Why does prevention matter more in a conservative practice?
Because tooth structure does not grow back. Everything a dental professional does to a tooth after decay has started involves removing something, and each subsequent treatment on the same tooth tends to remove a little more. A practice built around preserving structure has an obvious interest in the problem being found early, when the answer is a small bonded filling rather than a crown.
The gap between the two is mostly time. Decay that is caught as a shadow on a radiograph or a soft spot in a groove can often be dealt with in one short visit. The same tooth two years later — when it starts hurting — may need considerably more work, because pain usually means the decay has reached the nerve or that a cusp has fractured.
The same logic applies to gum disease. Bleeding gums respond well to cleaning and better technique at home. Once the supporting bone around a tooth has been lost, it does not come back, and treatment shifts from reversing the problem to slowing it down.
How often should I have a check-up?
The honest answer is that it depends on you. The familiar six-month interval is a convention rather than a clinical rule. Someone with a low decay rate, healthy gums and few restorations may safely be seen less often. Someone with a dry mouth, active gum disease, a high-sugar diet, several large old fillings or a history of grinding may need to be seen more frequently than that.
A recall interval should be set after an examination, based on what your mouth is actually doing, and it should be revisited as things change. Pregnancy, a new medication that reduces saliva, orthodontic appliances, diabetes and smoking all shift the risk.
What does not change is the value of continuity. A dental professional who has seen the same tooth over several years can tell the difference between a stain that has been there since 2019 and a lesion that has grown. A single visit cannot show that.
If it has been years since your last visit, that is not a reason to delay further. Comprehensive examinations exist precisely for this situation, and the findings are more useful than the interval.
What is air polishing, and is it gentler than scaling?
Air polishing cleans teeth with a controlled stream of fine, soft powder carried in temperature-controlled water. It lifts plaque, biofilm and surface staining from the tooth without the scraping sensation and vibration that many people associate with hand and ultrasonic instruments.
It is particularly useful for patients who find conventional scaling uncomfortable, for people wearing fixed orthodontic appliances where brackets and wires trap plaque, and around existing crowns, veneers and bonded restorations, where the powder can clean margins without abrading the restoration surface.
It does not replace scaling entirely. Hardened calculus below the gumline still needs instrumentation to remove, and the examination still has to happen. Air polishing changes how the soft deposits and stain come off, which is the part most patients dislike.
- Soft powders in temperature-controlled water, rather than scraping
- Well suited to sensitive teeth, braces and existing restorations
- Removes biofilm and surface stain, including from grooves and between teeth
- Used alongside, not instead of, examination and scaling where calculus is present
What are fissure sealants and who needs them?
The chewing surfaces of back teeth are not flat. They carry deep, narrow grooves — fissures — that are often narrower than a single toothbrush bristle. Food debris and bacteria settle into them and cannot be brushed out, which is why the majority of decay in children starts on these surfaces rather than between the teeth.
A fissure sealant is a thin flowable coating bonded into those grooves so the surface becomes smooth and cleanable. Placing one involves no drilling and no injection. The tooth is cleaned and dried, the surface is conditioned, and the material is flowed into the grooves and set.
Sealants are most commonly placed on newly erupted permanent molars in children and teenagers, because that is when the grooves are deepest and the enamel is least mature. Adults with deep, stain-catching fissures and a history of decay are sometimes candidates too. They need checking at recall visits, since a sealant that has worn or chipped needs topping up.
What are tooth-coloured fillings made of, and how are they placed?
A modern filling is a bonded composite resin — a tooth-coloured material that is chemically adhered to the remaining tooth rather than wedged into an undercut. That distinction matters: an adhesive restoration does not require healthy tooth to be cut away purely to hold it in place, which is what amalgam preparations traditionally needed.
Placement is layered. Decayed tissue is removed selectively, the surfaces are prepared for bonding, and material is built up in increments, each one set before the next. Shades are chosen to match the surrounding tooth, including its translucency at the biting edge, so the finished restoration is difficult to pick out.
This takes longer than the fillings many people remember, and the reason is technique sensitivity rather than fuss. Adhesive bonding depends on the tooth being properly isolated from saliva and each step being given its time. Rushed bonding fails at the margin, and a failed margin is where new decay starts.
Back teeth are treated the same way as front teeth. A restoration that is invisible is usually also a restoration that has been contoured correctly, and contour is what determines how the tooth cleans and how it takes load.
What else does a check-up look for?
More than cavities. A thorough examination includes the soft tissues — cheeks, tongue, floor of mouth, palate and throat — screening for changes that need investigation. It also covers the bite: how the teeth meet, whether there is evidence of grinding or clenching, and whether wear facets, cracked cusps or recession suggest the teeth are being loaded in a way that will cause damage.
Existing restorations are assessed too. Old fillings develop marginal breakdown long before they hurt, and a leaking margin is a common cause of decay that has spread underneath a restoration that looked intact.
Where something is found, the conservative question comes first: what is the least intervention that will actually solve it? Sometimes the answer is monitoring and a change in home care rather than treatment.
Common questions
How much does a check-up and clean cost?
It depends on what the visit includes — whether radiographs are needed, how much calculus has built up, and whether the appointment is a routine recall or a comprehensive first examination. Contact the practice for a quote before booking.
Does professional cleaning damage enamel?
No. Scaling removes calculus from the tooth surface and air polishing uses soft powders selected not to abrade enamel. Sensitivity after a clean is usually short-lived and comes from exposed root surfaces being uncovered, not from enamel being removed.
My gums bleed when I brush. Should I brush less?
No — bleeding gums are usually inflamed gums, and inflammation is caused by plaque sitting at the gumline. Brushing and cleaning between the teeth properly typically settles it within a couple of weeks. If bleeding persists beyond that, have it examined.
Do I still need check-ups if nothing hurts?
Yes. Decay and gum disease are both painless for most of their course. By the time a tooth hurts, the problem is generally larger and the treatment more involved. Examinations exist to find things before they announce themselves.
Are fissure sealants only for children?
They are most often placed on children's newly erupted permanent molars, but adults with deep grooves and a history of decay can benefit too. Whether they are appropriate depends on the shape of your teeth and your decay risk.
Does medical aid cover preventive dentistry?
Cover varies considerably between schemes and plan options, and many schemes treat examinations and cleanings differently from restorative work. Check your benefits with your scheme, and ask the practice for treatment codes so you can confirm before proceeding.