Most people squeegee the shower after they use it. It takes thirty seconds and keeps the glass from spotting. But every so often the shower still needs a proper cleaning: the corners, the grout, the showerhead. Nothing you do after each shower gets to those. Your teeth work the same way.
Brushing and flossing are the squeegee. They’re essential, they’re daily, and they handle most of the job. A hygiene visit is the deep clean. It gets to the places daily care can’t reach, and it’s the only time someone looks closely at what’s been building up since the last one.
What a cleaning removes that you can’t
Plaque is soft, and a toothbrush and floss can clear it. Plaque that stays put doesn’t stay soft. Minerals from your saliva harden it into tartar, also called calculus, and once it’s hard, no toothbrush, floss or rinse will take it off. It has to be removed with instruments. (If you’re wondering what mouthwash does do, we cover that separately.)
Tartar matters because of where it collects: along and just under the gum line, in the spaces between teeth, and behind the lower front teeth where the saliva glands empty. Its rough surface holds more plaque, and plaque sitting against the gums is what drives gum disease. That’s the corner of the shower your squeegee never touches.
Gingivitis: the stage you can still undo
Bleeding gums are a sign of inflammation, and they aren’t normal. A lot of people assume a little pink in the sink is just what happens when you brush. Imagine if your fingernails bled every time you pushed back a cuticle. You’d call a doctor. Gums that bleed when you brush or floss are telling you the same thing.
Healthy gums don’t bleed. If yours do, that’s inflammation, and it’s the earliest sign of gum disease.
That early stage is called gingivitis: gums that are red, a little puffy, and bleed when touched. At that stage nothing permanent has happened. Remove the plaque and tartar, keep it off, and the gums settle back to healthy.
Left alone, gingivitis can progress to periodontitis, where the inflammation starts destroying the bone that holds the teeth in. Bone lost that way doesn’t grow back on its own. So the cheapest, easiest moment to deal with gum disease is the moment most people ignore, because bleeding gums don’t hurt.
Your gums and the rest of your body
You’ve probably heard that gum disease is linked to heart disease. It is, and it’s worth being accurate about how. The American Heart Association reviewed the evidence and found that people with gum disease do have more heart and blood vessel disease, even after allowing for the risks the two share, like smoking and diabetes. What the evidence doesn’t show is that gum disease causes heart disease, or that treating your gums will prevent a heart attack.
Lockhart PB, Bolger AF, Papapanou PN, et al. Periodontal disease and atherosclerotic vascular disease: does the evidence support an independent association? A scientific statement from the American Heart Association. Circulation. 2012;125(20):2520-2544.
Diabetes is where the connection is clearest, and it runs in both directions. Diabetes raises the risk of gum disease, and treating gum disease lowers HbA1c by roughly 0.3 to 0.6 points at three months in pooled trials, a change comparable to adding a diabetes medication, though it fades somewhat by six months. If you have diabetes or pre-diabetes, your gums are part of that picture. Smoking matters here too, and it hides the bleeding that would normally warn you.
The other half of the visit: someone looking
The car version of this is the difference between a car wash and a service. You can keep a car spotless and still need someone to check the oil, the brakes and the tires every few months. Nothing about a clean car tells you the brake pads are thin.
A hygiene visit here is an hour, and the cleaning is only part of it. Every visit is a chance to compare your mouth against the last time we saw it, which is the only way to catch something that’s moving slowly: a cavity while it’s still small enough for a filling, early bleeding or bone loss around a tooth, an old filling starting to fail at the edge, or a change in the soft tissues. Most people see Dr. Sandquist for an exam twice a year alongside their cleanings, and if your cleanings are spaced further apart, so are your exams. That’s part of the trade-off of a longer interval. Every exam includes a check of the tongue, cheeks, floor of the mouth and throat.
Your hygiene visits are with Cathy or Helene, our hygiene team.
The benefit that shows up over decades
The clearest evidence for regular hygiene care isn’t about how clean your teeth feel next week. It’s about how many of them you still have in thirty years.
A Swedish practice followed 375 adults on a hygienist-led prevention program for thirty years, with visits every three to twelve months depending on each person’s need. Over those three decades, they lost on average between 0.4 and 1.8 teeth each, and in the whole group only 21 teeth were lost to gum disease or decay.
Axelsson P, Nyström B, Lindhe J. The long-term effect of a plaque control program on tooth mortality, caries and periodontal disease in adults. Results after 30 years of maintenance. J Clin Periodontol. 2004;31(9):749-757.
The effect is strongest in people who’ve had gum disease. A review pooling eight long-term studies found that patients who kept up their periodontal maintenance visits had about 44% lower risk of losing teeth than patients who came in erratically.
Lee CT, Huang HY, Sun TC, Karimbux N. Impact of patient compliance on tooth loss during supportive periodontal therapy: a systematic review and meta-analysis. J Dent Res. 2015;94(6):777-786.
If you’ve been treated for gum disease, your maintenance visits are the treatment now. They’re what keeps the bacteria from building back up to the level that caused the damage in the first place.
Is it a scam?
You’ll find people online who say routine cleanings are a scam. It’s worth knowing where that comes from, because there’s something real in it.
A 2018 Cochrane review looked at routine cleanings in healthy, low-risk adults who were already seeing a dentist regularly. Over two to three years, cleanings every six or twelve months made little difference to gum inflammation compared with no scheduled cleanings, though they did reduce tartar.
Lamont T, Worthington HV, Clarkson JE, Beirne PV. Routine scale and polish for periodontal health in adults. Cochrane Database Syst Rev. 2018;12:CD004625.
Here’s what that research didn’t show. The studies ran two to three years, not twenty, and they didn’t measure tooth loss at all. They only included people without serious gum disease, the people least likely to be harmed by skipping a visit. And every one of them was already a regular attender, with years of professional care behind them.
What it does support is something we already believe: not everyone needs the same schedule. A twice-a-year cleaning for everyone, regardless of what’s going on in their mouth, is a habit, not a diagnosis.
How often you need one
It depends on two things: how your gums are doing, and how well plaque is being controlled at home. If you’re diligent at home and your gums are healthy, your hygiene visits don’t need to be as frequent, and we’ll tell you so. If buildup comes back fast, or bleeding is part of the picture, we’ll want to see you sooner. If you’ve been treated for gum disease, it’s every three months. Our cleaning and prevention page covers how we set that interval.
If cost is what keeps you from coming in, our membership plans bundle the visits you need at a lower fee, including a version built around more frequent cleanings.
Where to start
Some people never deep-clean the shower, and some people never get the oil changed. The shower gets away with it longer than the car does. Your teeth are closer to the car.
If it’s been a while, the first visit is simply a look at where things stand. Call 702-734-0776, or read what a first visit here involves. If what’s kept you away is the appointment itself, there’s a page about that too.