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{{Short description|Oral hygiene practice}}
[[File:"An Elephant Never Forgets" (15866594818).jpg|thumb|Poster encouraging [[tooth brushing]] (New Zealand, 1950s).]]

'''Teeth cleaning''' is part of [[oral hygiene]] and involves the removal of [[dental plaque]] from [[Human tooth|teeth]] with the intention of preventing [[Dental caries|cavities]] (dental caries), [[gingivitis]], and [[periodontal disease]].

People routinely clean their own teeth by [[toothbrush|brushing]] and [[Interdental brush|interdental cleaning]], and [[dental hygienist]]s can remove hardened deposits ([[calculus (dental)|tartar]]) not removed by routine cleaning. Those with [[dentures]] and natural teeth may supplement their cleaning with a [[denture cleaner]].

== Brushing, scrubbing and flossing ==
{{main|Tooth brushing|Dental floss}}

=== Brushing ===
Careful and frequent brushing with a [[toothbrush]] helps to prevent build-up of [[dental plaque|plaque]] bacteria on the teeth.<ref>{{cite web |last=Curtis |first=J. |date=13 November 2007 |title=Effective Tooth Brushing and Flossing. |url=http://www.webmd.com/oral-health/effective-tooth-brushing-and-flossing |access-date=2007-12-24 |website=[[WebMD]]}}</ref> [[Electric toothbrush]]es were developed, and initially recommended for people with strength or dexterity problems in their hands, but they have come into widespread general use. The effectiveness of electric toothbrushes at reducing plaque formation and gingivitis is superior to conventional manual toothbrushes.<ref>{{cite journal | vauthors = Yaacob M, Worthington HV, Deacon SA, Deery C, Walmsley AD, Robinson PG, Glenny AM | title = Powered versus manual toothbrushing for oral health | journal = The Cochrane Database of Systematic Reviews | issue = 6 | article-number = CD002281 | date = June 2014 | volume = 2014 | pmid = 24934383 | pmc = 7133541 | doi = 10.1002/14651858.CD002281.pub3 }}</ref>

'''Instructions'''<br />
Source:<ref>{{Cite web|last=American Dental Association|date=2005|title=How to Brush|url=https://www.ada.org/~/media/ADA/Science%20and%20Research/Files/watch_materials_brush.pdf?la=en |access-date=October 2, 2020|website=American Dental Association}}</ref>

Ensuring effective brushing is important in getting rid of food and bacteria properly.

Step 1) Place a pea-sized amount of toothpaste on the brush and hold at a 45-degree angle.

Step 2) In small circular and back and forth motions, move the brush gently along teeth and gums.

Step 3) Brush all surfaces inside the mouth, including the tongue. Ensure that the back sides of the teeth (top and bottom rows) are being cleaned by brushing vertically in up and down motions.

Tip) It is recommended to use a 2/2 strategy which includes brushing two minutes in the morning and two minutes at night as a minimum standard for healthy gums and teeth.
=== Flossing ===
[[File:Dental floss (whole).jpg|thumb|Dental floss]]
In addition to brushing, cleaning between teeth may help to prevent build-up of [[dental plaque|plaque]] bacteria on the teeth. This may be done with [[dental floss]] or [[interdental brush]]es.

80% of cavities occur in the grooves, or pits and fissures, of the chewing surfaces of the teeth,<ref name="pmid2179337">{{cite journal |vauthors=Groeneveld A, Van Eck AA, Backer Dirks O |date=February 1990 |title=Fluoride in caries prevention: is the effect pre- or post-eruptive? |journal=Journal of Dental Research |volume=69 Spec No |issue=2_suppl |pages=751–755; discussion 820–823 |doi=10.1177/00220345900690S145 |pmid=2179337 |s2cid=32601535}}

* {{cite web |date=January 1, 2007 |title=Questions & Answers |url=http://www.healthyteeth.us/Questions___Answers/questions___answers.html#DoesWaterFluoridationAffect |archive-url=https://web.archive.org/web/20070730170432/http://www.healthyteeth.us/Questions___Answers/questions___answers.html#DoesWaterFluoridationAffect |archive-date=2007-07-30 |website=Healthy Teeth for a Lifetime}}</ref> however, there is no evidence currently showing that normal at-home flossing reduces the risk of cavities in these areas.<ref>{{cite journal | vauthors = Hujoel PP, Cunha-Cruz J, Banting DW, Loesche WJ | title = Dental flossing and interproximal caries: a systematic review | journal = Journal of Dental Research | volume = 85 | issue = 4 | pages = 298–305 | date = April 2006 | pmid = 16567548 | doi = 10.1177/154405910608500404 | s2cid = 53789465 }}</ref>

Special appliances or tools may be used to supplement toothbrushing and interdental cleaning. These include special [[toothpick]]s, [[oral irrigator]]s, and other devices. A 2015 Cochrane review found insufficient evidence to determine whether the interdental brushing decreases the levels of plaque when compared to flossing.<ref>{{cite journal | vauthors = Poklepovic T, Worthington HV, Johnson TM, Sambunjak D, Imai P, Clarkson JE, Tugwell P | title = Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults | journal = The Cochrane Database of Systematic Reviews | issue = 12 | article-number = CD009857 | date = December 2013 | pmid = 24353078 | doi = 10.1002/14651858.CD009857.pub2 | doi-access = free | pmc = 6481275 }}</ref>

== Professional teeth cleaning ==
[[Image:Tooth polishing 9332.JPG|thumb|[[Dental hygienist]] polishing a person's teeth]]

Teeth cleaning (also known as ''[[prophylaxis]]'', literally a preventive treatment of a disease) is a procedure for the removal of [[calculus (dental)|tartar]] (mineralized plaque) that may develop even with careful brushing and flossing, especially in areas that are difficult to reach in routine toothbrushing. It is often done by a [[dental hygienist]]. Professional cleaning includes [[tooth scaling]], [[tooth polishing]], and [[Debridement (dental)|debridement]] if too much [[Calculus (dental)|tartar]] has accumulated. This involves the use of various instruments or devices to loosen and remove deposits from the teeth. The American Dental Association has designated the code D1110 for adult prophylaxis or dental cleaning and has also designated the code D1120 for the same procedure in children.

As to the frequency of cleaning, research on this matter is inconclusive. That is, it has ''neither'' been shown that more frequent cleaning leads to better outcomes ''nor'' that it does not. A review of the research literature on the question concluded "[t]he research evidence is not of sufficient quality to reach any conclusions regarding the beneficial and adverse effects of routine scaling and polishing for periodontal health and regarding the effects of providing this intervention at different time intervals".<ref>{{cite journal | vauthors = Bader J | title = Insufficient evidence to understand effect of routine scaling and polishing | journal = Evidence-Based Dentistry | volume = 6 | issue = 1 | pages = 5–6 | year = 2005 | pmid = 15789039 | doi = 10.1038/sj.ebd.6400317 | doi-access = free }}</ref> Thus, any general recommendation for a frequency of routine cleaning (e.g. every six months, every year) has no empirical basis.<ref>{{cite web|url=http://askthedentist.com/how-often-should-i-go-to-the-dentist-for-a-teeth-cleaning/|title=How Often Should I Go to the Dentist for a Teeth Cleaning?| vauthors = Burhenne M |work=Ask the Dentist|date=19 August 2010 }}</ref><ref>{{Cite journal|last1=Lamont|first1=Thomas|last2=Worthington|first2=Helen V.|last3=Clarkson|first3=Janet E.|last4=Beirne|first4=Paul V.|date=2018-12-27|title=Routine scale and polish for periodontal health in adults|journal=The Cochrane Database of Systematic Reviews|volume=12|issue=4 |article-number=CD004625|doi=10.1002/14651858.CD004625.pub5|issn=1469-493X|pmc=6516960|pmid=30590875}}</ref> Professional dental cleaning reduces systemic inflammatory markers such as [[Tumor necrosis factor|TNF-α]], [[Interleukin 6|IL-6]] and [[C-reactive protein|CRP]], supporting a beneficial link between periodontal treatment and [[Cardiovascular disease|cardiovascular risk]] reduction.<ref>{{Cite journal |last1=Cardisciani |first1=Martina |last2=Di Nicolantonio |first2=Sara |last3=Altamura |first3=Serena |last4=Ortu |first4=Eleonora |last5=Del Pinto |first5=Rita |last6=Pietropaoli |first6=Davide |date=2025-08-28 |title=Temporal dynamics of early inflammatory markers after professional dental cleaning: a meta-analysis and spline-based meta-regression of TNF-α, IL-1β, IL-6, and (hs)CRP |journal=Frontiers in Immunology |language=English |volume=16 |doi=10.3389/fimmu.2025.1634622 |doi-access=free |issn=1664-3224}}</ref>

== Complications ==

Overly vigorous or incorrectly performed brushing or flossing may cause injury to the [[gingiva]] (gums). Improper or over-vigorous brushing may cause sore gums, damage to tooth enamel, [[gingivitis]], and bleeding gums. Dentists and dental hygienists can instruct and demonstrate proper brushing or flossing techniques.<ref>{{Cite web| vauthors = Donovan J | veditors = Wyatt AD Jr | title = Toothbrushing Mistakes You Make and How to Fix Them | website= Web MD | date = 12 November 2007 | url = http://www.webmd.com/content/tools/1/slide_brush_teeth.htm | access-date = 2007-12-24 }}</ref>

[[Aerosol]]s generated during dental cleaning procedures may spread infection.<ref>{{cite journal | vauthors = Harrel SK | title = Airborne spread of disease--the implications for dentistry | journal = Journal of the California Dental Association | volume = 32 | issue = 11 | pages = 901–6 | date = November 2004 | doi = 10.1080/19424396.2004.12224042 | pmid = 15651466 | s2cid = 22045777 }}</ref> During the [[COVID-19 pandemic]] on 12 August 2020, the [[World Health Organization]] recommended that routine dental checkups be delayed in areas of community transmission.<ref>{{Cite news | vauthors = Nebehay S |date=2020-08-12|title=Delay routine dental checkups in areas of COVID spread: WHO|language=en|work=Reuters|url=https://www.reuters.com/article/us-health-coronavirus-who-dental-idUSKCN2571WJ|access-date=2020-08-12}}</ref> Characteristics and detection rate of SARS-CoV-2 in alternative sites and specimens related to dentistry has been extensively reviewed.<ref>{{cite journal | vauthors = Shirazi S, Stanford CM, Cooper LF | title = Characteristics and Detection Rate of SARS-CoV-2 in Alternative Sites and Specimens Pertaining to Dental Practice: An Evidence Summary | journal = Journal of Clinical Medicine | volume = 10 | issue = 6 | page = 1158 | date = March 2021 | pmid = 33802043 | pmc = 8000787 | doi = 10.3390/jcm10061158 | doi-access = free }}</ref>

== Disinfection ==
{{Expand section|date=June 2022}}
Antiseptics help reduce the number of microorganisms present in the oral cavity.<ref>{{Cite journal |last= |date=2014 |title=Efficacy of preprocedural mouth rinsing in reducing aerosol contamination produced by ultrasonic scaler |journal=J Periodontol |issue=85 |page=4}}</ref> [[Chlorhexidine|Antiseptics]] are recommended for both daily home care regimens and for use in the dental office setting. These products are used as a preprocedural rinse to reduce bacterial counts prior to routine dental treatments and injections.<ref name=":0">{{Cite book |title=Wilkins' Clinical Practice of the Dental Hygienist |publisher=Jones and Bartlett |year=2021 |isbn=978-1-496-39627-3 |edition=13 |page=422}}</ref>

A common antiseptic rinsing agent used in the dental office is a 0.2% chlorhexidine product which provides a lowered bacterial count for more than 60 minutes.<ref>{{Cite book |last=Boyd |first=Linda D. |title=Wilkins' clinical practice of the dental hygienist |date=2021 |others=Lisa F. Mallonee, Charlotte J. Wyche, Esther M. Preceded by: Wilkins |isbn=978-1-4963-9627-3 |edition=13 |location=Burlington, MA |oclc=1096288166}}</ref>

== Acidity and decay relationship ==
{{Expand section|date=June 2022}}
The regulation of acid production and exposure in the oral cavity is of the utmost importance to maintain healthy enamel. When enamel, cementum, and /or dentin are subjected to an increased number of [[Acidogenesis|acidogenic]] and [[aciduric bacteria]] in dental [[biofilm]], the demineralization process begins. When acidogenic and aciduric bacteria predominate the oral flora, there is an increased risk of developing caries.<ref name=":0" />

=== Reducing acid exposure ===
Dietary habits:

* Reduce fermentable carbohydrate intake frequency
* Limit snacking between meals and in the middle of the night
* Avoid acidic beverages between meals
* Use xylitol gum or mints between meals

==History==
Historically, professional tooth cleaning was sometimes referred to as ''odontexesis'' (literally "tooth-scraping")<ref name=Denton1958>{{cite book|title=The Vocabulary of Dentistry and Oral Science: A Manual for the Study of Dental Nomenclature| vauthors = Denton GB |date=1958|publisher=Bureau of Library and Indexing Service, American Dental Association}}</ref> or ''odontexis'' ("scraping off"),<ref name="Denton1958" /> and the instruments involved ''odontoglyphs''.<ref name=":1">{{cite book |title=Wilkins' Clinical Practice of the Dental Hygienist |publisher=Jones and Bartlett |year=2021 |isbn=978-1-496-39627-3 |edition=13 |page=4}}</ref>

Alfred C. Fones, known as the "father of dental hygiene," was the first to develop the role of a dental hygienist into the current concept of a dental educator and dental professional. The dental hygienist is qualified, same as a dentist, to perform routine dental cleanings.<ref name=":1" />

== References ==
{{Reflist|30em}}

== External links ==
*[https://www.who.int/health-topics/oral-health/#tab=tab_1 World Health Organization site on oral health]
*[https://www.cosmeticdentistryclinic.co.uk/dental-hygienist-london Cosmetic Dentistry Clinic site on Dental Hygienist]
{{Dentistry}}

[[Category:Dentistry procedures]]
[[Category:Oral hygiene]]

[[ru:Чистка зубов]]
[[sv:Tandhygien]]

Teeth cleaning - Revision history

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