What Is Dental Prophylaxis?

Dental prophylaxis is another name for a dental check-up or dental cleaning. It refers to dental care done to protect your teeth and prevent gum disease. It includes a full examination of your mouth and teeth, as well as a thorough cleaning using an ultrasonic scaler, pick, or other tools to remove tartar, plaque, and calcifications. The teeth are then polished, and a fluoride treatment or dental sealant are applied.

In addition to the above, X-rays may be taken if a cavity is suspected or it has been a while since you had images taken.

This article discusses dental prophylaxis and preventive oral care. It provides a detailed explanation of different types of dental prophylaxis and what to expect the next time you see your dentist for a check-up.

Dental Prophylaxis Services

Dental services that are considered prophylactic (or preventative) include:

• Dental exams
• X-rays
• Cleaning
• Scaling or root planing
• Flossing and polishing
• Fluoride treatments or sealants

Each service provides a different function for your teeth.

• Dental exams: Check the mouth for cavities, gum disease, oral cancer, and more
• X-rays: Check for any signs of tooth decay
• Cleanings: Performed by a dental hygienist or dentist to remove plaque and calculus (also called tartar)
• Scaling or root planing: A form of cleaning or scraping to remove tartar and other deposits from teeth
• Flossing: Removes food and dental plaque between teeth
• Polishing: Cleans teeth with a pumice-type paste that removes stains and dental plaque build-up
• Fluoride treatments or sealants: A dental treatment (usually for kids) to prevent tooth decay

Dental Prophylaxis for Kids

Children have unique needs when it comes to dental care. They are extremely vulnerable to decay and other dental problems. One review by the American Academy of Pediatrics states: "Poor oral health is one of the most common health conditions of childhood in the United States.” 

Pediatric dentists specialize in helping children who experience fear and anxiety related to dental visits. The primary goal of early intervention of prophylaxis for young children is to get them accustomed to seeing the dentist early on.

This way, the dentist can administer preventative procedures when needed—such as sealants and fluoride treatments—to prevent tooth decay down the road.

Effectiveness of Prophylaxis Services

There are many recommendations about dental prophylactic measures, including how often each procedure should be done. How effective are these recommendations? Do they really help prevent tooth decay and gum disease? What does the scientific research say?

The journal Evidence-Based Dentistry (EBD) is committed to measuring the effectiveness of dental prophylactic practices. It provides reviews or summarizes reviews from other organizations. The EBD puts together evidence about what is working and what is not when it comes to dental procedures.

Do Regular Dentist Visits Prevent Problems?

A review of 36,000 kids from the Children’s Health Insurance Program (CHIP), found preventative visits were linked with fewer dental appointments for fillings and other restorative care in the future.

Contrary to many dentists' recommendations, however, the study authors reported that it was not actually cost-effective for children to see the dentist twice each year. 

However, it could be that kids who visit the dentist regularly don't have dental issues later on or that children who get sealants may be protected against other dental issues that would require more dentist visits.

Are Dental X-Rays Necessary?

Dental x-rays are a standard procedure at most annual dental prophylactic appointments. According to The American Dental Association (ADA), not everyone needs to get yearly X-rays, especially those who have no apparent dental problems. 

The ADA reports that adults who brush properly and take good care of their teeth (and have no cavities or gum/oral conditions) only need X-rays every two to three years.

Do You Need a Yearly Dental Prophylaxis (Cleaning)? 

The American Dental Association (ADA) recommends scheduling dental visits at intervals determined by your dentist. 

Yearly cleanings may not always be necessary. A review of eight studies that measured the impact of routine dental cleaning was inconclusive about whether scaling and polishing procedures provide more benefits or harm.

One potential harm from dental scaling is called periprosthetic joint infection resulting from bacteremia (bacteria in the blood). This occurs as a result of the agitation of the gums, causing bacteria to travel from the mouth into the bloodstream.

Treating dental patients with antibiotics before dental cleaning and/or restorative procedures is a preventative measure that can be used for people at risk of complications from bacteremia.

Many studies have shown the presence of bacteremia immediately following gum agitation from dental procedures but this doesn’t indicate that regular dental cleaning shouldn't be done.

What Do Sealants and Fluoride Treatments Do?

Sealants. The use of sealants—and not the preventative dental exam itself—may be the main reason for long-term protective effects against tooth decay.

Dental sealants can be applied by a dental hygienist—without an accompanying examination by a dentist—making it more cost-effective.

Fluoride treatments. Also known as fluoride varnishing, many research studies have shown fluoride varnish helps prevent tooth decay. In fact, the U.S. Preventative Services Task Force (USPSTF) recommends:

• Fluoride supplementation—also known as dietary fluoride supplementation—in geographic areas of the country where the water is not fluoridated
• Flouride varnish applied to primary teeth (baby teeth) for moderate tooth decay prevention.

Is Flossing Important?

Dental flossing is usually done by the dental hygienist after scaling and before polishing. 

According to a Cochrane Database of Systemic Reviews, flossing was found to lower the incidence of gingivitis (inflammation of the gums) when combined with brushing. 

However, the researchers also found in this study that flossing had no impact on plaque removal or lowering the incidence of tooth decay.

How Much Does Dental Cleaning Cost?

A 2016 survey of over 600 dentists, showed an average cleaning cost between $90 to $120. The cost may vary depending on where you live and the charges may be more if you have excessive plaque and tartar build-up.

If your dental visit involves a consultation from the dentist that includes x-rays, a full-mouth exam, impressions, or other procedures there will be additional fees.

Dental insurance may lower your costs if it's provided by an employer and your monthly premiums are either free or inexpensive. Insurance typically covers the cost of dental cleanings twice per year and most or all of the cost of x-rays.

For other procedures, like fillings or crowns, there is usually a shared cost between you and the insurance provider. It is always best to talk with your insurance provider to understand your out-of-pocket expenses.

How to Prevent Dental Problems

One aspect of dental prophylaxis is to teach patients how to perform preventative measures at home, such as correct techniques for regular flossing and brushing.

Dental Brushing

The most impactful preventative action that dentists teach their patients is that regular brushing is advantageous to oral health, lending itself to lowering the incidence of dental cavities. According to one Cochrane review, it's important that fluoride toothpaste is used.

When it comes to how often a person should brush the teeth for optimal results, there haven't been a lot of studies conducted that provide reliable information. The studies that have been done, however, generally support brushing twice per day.

A Word From Verywell

It's important to recognize that dental prophylaxis research contradicts some of the current standards of dental care. Various studies and reviews do support the idea of brushing two times each day with fluoride toothpaste for good oral health. For kids, the evidence strongly supports the use of fluoride varnish or sealants. Whether other recommended dental prophylaxis procedures are 100 percent necessary for oral health, however, requires further research.