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I am curious if there is a standard regimen that a dentist uses for cleaning teeth, how standardized it is, and what is the rationale for that process over say some other.

The process my dentist seems to use is to ask me to swig with peroxyl swish it around for 30 seconds and then spit it out. What's going on with that?

Then he/she tends to scrape up and down between the teeth as an inspection of how much tartar has been built up. Then with a water rinse he scrapes specific areas and uses a cavitron machine/water pick like thing, but I think there two he/she is mostly working in between the surfaces. This tool also has access to the back of the teeth.

Then finally does he apply toothpaste, and again he applies to the the back of the teeth as well as front. The time spent on this phase seems pretty small in contrast to the time with scraping the teeth either with a dental tool or the cavitron.

Is this standard? Any thoughts on why this process or another one?

Notes regarding the accepted answer:

Although the accepted answer is informative and detailed, it focuses on the "periodontal" aspects, which doesn't cover the part at the beginning where the dentists asks me to rinse my mouth, sometimes with water or with some bluish stuff that when I asked was called peroxyl. Nor the part where he/she applies toothpaste. I believe most dentists as part of their routine do something with the swish at the beginning, and toothpaste. Also, dentists periodically take xrays to look for cavities.

The answer is also a little light on the benefit of each of the steps, or why things are done in that order if it matters. One can kind of read between the lines to infer why each step might be useful and why a particular step might be done before another. Part of understanding and improving such process requires a little understanding and introspection of what needs to be done, how each step achieves that, and what are the alternative ways to achieve the various goals.

There can be a bit of fuzziness (if not a lack of critical thought) when it comes to dental processes and explanations.

  • Answer incoming. – enap_mwf May 19 '18 at 19:56
  • Rocky, I have found the deep cleaning done by a periodontist is far superior to the cleaning you get from a general dentist. It costs a bit more money but it's good to know that each cleaning you get, both your teeth and gums are cleaned thoroughly. Also, my periodontist doesn't use a polishing rubber cap tool - I feel that's a bit abrasive. Instead, they use this machine that sprays a cool mixture of dental grade baking soda and salt. So the "variation" in cleaning technique is significant, if you change practitioners. Good luck! – Jalapeno Nachos Jul 17 '18 at 23:02
  • I don't doubt a periodontist does better cleaning, since he/she is focusing on the part that is probably the most important. Now let's focus on the money part. A lot of what dentists you can do using less fancy tools which might not do as good a job, but you have the advantage that if you do it more often, in the long run it might do better. But what is lacking in most cleaning regimens is how to measure effectiveness. With a little guidance you can detect/feel/see film and plaque and gauge where it is and know how well you are cleaning your teeth – rocky Jul 17 '18 at 23:51
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Your question seems to be about the "cleaning" or periodontal maintenance portion of your appointment. (Periodontistry is a field in dentistry which is concerned with the gums or soft tissues around teeth)

As part of an initial exam or routine checkup, many dentists and their hygienists will perform all or some of the following steps:

  • Assess if there were changes in your health (medical history).
  • Perform a dental exam, including taking the necessary radiographs. It is here that the dentist uses a periodontal probe, an instrument that looks like a ruler to mesure the depth of the crevice around teeth (the space between the gums and the tooth) to assess changes in your periodontal "gum" health.

Periodontal Probe that is also my profile picture, most likely the UNC-15

During the second half of the appointment or at another date, the dentist and hygienist will proceed as follows:

  • Performe anesthesia ("Freezing"), if going far bellow the gums, which allows the scalling and root planing (S&RP - Deep cleaning) of the roots with minimum discomfort to the patient.
  • Some clinics have a mouth rinsing protocol to reduce the amount of bacterias preoperatively, to avoid having the bacterias in the aerosols produced by the cleaning. I don't have literature that supports the assumed purpose of this intervention. The fastest way would be to simply ask your dentist.
  • Use a water-cooled ultrasonic scaler (for instance Cavitron®) to break up most of the calculus. This shortens the appointment times considerably, but produces aerosols which may contain bacteria. Cavitron® universal tip
  • Use manual hand-instruments such as curettes to remove any remaining calculus on and in-between the teeth. Gracey® Curettes, of various calibres and angulations
  • Use an abrasive past to perform prophylactic (preventive) smoothing and polishing of the teeth surfaces. This step is necessary to discourage plaque from latching onto the freshly scaled surfaces, which can be rough at the microscopic level. This makes your home care more efficient too and can help decrease the frequency of appointments. If the previous 2 steps were done, this should take a minimal amount of time.

If severe gum disease is already present or for whatever reason the attempts at nonsurgical therapy are unsuccessful, a Surgical therapy can be planned and initiated, but this goes beyond the scope of your original question.

For a more in-depth look at basic and non-surgical periodontal care, one can look at the following article: https://www.ncbi.nlm.nih.gov/pubmed/11155183

N.B.: This is a general explanation of what is done in dentistry, and should not be taken as a treatment plan specifically for you or anybody else, as per Health.SE rules.

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    This is good. I will leave it unchecked a little while longer. From the link: "Regular home care by the patient in addition to professional removal of subgingival plaque is generally very effective in controlling most inflammatory periodontal diseases. ... adjunctive chemotherapeutic agents for controlling plaque and gingivitis could be as simple as placing the patient on an antimicrobial mouthrinse and/or toothpaste with agents such as fluorides, chlorhexidine or triclosan, to name a few." So why is there little mention of this in the daily regime? And hydrogen perixode may be just fine. – rocky May 20 '18 at 1:59
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    @rocky chemical agents (mouth washes amongst others) work best once the layers of biofilm have been mechanically reduced (flossing and toothbrushing), and are applied on a regular basis. No rush to check it as the right answer, let’s see if other people can contribute. – enap_mwf May 20 '18 at 2:04
  • Instead there is all of this focus in the daily regime on inefficient toothbrushes, and toothpaste (rather than peroxyl or hydrogen peroxide) which would be more effectively used if you separate the debriding from the polishing as dentists do. Or ways to remove daily plaque which includes the back of the teeth. – rocky May 20 '18 at 2:04
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    I don't dispute the superior qualiities of clorhexidine. As for the safety and effectiveness of the cheaper and more readily available H2O2 at 3% concentration there is joponline.org/doi/abs/10.1902/jop.1995.66.9.786 " Studies in which 3% H2O2 or less were used daily for up to 6 years showed occasional transitory irritant effects only in a small number of subjects with preexisting ulceration, or when high levels of salt solutions were concurrently administered. ... In patients, prolonged use of hydrogen peroxide decreased plaque and gingivitis indices." – rocky May 20 '18 at 3:06
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    @rocky to be fair, in both medicin and dentistry many things aren’t evidence based. That includes flossing. – enap_mwf May 20 '18 at 4:00

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