# Dental 'Deep Cleanings' a quasi-scam? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [May 14, 2010, 8:50pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474 "2010-05-14T20:50:21Z")\ **Posts on this page:** 20\ **Page:** 3
**Author:** ![Ann\_Hedonia](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ann_hedonia/32/319_2.png) [@Ann\_Hedonia](https://boards.straightdope.com/u/Ann_Hedonia)\ **Post date:** [October 21, 2014, 12:33pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/41 "2014-10-21T12:33:24Z")
> [@jupiteruno](#): > > Granted, my dental care was neglected once I lost my insurance 7 years ago, and I am aware some fillings fell out and some decay happened. But I’m almost 66 years old, my gums look fine, teeth are not loose at all, I have NO insurance and the dentist is pressing me for this deep scaling that will cost $900!!! I think I’ll get the fillings replaced, floss twice a day and forego the deep scaling!!! If my dentist tried to charge me $900 for a scaling ( he doesn’t call it deep-cleaning and I like it that he doesn’t dumb things down ) I’d be skeptical too. I had one ONCE on his recommendation - I’ve been a patient of his for over 10 years. But it cost $400 and this is an office located in Midtown Manhattan. He’s never recommended it since…even though I’ve asked if he thought I needed it done again. You’ll think I’m crazy but even though I hate going to the dentist I LOVE deep cleanings…it may hurt a little but it hurts in the same feel-good way that a good massage hurts…I call it the dental spa treatment. ---
**Author:** ![Sir\_T-Cups](https://avatars.discourse-cdn.com/v4/letter/s/ed655f/32.png) [@Sir\_T-Cups](https://boards.straightdope.com/u/Sir_T-Cups)\ **Post date:** [October 21, 2014, 12:45pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/42 "2014-10-21T12:45:05Z")
This thread is very interesting to me and thanks for zombifying it. I haven’t had insurance for around 6 years now, and haven’t been to a dentist because of it. I got a Groupon for a dentist who tells me I have 8 (I think it was 8…coulda been 9) cavities and gives me a “deal” to fix them for $22,000 or whatever stupid high number he gave me. Never did it cuz I never had the money, and since then I’m scared to go back. Whenever hell freezes over and I get a job/insurance again I’m weargard(worried and eager) to go to a new dentist, not tell them my predicament, and see what their xrays say. This thread has given me a bit of piece of mind though. Crooked dentists…whoda thought? ---
**Author:** ![FairyChatMom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fairychatmom/32/21906_2.png) [@FairyChatMom](https://boards.straightdope.com/u/FairyChatMom)\ **Post date:** [October 21, 2014, 6:58pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/43 "2014-10-21T18:58:54Z")
We just recently changed dentists because my husband was very unhappy with the way they treated him. When I was looking for a new practice, I did a little research on line and came across [this](http://benemax.go2dental.com/ReaderDigestArticle.pdf)- very enlightening!! Everyone should read and heed!! ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [October 21, 2014, 10:38pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/44 "2014-10-21T22:38:34Z")
> [@LynnM](#): > > Pardon my naive question–I’ve never done this–how do you go about getting a second opinion? Well, first you find another dentist… > [@](#): > > Does dental insurance typically pay the cost for getting a second opinion? Not usually, no. However, you can always _ask_ if they’ll do that. If you explain the situation they might approve it. Or they might not. > [@](#): > > Do you tell the second dentist your visit is only for a second opinion? Does dentist then reduce or waive the cost? Or is it treated like a regular dental checkup, for which you pay normal cost? In my particular case I was explicit I was looking for a second opinion. I waited sufficient time (fending off calls from the pushy dentist for months) until my insurance would pay for the visit. You can always ask for a reduced price… they worst he’ll say is no, right? Then you have to decide if you’ll pay out of pocket or not. But, to my mind, paying $100 to make sure $5k or $10k of treatment is really required is a good trade. YMMV. ---
**Author:** ![jtur88](https://avatars.discourse-cdn.com/v4/letter/j/e9c0ed/32.png) [@jtur88](https://boards.straightdope.com/u/jtur88)\ **Post date:** [October 22, 2014, 2:15am UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/45 "2014-10-22T02:15:25Z")
I’ve only had my teeth cleaned twice in my life, and both times, I got an infected tooth within six months that had to be lpulled. ---
**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\ **Post date:** [October 22, 2014, 3:42am UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/46 "2014-10-22T03:42:50Z")
> [@FairyChatMom](#): > > Last place we lived, our dentist kept pushing some sort of sealant for our teeth. I declined. I’m 56, still have my own teeth, and I just have a few fillings - all this after avoiding a dentist for most of my 20s. Being broke takes care of a lot of “necessary” procedures. Sweet Jebus, if that is the sealant they were working on back in the 70s at Eastman School in Rochester NY, fucking get it, do not stop, RUN! I was one of the test kids, and I have always had craptastic enamel even with the fluoride treatments and everything [I ended up with cavities no matter what] and the 2 years after I got them sealed I had absolutely no cavities or demineralization from acid at all. Damn, I have never had it offered to me since … I need to see if I can get it! ---
**Author:** ![Erdosain](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/erdosain/32/7284_2.png) [@Erdosain](https://boards.straightdope.com/u/Erdosain)\ **Post date:** [October 22, 2014, 4:35am UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/47 "2014-10-22T04:35:37Z")
> [@Amberlei](#): > > I went into a large national chain dental office for a routine cleaning a few years ago. They wouldn’t do the cleaning, or even x-rays until I had deep-scaling done. I opted to forgo it and found another dentist. I mentioned the deep-scaling to him and he said I didn’t need it. I’ve moved a few times since then and gone to three other dentists, and not once has one of them mentioned this. A friend of mine recently went to another branch of the same national chain that told me I needed deep-scaling done and go figure, this office told him the same thing. I would definitely get a second opinion before getting this treatment. I know there are times it’s legitimately needed, but sometimes it really isn’t. I had almost this exact experience when I went to Aspen Dental for the first time. My regular dentist retired and I was dentist-less and I just needed a cleaning on a Saturday. Nope. No cleaning ever happened. My experience was a little different because they did give me x-rays, a lot of x-rays. After what seemed like 18 or so I started to get nervous and tried to keep count. Anyway, they quickly declared that I needed scaling and furthermore that they absolutely could not give me a cleaning until months AFTER the scaling was completed, to prevent further infection or something. I was told a lot of scary numbers about my gums. Anyway, the thing that bothered me most was that 90% of my visit and dental planning was with the office manager. They trotted the dentist (clearly a recent grad in their 20s) out for about five minutes to declare that I needed scaling, but all the dental decisions were guided by the office manager. I stuck around for one treatment (a hygienist scaled one quadrant and packed some sort of antibacterial powder under my gumline) and then found a local dentist practice. One with the actual dentist’s name on the door. Surprise, surprise, I haven’t heard another word about scaling and they actually give me a cleaning every six months. I really have serious misgivings about the ethical standards of national dental chains. There doesn’t seem to be any accountability besides to their shareholders. I also think that any dentist worth his or her salt wouldn’t work in a place where the actual dentists seem to have so little apparent authority or influence. ---
**Author:** ![Mama\_Zappa](https://avatars.discourse-cdn.com/v4/letter/m/71e660/32.png) [@Mama\_Zappa](https://boards.straightdope.com/u/Mama_Zappa)\ **Post date:** [October 22, 2014, 3:04pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/48 "2014-10-22T15:04:53Z")
> [@Ichini\_Sanshigo](#): > > ETA: > > Also, just because your insurance carrier doesn’t allow it doesn’t mean it’s not necessary. I handle insurance for our office, and I can tell you, coverage is all over the damn place. What gets covered depends on your carrier, as well as on your particular plan within the carrier. Perio stuff is sometimes covered under “preventive”, and sometimes, basic, and I think I saw one plan that had it under major. Most plans will only cover two cleanings per year, but the thing with gum disease is that after your cleaning, the bacteria in your gums will have regenerated after 3 months (hence the checkups every 3-4 months instead of 6). > > Really, your hygienist (dentist? who does your cleanings?) should have explained this. But, yeah, if you’ve got perio disease, it’s not a scam. My husband was told he had periodontitis and needed to have this done. Insurance declined the extra cost, saying they didn’t see evidence of enough perio disease. We tried fighting it but basically they ignored the appeal and we didn’t have the energy to push. So since then, when he gets a perio cleaning (or some other perio treatment; he’s had gum and bone grafts) they decline THOSE because he has no history of perio disease. The lack of history is, of course, because their records show they’ve never paid for such treatment in the past. Because they declined to pay for it that first time. Nice scam. ---
**Author:** ![rsat3acr](https://avatars.discourse-cdn.com/v4/letter/r/a3d4f5/32.png) [@rsat3acr](https://boards.straightdope.com/u/rsat3acr)\ **Post date:** [November 1, 2014, 12:22am UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/49 "2014-11-01T00:22:45Z")
I was asked to weigh in on this via PM. I feel flattered. Sorry to take so long as I’ve been offline for a bit. Deep Cleaning = Scaling and root planing = SCRP is a real thing needed by many people. It is used to treat gum disease/periodontitis. It is indicated for removal of tarter under the gum line. Subgingival tarter harbors bacteria which allows for further gum loss due to inflamation. Does everyone need it, of course not, something like 10-25 percent or so. There is a bit of room for interpretation. To determine if you need it the dentist examines the x-rays for evidence of bone loss and takes measurements of the pocket depths. They use a periodontal probe and take 6 measurements around each tooth. Healthy pocket depths are 2-3mm. A few 4s or a couple of 5s is a bit of a worry 6s and up is usually a problem. If you have questions ask about it they should be happy to explain. There are offices that over use it but a lot of offices also undercall it. This is why some people have been at one office for years without it being mentioned and then a new office makes the proper diagnosis. Most insurance covers it with limitations. One other problem is that patients ask to “just have a regular cleaning”. The problem here though is that if one has peridontal disease a regular cleaning is not an appropriate treatment. If the dental office only works on the tooth above the gumline while ignoring the subgingival tarter it is malpractice. Of course during the SCRP the supragingival tarter would also be removed and the teeth polished, the regular cleaning that folks want. ---
**Author:** ![Erdosain](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/erdosain/32/7284_2.png) [@Erdosain](https://boards.straightdope.com/u/Erdosain)\ **Post date:** [November 1, 2014, 1:21am UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/50 "2014-11-01T01:21:34Z")
Thanks for weighing in, **rsat3acr**. It sounds like my treatment may actually have been correct, just poorly explained to me. You mention that the supragingival tartar can be removed at the same time as the scaling. Can you think why they might have told me that I’d have to wait months to get a regular cleaning to “avoid spreading bacteria”? Also, if some dental practices don’t identify and treat cases needing scaling and planing, what happens to their patients long term? Do they get more cavities or lose teeth or what? Can you get a cavity below the gum line? ---
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [November 1, 2014, 2:32am UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/51 "2014-11-01T02:32:16Z")
Well, my mom lost her teeth not to decay but to gum disease - the gums were so destroyed they simply could no longer hold her teeth in her jaw. So… I suppose that’s a possible end for the process. ---
**Author:** ![rsat3acr](https://avatars.discourse-cdn.com/v4/letter/r/a3d4f5/32.png) [@rsat3acr](https://boards.straightdope.com/u/rsat3acr)\ **Post date:** [November 1, 2014, 7:51pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/52 "2014-11-01T19:51:41Z")
> [@Erdosain](#): > > Thanks for weighing in, **rsat3acr**. It sounds like my treatment may actually have been correct, just poorly explained to me. You mention that the supragingival tartar can be removed at the same time as the scaling. Can you think why they might have told me that I’d have to wait months to get a regular cleaning to “avoid spreading bacteria”? > > Also, if some dental practices don’t identify and treat cases needing scaling and planing, what happens to their patients long term? Do they get more cavities or lose teeth or what? Can you get a cavity below the gum line? scaling **IS** removing the tarter, root planing is scraping the root to make it smoother so tarter and bacteria have a harder time gaining a hold. In my mind a holdover from days past when they thought it made a difference. When viewed microscopically the planed root isn’t smooth. One would always remove supra and subgingival tarter at the same appointment if doing SCRP. Why they said that about spreading bacteria I don’t know. Makes no sense to me. May be what they say when trying to hard sell treatment. Failure to diagnosis periodontal disease is one of the major reasons for dental malpractice suits. Often it isn’t explained well. Patient confusion if the biggest problem I see when giving second opinions. In the long term untreated periodontal problems lead to tooth loss. It is the major reason for tooth loss in the U.S. Yes one can get cavities subgingivally but that usually isn’t as big a problem as loss of the bone that holds the teeth in. ---
**Author:** ![CLA1031](https://avatars.discourse-cdn.com/v4/letter/c/9fc29f/32.png) [@CLA1031](https://boards.straightdope.com/u/CLA1031)\ **Post date:** [March 18, 2015, 12:23am UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/53 "2015-03-18T00:23:12Z")
I have to jump in with and ask for advice also, please. Last year my office stated I needed a deep cleaning. It took about an hour and cost me $60. They said insurance doesn’t cover it. They said my pockets were 4 and 5’s, if I recall correctly. Anyway, over done with, right? No, they say I need to come every 4 months and pay out of pocket for deep cleanings every visit. My last one took about 30 minutes. 1. Is it normal to need deep cleanings 3 times a year and be told in advance? 2. Why was mine so cheap? 3. Is 30 minutes enough time to do a SCRP? ---
**Author:** ![GrumpyBunny](https://avatars.discourse-cdn.com/v4/letter/g/bc8723/32.png) [@GrumpyBunny](https://boards.straightdope.com/u/GrumpyBunny)\ **Post date:** [March 18, 2015, 1:07am UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/54 "2015-03-18T01:07:30Z")
> [@Yarster](#): > > Ichini Sanshigo - so, have you ever been asked to upsell this service? Or is it common in the dental field? I ask because I once heard (from a highly biased friend, obviously) that one of the purposes of the Health Insurance Portability and Accountability Act (HIPAA) was to “stop all the crooked dentists and chiropractors from overbilling”. I’d love to know how on earth HIPAA was supposed to do that! Anyway, agree with everyone who points out that a “deep cleaning” is necessary for people with periodontal disease. BTW, the deep cleaning isn’t awful. I have comparatively minor perio (both of my parents have it, too, much worse). I had a deep cleaning two years ago and was fine last year when the hygienist checked my gums. I know at least one pocket seems to have resolved itself. We’ll see how it is at my cleaning this year. ---
**Author:** ![GrumpyBunny](https://avatars.discourse-cdn.com/v4/letter/g/bc8723/32.png) [@GrumpyBunny](https://boards.straightdope.com/u/GrumpyBunny)\ **Post date:** [March 18, 2015, 1:12am UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/55 "2015-03-18T01:12:01Z")
> [@Lsura](#): > > I am going to miss my dentist when I move - I have never felt pressured into having work done for the cost - he explains why he’s recommending something and when he needs to refer, I trust him to refer to an excellent professional, as he did when I had a major problem last fall. I refer everyone in the Jacksonville, FL area to my former dentist. I also wish that I could Star-Trek-transport myself to his office for treatment. I’ve had a lousy time finding a dentist in my new city. ---
**Author:** ![rsat3acr](https://avatars.discourse-cdn.com/v4/letter/r/a3d4f5/32.png) [@rsat3acr](https://boards.straightdope.com/u/rsat3acr)\ **Post date:** [March 18, 2015, 3:08am UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/56 "2015-03-18T03:08:10Z")
> [@CLA1031](#): > > I have to jump in with and ask for advice also, please. > > Last year my office stated I needed a deep cleaning. It took about an hour and cost me $60. They said insurance doesn’t cover it. They said my pockets were 4 and 5’s, if I recall correctly. Anyway, over done with, right? No, they say I need to come every 4 months and pay out of pocket for deep cleanings every visit. My last one took about 30 minutes. > > 1. Is it normal to need deep cleanings 3 times a year and be told in advance? > > 2. Why was mine so cheap? > > 3. Is 30 minutes enough time to do a SCRP? Welcome aboard **CLA1031** A lot of people need to come in three times a year, a lot of people don’t. 4-5 mm pockets are probably moderate perio at best. Very often these people, with good oral hygiene, can get by with regular cleanings. Can’t say why yours was so cheap. That would be close to a usual amount for a regular cleaning. Thirty minutes is pretty quick for a SCRP. One possiblility is, and I am not making accusations, they billed the insurance for a regular cleaning as well as you for the SCRP. I’d check my EOB. Of course this may also just what they charge. ---
**Author:** ![dboc2000](https://avatars.discourse-cdn.com/v4/letter/d/8dc957/32.png) [@dboc2000](https://boards.straightdope.com/u/dboc2000)\ **Post date:** [December 30, 2015, 5:38pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/57 "2015-12-30T17:38:08Z")
I am a dentist. I am honest. Most dentists are honest. Some are not. Same for every profession. A “deep cleaning” is really a procedure called scaling and root planing, a dentist should recommend it if you have periodontitis (gum disease) and a regular cleaning if you have healthy gums or just gingivitis. The root planing part means the dentist or hygienist will numb you and go down under your gums and lift and scrape tartar off of the very roots of your tooth. This is different from a regular 40 minute 6 month cleaning. I understand the confusion that “deep cleaning” creates and personally do not use the term “deep cleaning” with my patients because it doesn’t really do justice to the procedure. It makes it sound like selecting a regular wash vs a silver wash at the car wash. My car looks the same after either. Normally if you have gum pockets that measure 4mm or more you have periodontitis. If you have periodontitis, a regular preventative cleaning will not heal your gums and over time you will slowly lose your teeth due to gum disease. Doing a regular cleaning will not remove the tartar that is attached to the roots of your teeth. That’s the difference. Many patients don’t like to hear about needing scaling and root planing (deep cleaning) for one reason, it means out of pocket cost. The secret is that dental insurance isn’t really insurance and only covers part of the cost of scaling and root planing or most procedures. Ask me anything. ---
**Author:** ![FairyChatMom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fairychatmom/32/21906_2.png) [@FairyChatMom](https://boards.straightdope.com/u/FairyChatMom)\ **Post date:** [December 30, 2015, 6:45pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/58 "2015-12-30T18:45:31Z")
My inlaws picked a dishonest dentist, but they never went back. For years, they drove a couple of hours to their old city to see their old dentist, but the drive is a lot for a couple in their 80s, so they looked for someone in their town. They were immediately told they needed all sorts of procedures, including deep cleaning, totaling several thousand dollars, and they declined and made the gawd-awful drive again. Their old dentist told them they didn’t need deep cleaning or any of that stuff, and they’re at a loss as to how to find an honest practitioner in their town. We’re really pleased with the practice we changed to - a husband and wife team and their cadre of hygienists - no pressure, no nonsense. They told me they could do some cosmetic stuff for me if I was interested, but I’m not and they dropped it. ---
**Author:** ![Czarcasm](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/czarcasm/32/4050_2.png) [@Czarcasm](https://boards.straightdope.com/u/Czarcasm)\ **Post date:** [December 30, 2015, 6:50pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/59 "2015-12-30T18:50:50Z")
> [@dboc2000](#): > > Ask me anything. What is your position in regards to mercury poisoning supposedly caused by leaking amalgam fillings? ---
**Author:** ![DrDeth](https://avatars.discourse-cdn.com/v4/letter/d/b487fb/32.png) [@DrDeth](https://boards.straightdope.com/u/DrDeth)\ **Post date:** [December 30, 2015, 7:01pm UTC](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474/60 "2015-12-30T19:01:08Z")
> [@Yarster](#): > > Maybe it’s just a coincidence, but my wife and I have been going to a very large dental practice for the last 10 years and have been noticing a huge effort to push the so called ‘deep cleaning’. Basically, it’s an additional teeth cleaning, except they do a little more work on the area below the gumline. > > I am especially religious about going for the six month cleanings, brush twice a day, floss reasonably often, and yet every two years, they seem to want to do the deep cleaning. The previous 20 years of my life when I took far less good care of my teeth, no such service was ever requested or even offered. Naturally, this ‘extra’ is not completely covered by the insurance and seems to make them additional money since they are hitting you up three times a year instead of two. I have consistently gone in to get it when they ask to do it, but today both my wife and I were hit up for it, and they asked us “when was the last time you had a deep cleaning?”. This struck me as strange because that shouldn’t matter, should it? All that should matter is whether I need it. It felt like they were really asking “when was the last time you had it because the insurance carrier only allows us to hit them up every so often and we want to know if enough time has passed for us to hit the cash register again…” > > Maybe I’m just paranoid, and when it comes to my health, I’m obviously going to do what I can to stay as healthy as possible, but something about this procedure struck me as somewhat “made up”. What say you on this? I’d particularly like to hear from anyone in the dental field, particularly any former hygenists who might fess up as to whether they have been asked to upsell this… Are you a smoker or tobacco user? [Previous page](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474.md?page=2) [Next page](https://boards.straightdope.com/t/dental-deep-cleanings-a-quasi-scam/539474.md?page=4)