Scale and Polish (Tartar Removal)

Tartar (calculus) is bacterial plaque on the tooth surface that has hardened with minerals from saliva. Plaque is soft and comes off with a toothbrush; but plaque that is not removed within a few days starts to harden, and once it has turned into tartar, neither a brush nor floss can dislodge it. Its rough surface makes it easier for new plaque to stick and keeps the gum constantly inflamed.

A scale and polish removes this hard layer from above the gum and from just below the gum line, and then polishes the surface. It is the first, and often the only, step in treating gingivitis; for the overall picture of the disease, see the gum disease treatment page.

Where does tartar build up most?

Tartar forms faster close to where the salivary glands open into the mouth: on the tongue side of the lower front teeth and the cheek side of the upper molars. Tartar above the gum is usually yellowish-white and can be seen in a mirror. Tartar that forms below the gum is darker, brown or blackish, and sticks firmly to the root; you cannot see it, and it is picked up only with a probe at the examination or on an X-ray.

How quickly tartar builds up varies a great deal from person to person. The composition of your saliva, smoking, crowded teeth and brushing habits are the deciding factors. Of two people who brush with equal care, one may need a clean once a year and the other every few months.

How is the cleaning done?

1. Measurement. The gums are checked first. If there are deep pockets, a surface clean is not enough; in that case the plan continues with deep cleaning (root planing).
2. Ultrasonic cleaning. The ultrasonic tip vibrates at high frequency and, together with a water spray, breaks the tartar away from the tooth. The water cools the tip and rinses away the debris; that is where the cold sensation and vibration you feel during the procedure come from.
3. Fine cleaning with hand instruments. Fine hand instruments are used between the teeth and in corners the ultrasonic tip does not reach well.
4. Polishing. The cleaned surface is polished with a paste, or with a system that sprays powder and water. A smoother surface slows down plaque re-attaching, and most tea, coffee and tobacco stains also come off at this stage.
5. Home care. We show you where tartar is building up and adjust your brushing and cleaning between the teeth to those areas.

For the whole mouth, the procedure usually takes 30–60 minutes. Most patients do not need numbing; for sensitive teeth or heavily inflamed gums, local anaesthetic can be given to that area.

Does cleaning damage your teeth?

This is the real question on most people's minds when they reach this page. Here are the beliefs we hear most often, one by one:

• "It wears away the enamel." Enamel is much harder than tartar, and a tip used with the correct technique separates the tartar from the enamel without scraping the enamel itself. The area that needs care is the softer root surface exposed by gum recession; there we take care not to work harder or more often than necessary.
• "It opens up gaps between the teeth." Cleaning does not create gaps; it reveals ones that are already there. Tartar and swollen gum fill and hide the space left by bone loss. Once the tartar is removed and the swelling goes down, that space shows. The culprit is not the cleaning but the damage the tartar has been doing for years.
• "It makes the teeth loose." A thick layer of tartar sometimes glues a few teeth together and holds them like a splint. When the tartar goes, the looseness underneath becomes noticeable. The real cause of the looseness is bone loss.
• "If I have it done often, I will get more tartar." How fast tartar forms depends on your saliva and your home care, not on how often you have a clean.

What will it feel like afterwards?

If the gums are inflamed, there may be bleeding during the cleaning and for the first day or two. If root surfaces that were covered by tartar have been exposed, sensitivity to cold and heat for a while is also common. This sensitivity mostly eases within a few days to a few weeks; if it lasts longer, we can talk about sensitive teeth treatment options. Redness and swelling of the gums settle noticeably within a week or two. If bleeding does not reduce after the cleaning, that is a sign of a problem remaining below the gum, and the pockets need measuring again.

How often should you have it done?

Situation	General interval
Healthy gums, little tartar	Once a year
Prone to tartar, a smoker, or in orthodontic treatment	Every 6 months
Previously treated for periodontitis	Every 3–6 months, as supportive care

These intervals are a starting point. The right one is decided by how fast we see tartar building up at the examination; we will not recommend cleaning more often than necessary to someone who forms little tartar.

Does a scale and polish whiten teeth?

No. Polishing removes only surface stains, and the tooth returns to its own colour. If you want to lighten the natural colour of your teeth, teeth whitening is a separate procedure, and it is done on clean gums that are free of inflammation. That is why at our clinic in İzmir we plan a clean as the first step before whitening.

What decides the cost?

The cost depends on how much tartar there is, whether it can be finished in one visit and whether anaesthetic is needed; you receive a written, itemised quote after the examination. If you have dental insurance, cover for treatment abroad varies, so check with your own insurer.