Checkups and cleanings

A checkup is an exam by a dentist. The dentist looks at your teeth, gums and the rest of your mouth, checks for signs of oral cancer and decides whether you need X-rays (ADA).

A cleaning is usually done by a dental hygienist. It removes plaque and tartar. Tartar is plaque that has hardened on the teeth, and only a dentist or hygienist can remove it (NIDCR).

Routine visits are for children and adults. They can find problems early, when treatment is likely to be simpler and cost less (ADA). Gum disease can become serious before you notice it, which is one reason the CDC advises seeing a dental provider at least once a year (CDC).

There is no single right interval. Some people need a visit once or twice a year and others need more (ADA). A 2020 Cochrane review looked at adults who already see a dentist regularly. Over four years, visits timed to each person's risk gave about the same results as visits every six months, for cavities, gum bleeding and quality of life. The evidence for children was uncertain (Fee 2020). Ask your dentist how often you should come back, and why.

A checkup and cleaning usually take one visit.

1. Health history. You are asked about your health and medicines (ADA). Mention pregnancy, new conditions and any pain or sensitivity.
2. Exam. The dentist checks your teeth and gums. For the oral cancer check, the dentist looks at your tongue and mouth and feels your jaw and neck (ADA).
3. Gum check. The hygienist may measure the spaces between your gums and teeth with a small probe. Deeper spaces can be a sign of gum disease (NIDCR).
4. X-rays, if needed. The ADA says there is no "one size fits all" schedule for dental X-rays. It depends on your oral health, age, risk of disease and symptoms (ADA).
5. Cleaning. The hygienist removes plaque and tartar and polishes the teeth.
6. Plan. If the dentist finds a problem, ask for a written treatment plan before you agree to more work.

A filling repairs a tooth after the dentist removes decay. Common materials are tooth-colored composite resin, glass ionomer cement and silver-colored amalgam (FDA).

Amalgam contains mercury. For people at higher risk, such as pregnant women, children under six and people with kidney problems, the FDA strongly encourages other materials when they suit the tooth. The FDA does not advise removing amalgam fillings that are in good condition unless a health care professional finds it medically necessary (FDA).

• Brush twice a day with fluoride toothpaste (NIDCR).
• Floss or use another tool between your teeth every day (NIDCR).
• If you use tobacco, ask for help to quit. Smoking is the biggest risk factor for gum disease (NIDCR).
• Book your next visit before you leave, at the interval your dentist suggests.

• X-rays. Dental X-rays use a small dose of radiation. Dentists aim to keep each dose "as low as reasonably achievable" and to take X-rays only when the benefit justifies them (ADA). The ADA reports that a 2024 expert panel advised against thyroid collars for dental X-rays, because a collar can block the image and lead to a retake (ADA).
• Bleeding gums. Gums that bleed when you brush or during a cleaning can be a sign of gum disease (CDC). Tell the hygienist.
• After a filling. Ask how long the numbness should last and what to do if the tooth feels high when you bite.

• Whether you need X-rays at this visit, and which kind.
• Whether you need a routine cleaning or a deeper cleaning for gum disease.
• How many fillings you need, how large they are and which material is used.
• What your dental plan covers, how often it covers checkups and cleanings, and any yearly maximum.

Before any treatment beyond the checkup, ask for a written estimate that lists each procedure separately. Ask for the dental procedure code (CDT code) next to each line. Insurers use these codes, and they make estimates easier to compare (ADA).

1. How often should I come in, given my risk?
2. Do I need X-rays today? Which ones, and why?
3. Do I have any signs of gum disease?
4. Does this cavity need a filling now, or can we watch it?
5. Which filling material do you suggest for this tooth, and why?
6. What will this cost, and what will my plan pay?