Dentist Questions Dental Exam

Why do some dentists hurt during cleanings more than others?

My most recent dental cleaning was done by a different dentist at the office I go to, and it was so much more painful than usual. She said my gumline is receding but my regular dentist never told me that. I bled a lot more than usual, too. Why was this experience so different?

23 Answers

Some hygienists are more aggressive than others. That may mean they just did a really good job cleaning or you could have had more buildup on your teeth than usual. Take some ibuprofen if needed.
Dental cleaning is often a procedure that is sensitive when it is done. It also depends on how deep the dentist is cleaning. It sometimes happen that a dentist just clean above the gum line. This is less sensitive, but is also not a proper cleaning. It is important to clean in the sulcus of the gum, because that is where the bacteria accumate that causes the gum infection. This can be very sensitive and the gums can bleed if it is infected.
If receding gums are present sensitivity will also be a problem. This means that where the gum is reciding, the dentine of the root is exposed and will be sensitive to even just cold air.
You may have gingivitis and or a slight case of periodontal disease.
Ok, there are a few things to understand. When a dentist performs a
"cleaning" the term used and the insurance code is a "prophylaxis". That
means prevention and it is defined as cleaning and scraping away the
buildup and stains at or above the gumline. That kind of cleaning does not
hurt much unless you have receeded gums and cold drinks are bothersome(root
sensitivity). But the buildup exists below the gumline too in most cases,
and some dentists are so devoted that they will clean below the gumline to
remove as much buildup as possible, which is a better service and really
MORE than a prophy. This unfortunately can be more painful, Novocaine gel
can be applied beforehand to lessen this. You really need to get evaluated
for periodontitis which is irreversible bone loss- gum disease- as opposed
to gingivitis which is reversible inflammation. Get your perio charting of
the whole mouth and any pockets measuring 5mm or more indicate
periodontitis which requires Scaling and root planing (different code and
term than prophylaxis which means definitive removal of the mineralized
buildup below the gumline) and it is often performed with novocaine
injections prior to treatment to control discomfort. This is not medical
advice, it is only my opinion. Thanks Dr. Acquista
Sometimes while getting a cleaning you can feel some discomfort. The increase in the bleed can be caused by some medication or at time the body holds on to more bacteria causing the gums to bleed more. Receding gums can come from brushing to hard and many other things. If you would like a second opinion please feel free to contact my office and we can address these issues one on one.
Some cleanings can be more extensive than others and all depends on the techniques used, or the relative gentleness of the dentist or hygienist. If you do indeed have gingival recession, cleanings can definitely be more sensitive due to root exposure. If this becomes common during routine cleanings, I would advise taking 400-600 milligrams of Advil an hour before your cleaning and the same dose 5 hours later. Also, brushing with a sensitivity toothpaste such as Sensodyne routinely can help with this type of sensitivity.
It could hurt more because your gum conditions might have changed with time, oral hygiene habits or many other reasons. Another reason could be different kind of instruments. Mostly newer dentists are using advanced technology like Piezon these days . It might hurt more with these instruments but research has shown they are more effective than regular ultrasonic cleaners.
It could be the gentleness of the person who cleaned your teeth but most likely it could be if your gums were inflammed and not healthy, they would be more sensitive during the cleaning. Once your gums are healthy future cleanings will be easier and more enjoyable for you.
The new dentist might have done deeper cleaning to remove plaque and calculus built up. Rinse hourly with warm salt water.
Every dental care provider is different & may use different (but similar) techniques. This is not wrong, just different, & in your case, uncomfortable. It is hard to say why there was more bleeding without a full scope of your individual case (how long since your last cleaning, changes to eating and/or hygiene habits. changes to health history/medications, etc). There are multiple factors that affect how each visit goes. Also, seeing different dentists will render different opinions in regards to the best course of treatment. If you were not comfortable with this last dentist, maybe it is possible to request to be scheduled with the dental provider you are most comfortable with. Check with your dental office to see if that is an option.
Gingival health and tenderness can be affected by hormones or medications ( or being overdue for care). If none of these are the case you may just have experienced a more aggressive practitioner
The only explanation for the discomfort that you felt is that possibly the technique used by previous dentist was not as thorough as the last one. The idea is with proper thorough brushing and flossing there should be minimal recession between check-ups that is not explained by trauma or some reason that to shifted to cause the gum to recede in that local area. The technique of the dentist should be pretty much equal for routine cleanings and this could have been a one time poor experience. But there should be no bleeding around your gums unless there is an infection not from overzealous probing by the dentist.
The dentist you saw recently may have done a more thorough job cleaning your teeth by getting further under the gumline to clean out bacterial plaque and calculus (tartar) than the previous dentist. Cleaning below the gumline isn't always comfortable but it is necessary to maintain a healthy mouth. The bleeding you experienced is also due to inflammation in the gums. If you only clean above the gumline, you won't have any bleeding, but the plaque bacteria below the gumline will remain and cause further inflammation and bone loss around the teeth. You might ask your dentist to use a topical anesthetic on your gums to make the cleaning more comfortable
I hear this quite often, especially when patients change dentists . Some dentists are just more aggressive than others and you of course notice the difference. I personally try to approach cleanings is a manner that is not painful . I don't think "no pain , no gain " applies to cleaning your teeth. Hope that helps. Dr Thomas Reinhard
It is possible you may have an undiagnosed periodontal condition called gingivitis. This is caused from plaque buildup along the gums resulting in a bacterial infection making your gums appear more red in color rather than pink. Normal healthy gum tissue should appear pink and stippled and not bleed easily. Keep your cleaning intervals closer together, for some 3-4 month intervals may be needed to maintain healthy gum tissue and less traumatic dental visits. -Dr Joe Ferraro
Dear patient, It is hard to tell what is really going on! Although having a gentle touch goes a long way, it you need to k ow that some dentists and hygienists only clean the top part of tooth and never touch underneath the gum! In that case, patient may have a very smooth gentle cleaning experience with no bleeding and pain. On the other hand, some dentists are much more thorough with their cleaning and spend more time and effort to clean underneath the gums as well ( this is the best kind of cleaning). Although more painful and bloody, this type of cleaning will help patient with gingivitis and inflammation of the gums. I hope this answers your question. Best of luck.
Teeth and root sensitivity
Or clinician who is not careful?
Sometimes, if it has been a bit longer than your regular recall, then the gums will be a bit more sore. Every dentist practices their own way and techniques.
There are many circumstances that may contribute to discomfort that you experienced during the dental cleaning, but there is always a way to make you comfortable. Make sure that you voice your concern to the operator during the dental visit ,and it should be remedied.

This can be because the last hygienist you saw was 'heavy handed' or the hygienist you saw the time before could have left tartar behind which makes your gums more sore the next time. If you go to the same hygienist every time and it continues to hurt, you need to try another hygienist. Some are better than others at not hurting you. Also though, and very important, is how infected your gums are going in. If you floss everyday and have healthy, tight, non-bleeding gums, then it should not hurt to get your teeth cleaned. If you don't floss regularly and have infected gums, it will usually hurt to clean the tartar out, no matter how 'gentle' the hygienist is.
Sounds like your home care is NOT good...some recession is normal with age and THEN the root surface of the tooth is exposed. The root surface has nerve endings present ON the surface and thorough cleaning CAN stimulate them. The bleeding indicates poor (tsk tsk) home care OR some underlying health issue (NOT likely). Get the deep cleaning done, start better home care, use Sensodyne for the sensitive root surface and see the hygienist or dentist more frequently.
Whether your cleaning was by a dentist or hygienist, it does not have to be painful. The question is did they educate you about what was going on in your mouth. If your gums were inflamed to start with, why? What is the appropriate treatment for you, and how do you improve your personal brushing and flossing techniques to make things better. Education is the key.
Some dentists may be using different tools to do cleanings. The more modern technology, the ultrasonic scaler, combines the oscillating motion with water so the result is less painful. The traditional hand scalers may sometimes cause more sensitivity as in order to remove tough calculus, more scraping is necessary. Ultimately, the condition of your oral cavity dictates whether you will have sensitivity. Healthy gums and teeth should result in minimal sensitivity.