To Go or Not To Go: Do You Return For Your Routine 6-Month Dental Appointment or Not?

This is the question that all conscientious, science-based dental patients should be asking. The problem is many people feel guilt about missing a scheduled visit or fear something bad will happen - just because they don’t show up!

Let’s get past irrational emotions and if necessary blame Claude C. Hopkins (an advertising genius) who in the early 1900’s made the public fear their teeth would turn yellow if they didn’t brush with Pepsodent toothpaste! There was not a shred of science– just a seed of fear that worked like a charm for his pocketbook! Remember dental insurance, marketing and equipment companies have a vested interest in dental appointments and it was they who funded an ad campaign in the 1980’s to bring patients into the office for 6-month recalls (rather than every year or two - which was the norm). Dentists generally believe there are only positive benefits from dental visits since many have never considered the flip side.

But now the World Health Organization warns us that the danger of attending dental office visits during the COVID pandemic is greater than previously thought.

And the most recent recommendation from the ADA states dental cleanings are “non- emergency” and should be postponed if possible. 

So now let’s look at some facts and try to determine:

• Do you need a cleaning to improve the health of your mouth?
• How do you judge the health of your mouth at home - prior to going for a cleaning?

A lack of science for 6-month interval cleanings was first noted in 1977 in the Lancet medical journal. This study concluded “….persons having dental examinations at intervals longer than 6 months were not at a disadvantage. They did not have more severe dental caries or periodontal disease than those attending at intervals of 6 months…..” 

A similar finding was published in the British Dental Journal in 2003 and the National Health Service commissioned a detailed review and concluded appointment intervals should be based on a person’s risk for disease. 

In 2013 the ADA made recommendations from a Cochrane Database Systematic Review by Riley (published in the Journal of Dental Research) and suggested patients should be “stratified” for preventive care. In other words, the healthier your mouth, the less you need a cleaning. 

So Is Tooth Cleaning A Scam? Actually, this was the title of a 2008 article by an investigative reporter Ian Ayres, who took a detailed look at the “facts” and was amazed to find there was no science to support 6-month recall appointments.

I discuss the pros and cons of having a cleaning in my book Mouth Care Comes Clean on pages 4-14 and explain the harm and potential dangers from unnecessary cleanings on pages 159-162. Today it is easier than ever to evaluate the health of your mouth at home. This is an important idea if you are going to avoid an appointment since we know almost 50% of young adults (30 years old) and 90% of older adults have plaque and bad/harmful bacteria lurking in their mouths – often with no clinical symptoms.

Saliva Testing: Saliva testing can help you know if you have a healthy or an unhealthy/infected mouth.

Sign up here for more information about:

• An oral DNA test will show Periodontal Pathogens
• A Nitric Oxide test can help show the health of the bacteria in your mouth

If you have an unhealthy mouth, you have two options:

1. Take control of poor mouth health and turn it around by changing your oral care strategies.
2. Continue with regular cleanings that will become more and more frequent as your situation deteriorates.

If you have a healthy mouth, you also have two options:

1. Postpone your appointment and be careful to continue to use good strategies that protect your mouth health.
2. Accept the risk of picking up an infection, developing sensitivity, or thinning your enamel at an unnecessary dental cleaning. The risk is extreme for any one with a dry mouth or titanium implants. Tiny particles of titanium can be shredded into your gums during a cleaning. In 2019 titanium implants were linked to an increase in body inflammation: https://www.mdpi.com/2077-0383/8/9/1368

For anyone who feels uncomfortable postponing their recall visit, prepare yourself prior to your appointment - using the strategies discussed in my blog Splatter Matters. Be sure to ask your dentist why you "need" a cleaning, and if you could safely extend the intervals between your visits.