The Frontal Cortex

Cleaning Teeth

In the past year, I’ve spent a small fortune at the dentist. Between wisdom teeth removal, a few routine cleanings and the replacement of an old cavity, my tab has come to several thousand dollars. (Needless to say, I don’t have dental insurance: I’m a freelance writer. But I do have a dental plan.) After my last trip to the dentist, I left the office with two thoughts: 1) novocaine just might be the most effective medication neuroscience will ever invent and 2) do those cleanings by the dental hygienist (an extra $65 in my case) really do anything? I use one of those fancy toothbrushes, and my teeth don’t feel very different after getting a professional cleaning.

Luckily, Ian Ayres provides us with some answers:

Thank God for Google. It turns out there is an entire journal called “Evidence Based Dentistry.” And in just a few minutes, I was looking at a formal Cochrane review titled “Insufficient evidence to understand effect of routine scaling and polishing.”

The review looked for evidence to answer two related questions:

The first is, do scale and polish procedures [having your teeth cleaned] lead to any difference in periodontal health compared with no scale and polish? Second, does the interval between these scale and polishing procedures make any difference?

The results were not heartening for those of us who have suffered through dozens upon dozens of cleanings. The meta analysis of qualifying studies suggested that the evidence was mixed, at best. For example, there is not strong evidence that hygienist cleaning reduces gingivitis:

[T]he authors of the only study that found differences in gingivitis scores (at 6, 12 and 22 months) deemed those differences clinically irrelevant….

My dad always told me that dealership rust-proofing was a scam to give dealerships some extra cash without providing your car with any extra protection. Could getting your teeth cleaned be the economic equivalent to having a car dealership rust-proof your car?

That strikes me as an unfair comparison. But I am going to think twice about spedning money on a full-cleaning the next time I’m at the dentist.


  1. #1 OftenWrongTed
    May 27, 2008

    Where I spend the working day is decidedly hard on the teeth. The 1/4 of a percent relative humidity makes water taste dry when drinking it. I stumbled on using an electric tooth brush, flossing, and have had no dental problems. My sympathies on the wisdom teeth, my work required their removal prior to being accepted into my field. Nasty procedure.

  2. #2 Diane
    May 27, 2008

    Interesting that this post comes on the day I had my teeth cleaned and was thinking the VERY SAME THING while the hygenist picked away at my teeth. I found myself thinking how our ancestors used twigs instead of toothbrushes and wondering things like if our teeth were really meant to last 80+ years, and REALLY, how beneficial is it for someone to be scraping at my teeth with a metal pick? Hours later, my teeth and jaws still hurt. Whether it’s beneficial or not seems well worth looking into, actually.

  3. #3 Kevin
    May 27, 2008

    I found myself thinking how our ancestors used twigs instead of toothbrushes and wondering things like if our teeth were really meant to last 80+ years

    I was in Senegal and the locals there didn’t traditionally use tooth brushes, but instead sticks and twigs. Always saw these old women (like, 35 yrs old, but looked like 80; seriously)

    Sticks, I wondered? Actually, they were a particular kind of stick. They actually purchased them, just for the purpose, since they weren’t locally grown in the city. They are very stringy, tough sticks, and after a good chewing start to resemble tooth brushes in texture, firmness, etc. And, to boot, this particular kind of stick is reported to have some chemical/medicinal properties that is good for teeth beyond just mechanical cleaning, a sort of natural flouride or novocaine or something. (What evidence for this? I have no idea… so maybe just a myth).

    Anyway, I was going to dispute the “sticks and twigs where good enough for our ancestors” nonsense. Few of the senagalese have any teeth left by age 45 or so, seemed like. The sticks didn’t seem to be working much.

  4. #4 Noah
    May 29, 2008

    Unless this is one of those Wikipedia articles that my profs and Andrew Keen are always trying to warn me about, looks like neuroscience didn’t have a whole lot to do with the invention of Novocain.

  5. #5 Hugo
    May 30, 2008

    Interesting article. Remember, however, that the job of a dental hygienist is not to stop gingivitis. Gingivitis requires sustained oral hygiene in the form of brushing and flossing on the part of the patient.

    Dental hygienists will remove calculus (tartar) which is the result of poor oral hygiene and is sort of like solidified plaque, which, no matter how much you brush, you cannot remove.

    A dental hygienist should also attempt to educate people about oral care and that is, perhaps, their most important job. They should check people’s brushing and flossing technique and, if wrong, correct it.

    So although those cleans you (and Ian) ‘suffer’ may not, in themselves, reduce gingivitis, the overall role of the dental hygienist is very important… if you do what he/she tells you, that is.

  6. #6 carielewyn
    May 31, 2008

    i hate you. i couldn’t sleep so i thought: reading always does the trick – and i picked up your madeleine cookie book from my *to read* pile. now it’s past 5am and i’m still awake. thanks :)

  7. #7 geciktirici
    February 15, 2009

    Thank God for Google. It turns out there is an entire journal called “Evidence Based Dentistry.” And in just a few minutes, I was looking at a formal Cochrane review titled “Insufficient evidence to understand effect of routine scaling and polishing

  8. #8 Walsall dentists
    June 17, 2009

    Regular teeth brushing, flushing and cleaning along with dental check ups will give the oral care and dental health.

  9. #9 Dentist Vaughan
    June 26, 2009

    Regular visits to the dentist along with good oral hygiene are important in maintaining dental health. If these areas are neglected, serious health consequence can result.

  10. There is a link between gum disease(periodontal disease) and heart disease. So this should not be taken lightly.

  11. Regular dental cleanings are important because the tartar accumulation you develop around the gums irritate the gums and can lead to gum disease.

  12. #12 Seneca Dental
    September 10, 2009

    Many people who do not believe in getting regular dental care or dental cleanings often lead to missing teeth later in life and other health consequences.

  13. #13 samwalker
    April 13, 2010

    Interesting post! dental health should not be taken lightly, and of course, we should always take into consideration, that although our teeth are the strongest bones in our body, it needs proper care and hygiene.

    gentle care + beautiful smiles =

  14. #14 Dental Milpitas
    August 9, 2010

    This is an interesting analysis. If you don’t feel confident that your dentist is doing a good job of cleaning your teeth, maybe you should have him/her explain what he/she does exactly during a cleaning so you’ll know what to expect.

  15. #15 Dentist in Orange
    August 23, 2010

    Maybe you should try another dentist if you think your dentist is not doing his/her job well.

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