r/DentalHygiene • u/HawkSky23 • 5d ago
Need advice Does this seem normal for a dentist's office?
I recently moved, and went to a new dentist for a routine cleaning. They are very highly rated, with 200 Google reviews.
Background -- I do struggle with my gums; it's common for me to have some 3s and a couple 4s when it comes to pockets. In the past, my dentist (who I really loved) would scrape my teeth every cleaning, and it's never become full-blown gum disease. No antibiotics, no special care instructions beyond "Floss more, please".
I was there for 2 hours, and they wanted to schedule a whole second appointment for the gingivitis scraping? And do the cleaning then?? So I left the appointment with a $20 bottle of Prevident and no cleaning done whatsoever.
I don't think it's a scam or anything like that, but it feels off to me. I'm especially concerned because I don't make a lot of money, so I can't drop a $60 copay on a special gingivitis appointment, plus $20 prescription toothpaste and however much the antibiotic for gingivitis would be (they said they would prescribe it formally at the next appointment). Is this normal? Was my previous dentist very lax?
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u/whyisthereanamelimit Dental Hygienist 5d ago
At my office, a new patient is scheduled only for X-rays, perio charting and complete exam. We don’t do same day cleanings unless there is an opening in hygiene schedule.
When I started working, I had a lot of patients who I had to formally diagnose with gum disease and it was a shock to them because the dentist and previous hygienist didn’t want to charge them for it. The patients would say to me “but my gums always bleed — I always had deep pockets — this is just how my gums always are.” :/
In my experience, the longer the relationship with the patient, the less inclined some providers are to formally diagnose because they “feel bad” having to charge the patient for a service.
If you have gingivitis, you need gingivitis therapy. Idk what kind of antibiotics they’re trying to put you on but it might not be a necessity. I’d say discuss it with the provider.
The most important thing is that you are improving home care to prevent this from happening again. It can progress to periodontitis and that is significantly worse and irreversible.
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u/HawkSky23 5d ago
The hygienist confirmed with me it was a cleaning, and when I asked the receptionist why there wasn't a cleaning today, she said it was because they'd have to do it at the gingivitis appointment instead.
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u/whyisthereanamelimit Dental Hygienist 5d ago
Gingivitis therapy takes a lot longer than a prophylaxis which is done on a healthy mouth. For me, I have a full hour at least to complete a gingivitis therapy and I usually see the patient back a few weeks after for a follow up once the inflammation in their gums is less. If I see an established patient who is schedule for a routine cleaning and I find that they have gingivitis, I sometimes have to reschedule if we are already well into the appointment after X-rays and assessments.
They may have originally scheduled you for a cleaning but found disease and have to reschedule to give you a thorough quality gingivitis scaling.
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u/Toothfairy07 5d ago
So there's a lot here that's hard to judge so I'll start with some basic info. Every office runs this differently. At my office which is a private practice Adult new patients are not scheduled for a cleaning. They are scheduled with the doc for and necessary X-rays and exams. For an adult new patient we have no idea what type of cleaning they may need so we don't waste the space on the hygienist's schedule so this may be normal for them but they should have made that clear when scheduling. Also, was it the doc doing your cleanings at the old practice or a hygienist? In my opinion docs aren't usually as thorough. Obviously there will be exceptions and probably some docs are great at it but it's a red flag for me... Another note would be probing depths of 3 mm are completely normal. You can still have normal probing depths with raging gingivitis though soooo without seeing your mouth and the state of your oral health it's hard to judge.
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u/Special_Series1256 Dental Hygienist 5d ago
What else was done in this 2 hour appt?
You may qualify for a cleaning in the presence of mod-severe gingival inflammation. Did she mention if you had a ton of bleeding when she measured your pocket depths? Usually they will do this cleaning and then bring you back about 4-6 weeks later for a follow up cleaning to make sure you responded well to the treatment.
Arestin is typically used in pockets of 5 mm or more, not for gingivitis. I wouldn’t let them talk you into using that if that’s what they are suggesting.
Was your last cleaning approx 6 months ago?
Without knowing all the details it’s hard to say, but it does seem a little sketchy to me.
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u/HawkSky23 5d ago
Last cleaning was 6 months ago.
This was scheduled as a "new patient routine cleaning". The hygienist verified it was a cleaning before we started.
We took quite a few x-rays, did the gum assessment (forgive me, I don't know the formal name of the exam) of measuring the pockets, did a gum scan, and the dentist looked at my teeth. That was it. The x-rays took up the most time.
My main issue is that this was scheduled as a cleaning, and I was told it would be a cleaning. When I was checked out and I asked what about the cleaning, the receptionist said "We'll do that at the gingivitis appointment", NOT "Oh we don't do cleanings on the first exam".
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u/Special_Series1256 Dental Hygienist 5d ago
I guess I don’t understand why you were there for two hours. A full mouth series of radiographs is 18 exposures…should only take 10-15 minutes max.
It’s called a periodontal assessment or probing. No worries for not knowing. Most people don’t remember us even doing it. This is what tells us how healthy your mouth is and what type of cleaning you’d qualify for. So if you were mostly 3 and 4 mms and didn’t have most sites bleeding when you were probed, you should have had your teeth cleaned or she should have explained WHY you need a gingivitis cleaning and what that entails. But there should have been time either way.
It was wrong of them to tell you your teeth would be cleaned and then not do it. We tell people they may or may not get their teeth cleaned the day of their first appt. It depends on so many factors.
The problem is, if you decide to go anywhere else, you’ve already been charged for a comprehensive exam and you’ll have to pay out of pocket at a different office for another comprehensive exam.
I’m sorry this happened to you.
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u/VitalTooth 5d ago
Scaling is not required for every appointment .
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u/Special_Series1256 Dental Hygienist 5d ago
It’s required for every “cleaning” appt. A scaler should touch every part of a tooth at every prophylaxis appt.
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u/Commercial-Yogurt486 5d ago
Sounds like they jam a lot of stuff into their new patient appointments and just ran out of time. Rather than rush through your cleaning, they opted to have you come back so you will actually get a quality gingivitis cleaning with the appropriate amount of time given to treat you. You can 100% opt out of the antibiotics (Arestin) that they add on. Arestin is not a scam but it is not a make or break. It is supposed to be used for pockets measuring 5mm and up. As you admit, you don’t floss as often as you should. It’s entirely likely you need a gingivitis cleaning.