Question

I (51) had my tartar removed three weeks ago. I found this treatment quite painful. A few hours later, a piece of a mended tooth broke off. I associated this breakage with the scaling. The dentist denied this and explained to me that this could happen due to the immense pressure on the teeth every day and the age of the fillings. Two weeks later, the same thing happened to another tooth. I am now really struggling to believe in a "double coincidence". Is scaling really that harmless? M. A. in B. 

Short answer

If the cleaning instruments are used correctly, neither healthy teeth nor fillings, crowns, porcelain veneers or the like will be damaged during scaling. It is not possible to cause or subsequently trigger tooth fractures with the instruments.

The bacterial film (plaque), which begins to form again on the tooth surfaces within a few hours of brushing, will continue to grow thicker if it is not removed by regular brushing. 

In most people, the plaque that has grown will become hard: This is called tartar. The composition of the saliva determines how quickly the tartar starts to form. 

Tartar formation unavoidable 

Regular and perfect cleaning of the tooth surfaces and interdental spaces would theoretically prevent the formation of tartar. However, as no one achieves this perfection, tartar will form to varying degrees, even in people who clean their teeth regularly and well. 

Once tartar has formed, it can no longer be removed with conventional dental cleaning instruments (toothbrush, dental floss, etc.). It adheres too strongly to the tooth surfaces. To prevent tartar from damaging the gums and bones, regular professional help from a dentist or dental hygienist is therefore necessary. These specialists use stable and sharp "scrapers" by hand or mechanical instruments that vibrate at very high frequencies (ultrasound). Of course, like all instruments, these must be used professionally and correctly. When used correctly, neither healthy teeth nor fillings, crowns, porcelain veneers or the like are damaged. It is not possible to cause or subsequently trigger tooth fractures with these instruments. However, fillings or similar restorations that are already leaking, cracked or defective in some other way can be detected. In rare cases, it is possible for such defective restorations to become completely detached. However, these are always already damaged restorations. 

Safety through regular cleaning and inspection 

It is generally advantageous to detect defects at an early stage, before the hidden damage has become too extensive and major follow-up treatment becomes necessary. Countless scientific studies have shown that regular professional dental cleaning and check-ups by the dental team provide the greatest assurance that teeth will remain healthy. The excellent results of Swiss school dental care also provide impressive proof of this fact. 

Author: Dr. med. dent. Jürg Eppenberger
Published in: Neue Luzerner Zeitung on March 28, 2007