Check-up and clean

A check-up and clean is the single most cost-effective appointment in dentistry. It finds problems while they are still small and cheap, and it removes the build-up that brushing cannot. This page covers what happens, what it costs, and how often you actually need one.

Fees

Each includes a periodic oral examination (item 012), removal of plaque and stain (item 114 for adults, 111 for children) and topical fluoride (item 121). Radiographs, if clinically indicated, are additional and you will be told before they are taken.

These are the figures for this appointment. Eligible children aged 0–17 may be able to claim under the Child Dental Benefits Schedule. See our promotions page for any current new patient offer.

Why it matters more than it sounds

The two diseases this appointment exists to catch are both silent. Decay does not hurt until it reaches the nerve, by which point the cheap filling has usually become a root canal and a crown. Gum disease does not hurt at all until teeth loosen, and it is the leading cause of adult tooth loss.

By the time something hurts, the inexpensive option has generally passed. That is the entire argument for coming when nothing is wrong.

The left column is the same disease at different points on the same timeline. The appointment exists to keep you near the top of it.

The examination

Teeth. Each tooth is checked for decay, cracks, wear and failing fillings. Decay between teeth is not visible to the eye, which is why radiographs are taken at intervals matched to your risk.

Gums. The space between gum and tooth is measured around each tooth. Healthy readings are shallow; deepening pockets and bleeding on probing are the early signs of gum disease.

Everything else. Tongue, cheeks, palate, throat, lips, jaw joints and the lymph nodes of the neck. This is an oral cancer screen — uncommon, painless in its early stages, and far more survivable when found early. It is one of the better reasons to keep coming when nothing hurts.

History. Your general health, medications and any concerns. Many common medications reduce saliva and change your decay risk; tell us what you take, including anything from a pharmacy or naturopath.

At your first visit this is also the moment to tell us if you are anxious. It changes how we pace things.

For what a full diagnostic appointment involves, see dental examination.

The clean

Plaque is the soft film of bacteria that forms constantly on teeth. Left alone for a day or two it begins to harden into calculus, also called tartar, which is mineralised and cannot be brushed off at any pressure. Once it is there it gives plaque a rough surface to cling to, and the cycle accelerates.

Calculus is removed with an ultrasonic scaler and fine hand instruments, above and below the gumline. Then a polish removes surface staining.

In order

1. A look around first, so we know where the build-up and the tender areas are before anything starts
2. Ultrasonic scaling — vibration and water spray break up the bulk of the calculus. It is noisy and wet rather than painful
3. Hand instruments for what the ultrasonic cannot reach cleanly, particularly just under the gumline and behind the lower front teeth
4. Polishing with a rubber cup and paste, which removes surface stain and leaves the surface smooth
5. Flossing through, to clear anything loosened between the teeth
6. Fluoride, painted on at the end
7. A conversation about the two or three places your routine is missing — which is the part that changes anything

It should not hurt. Where there is heavy build-up or sensitive areas, a topical anaesthetic gel makes it comfortable, and local anaesthetic is available if you would prefer it. Gums that are inflamed may bleed a little during cleaning — that is the inflammation, not the instrument, and it settles as the gums recover.

A clean removes surface stain from tea, coffee and tobacco, and many people are surprised by the shade afterwards. It does not change the underlying colour of teeth; that is whitening.

What this is, next to what it is not

The words get used loosely, and the differences are real.

If you have been told you need a "deep clean", that is a different and longer treatment — see gum care.

Afterwards

Gums can be tender for a day or two, particularly if there was a lot to remove, and some sensitivity to cold is common and short-lived. If your gums bleed a little when you brush over the next few days, keep brushing gently rather than avoiding the area — the bleeding stops as the inflammation resolves.

Avoid strongly staining food and drink for the rest of the day while the polished surface re-mineralises.

Two things people notice and worry about unnecessarily: gaps that feel bigger — that is calculus gone from between the teeth, not gum lost during the appointment; and teeth that feel slightly loose where there was heavy build-up holding them, which settles as the gums firm up.

Sensitivity that is still there after a couple of weeks, or pain on biting, is worth a call.

How often?

Six months is the conventional interval and suits many people. It is a default, not a rule. Your dentist will set your recall based on your decay history, gum health, smoking, dry mouth, diet and existing dental work — which can mean anything from three-monthly to annual.

Ask why your interval is what it is. You should get an answer about your mouth, not a policy. More on how often to visit.

Do not wait for your recall if

• Your gums bleed every time you brush, and have done for more than a couple of weeks
• A tooth has become sensitive to cold and it is not settling
• Anything is sore to bite on
• A filling, crown or piece of tooth has come away
• There is a lump, ulcer, or red or white patch that has lasted more than two weeks
• A tooth has moved, or your bite feels different
• There is any swelling of the face or gum — that is the same day, not next week

See emergency dentist.

What this appointment does not include

It is an examination and a clean. It is not a deep clean for established gum disease, which is a separate, longer treatment done under anaesthetic over more than one visit — see gum care. It is not whitening. It is not treatment for anything found; that is planned, quoted and booked separately.

If we find something, you will be told what it is, what happens if it is left, and what the options cost, before anything is booked.

If it has been years

Plenty of people come in after a long gap, often because something has started hurting or because they have been putting it off. You will not be lectured. The first visit can be an examination and a conversation and nothing more, and treatment can be staged over time so it is affordable.

The longer gap does mean allowing more time for the first clean, and occasionally splitting it across two visits.

Children

A first visit around the age of one, or when the first tooth appears, is the current recommendation. Early visits are short, friendly, and largely about making the place familiar.

A child's clean is gentler and often mostly a polish and fluoride, because calculus is uncommon in children. What the appointment is really doing is watching eruption, checking the grooves of new molars, and building the habit of coming in before anything hurts. See family and children's dentistry.

Between visits

What happens in the chair matters less than what happens for the other 364 days.

• Brush twice daily for two minutes with a fluoride toothpaste, spit and do not rinse
• Clean between the teeth daily, with floss or interdental brushes sized for your gaps
• Limit how often you have sugar, which matters more than how much
• Do not brush straight after anything acidic; wait around thirty minutes
• Drink tap water, which is fluoridated in Melbourne

Two refinements worth the effort. Interdental brushes beat floss where they fit — ask which size suits your gaps, because a brush that is too small does nothing. And the last thing at night matters most, because saliva flow drops while you sleep and whatever is on your teeth stays there.

Who you will see

Our dentists, oral health therapists and dental hygienists all provide check-ups and cleans. Oral health therapists and hygienists are registered practitioners in their own right with a defined scope; anything outside it is done by a dentist. Victorian Dental Group is a general practice and none of our practitioners holds specialist registration.

Claiming and payment

HICAPS on-the-spot health fund claiming — bring your card and pay only the gap, which depends on your cover. Most extras policies cover two preventive visits a year, often at a high rebate, so this is the appointment your cover is best suited to. Afterpay and Zip accepted. See payment options.

Two practical notes: extras limits generally reset on 1 January, and unused preventive cover does not carry over; and if you have recently joined or upgraded a policy, check whether a waiting period applies before you book.

Questions we are asked

Does a clean damage enamel? No. Scaling removes calculus, not tooth structure.

Why do my gums bleed during it? Because they are inflamed. Healthy gums do not bleed when cleaned.

Will it whiten my teeth? It removes surface stain, which often looks like whitening. It does not change the natural shade.

Can I have a clean if I am pregnant? Yes, and it is worth doing. Pregnancy makes gums more reactive.

Do I need X-rays every time? No. They are taken at intervals matched to your risk, and you will be told why before any are taken.

I brush and floss well. Do I still need this? Yes. Calculus forms in places no home routine reaches, particularly behind the lower front teeth, and the examination is the part that finds things early.

Why does calculus keep coming back so fast? Some people simply mineralise plaque more quickly — it is partly down to saliva chemistry and is not a character flaw. It usually means a shorter interval rather than harder brushing.

Can I have the clean without the examination? We would rather not. The clean removes the build-up; the examination is the part that finds decay, cracks and anything on the soft tissues.

Will it hurt if my gums are already sore? It can be tender. Say so — topical gel or local anaesthetic makes it manageable, and there is no reason to sit through discomfort.

Can I bring my children to the same appointment? Book them their own. Children's appointments are paced differently, and a rushed first visit tends to set the tone for years.

Booking

Allow 45 to 60 minutes. If you want a clean at the same visit, select it when booking online or mention it by phone so the right practitioner is available.

Victorian Dental Group — 291 Wattletree Road, Malvern East VIC 3145 · (03) 9088 5808 · Monday to Friday, 8:00am–5:00pm · book online

Read more about dental examinations, X-rays and OPG or gum care.

This page is general information and does not replace advice from a registered dental practitioner about your own circumstances. Please see our Disclaimer.