Routine cleanings and deep cleanings are different procedures targeting different problems. Knowing which one applies to you avoids surprises at the front desk.
Regular cleaning (prophylaxis) - what it is
A regular cleaning, technically called adult prophylaxis (D1110 on insurance), is preventive care for healthy gums. The hygienist removes plaque, tartar, and stain from above and just below the gum line. No anesthesia. One visit, 45-60 minutes. Insurance typically covers two prophylaxis visits per year at 100%. Patients with healthy probing depths (1-3 mm) and no bone loss qualify for prophylaxis.
Deep cleaning (scaling and root planing) - what it is
A deep cleaning, technically scaling and root planing (SRP, codes D4341/D4342), is a treatment for active gum disease. The hygienist or dentist uses local anesthesia to numb the gums and removes tartar and bacterial biofilm from deep below the gum line, smoothing root surfaces so the gums can re-attach. SRP is usually done by quadrant - your mouth divided into four sections - across two visits. Each quadrant takes 30-60 minutes.
It is a treatment, not preventive care. It is recommended when probing depths are 4 mm or deeper with bleeding, and when X-rays show bone loss.
Cost and insurance coverage
Typical California fees:
- Routine cleaning (prophylaxis): $90-$150 per visit; usually 100% covered (2x/year).
- Deep cleaning (SRP): $200-$350 per quadrant. Most plans cover at the basic-restorative tier (70-80%), once per quadrant every 24 months.
- Periodontal maintenance (after SRP): $115-$175 per visit; covered at the same frequency as prophylaxis on most plans, once you have a documented perio diagnosis.
We always submit a pre-treatment estimate before SRP so you know your out-of-pocket before we begin.
How we decide which cleaning you need
The decision is made from objective measurements, not opinion. We look at:
- Probing depths. 1-3 mm = prophylaxis. 4-5 mm with inflammation = SRP candidate. 6+ mm = SRP plus possibly periodontal referral.
- Bleeding on probing. Generalized bleeding even in shallow pockets points toward SRP.
- Bone loss on X-rays. Visible bone loss confirms a perio diagnosis.
- Plaque and tartar burden. Heavy supragingival tartar in someone overdue for cleaning may still qualify for prophylaxis if pockets and bone are intact.
If the chart numbers don't support SRP, we don't recommend it - overdiagnosis of perio is a real problem in some practices, and we don't do it.
Recovery and ongoing care
After SRP, expect:
- Mild tenderness for 1-2 days; manage with ibuprofen.
- Sensitivity to cold for 1-3 weeks (newly exposed root surface).
- Improved gum color within 3-4 weeks as inflammation resolves.
- Pocket depth re-measurement at 6-8 weeks to verify healing.
- Transition to periodontal maintenance every 3-4 months going forward, indefinitely. This more frequent schedule is what keeps perio stable; reverting to twice-yearly prophylaxis is the most common reason patients backslide.
Frequently asked questions
- Do I really need a deep cleaning, or am I being upsold?
- A legitimate SRP recommendation is supported by probing depths, bleeding, and bone loss on X-ray. Ask to see the numbers and the X-rays. A second opinion is reasonable if you are unsure - and we provide one without pressure.
- Will it hurt?
- During the procedure, no - local anesthesia eliminates pain. Expect mild soreness for 24-48 hours and root sensitivity to cold for a few weeks afterward.
- Can I just keep getting regular cleanings if I have gum disease?
- Continuing regular cleanings on diseased gums is below the standard of care and accelerates bone loss. Some patients delay SRP for budget reasons; we work with them on phasing the case but we do recommend treatment.
- How quickly does gum disease come back after deep cleaning?
- Without consistent perio maintenance, pocket depths typically rebound within 6-12 months. With 3-month maintenance, most patients hold their improvement long-term.