Dental prevention and prophylaxis are often the most effective methods for maintaining long-term oral health. Even when we have very good oral hygiene at home, over time we may encounter tartar build-up or gum inflammation, which cannot be controlled by daily brushing alone.

For this reason, professional cleaning at the dentist's office is recommended twice a year. Professional cleaning refers to all procedures performed at the dentist's office to remove bacterial plaque, tartar and dental stains, with the aim of preventing cavities and gum disease.  

According to the International Dental Federation, regular professional prophylaxis is essential for maintaining long-term oral health.

We invite you to read this article if you want to find out the differences between professional brushing, scaling and air-flow procedures. 

Scaling is the procedure by which dental tartar deposited on the surface of the teeth, above and below the gum line, is removed. Tartar is a hard, mineralised structure that promotes bacterial accumulation and gum inflammation.

Studies show that bacterial plaque begins to form just a few hours after brushing, and if not removed effectively, it mineralises and turns into tartar in about 48–72 hours. Once formed, tartar cannot be removed by regular brushing.

There are two main methods of tartar removal:

Manual scaling – performed with special instruments (scalers), which requires greater physical effort due to the forces applied to the tartar and a longer working time, often being more uncomfortable for the patient.

Ultrasonic scaling – uses high-frequency vibrations and a water jet to effectively break up and remove dental tartar. It allows cleaning of hard-to-reach areas, including subgingival areas, with minimal risk of trauma to soft tissues.

"According to the clinical guidelines of the European Federation of Periodontology (EFP), ultrasonic scaling is the standard method for the prevention and initial treatment of mild periodontal disease," says Dr Felicia Velicu, dentist at the DENT ESTET Sibiu clinic.

Benefits of scaling:

• reduces gum inflammation;
• prevents gingivitis and periodontitis;
• improves breath;
• creates a smoother tooth surface, less favourable to bacterial plaque adhesion. 

Professional brushing is a procedure that cleans the surface of the teeth using rotating brushes and special abrasive pastes, using techniques tailored to each patient.  

Unlike scaling, it does not remove hard tartar, but soft bacterial plaque and superficial pigmented debris.

"Professional brushing is essential after scaling, as it helps to finish the tooth surfaces and prolong the effect of cleaning. Proper professional brushing makes the tooth surface much less 'welcoming' to bacteria," explains Dr Felicia Velicu.

The benefits of professional brushing:

• smoothing of the enamel surface;
• reducing bacterial retention;
• improving the aesthetic appearance of teeth;
• maintaining gum health. 

Airflow is a modern dental cleaning method that uses a controlled jet of air, water and fine powder (usually sodium bicarbonate, erythritol or glycine) to remove stains from coffee, tobacco, tea or red wine from the surface of the teeth.  

The powder is projected onto the tooth surface and into hard-to-reach areas without affecting the tooth enamel or healthy gums, effectively removing:

• stains caused by coffee, tea, red wine and smoking;
• bacterial plaque from hard-to-reach areas;
• bacterial biofilm on the enamel surface and around orthodontic appliances.

"Recent studies recommend airflow as an integral part of modern prophylaxis. At DENT ESTET clinics, airflow is an important step in professional EMS hygiene, a modern prophylaxis technique based on Guided Biofilm Therapy (GBT). Created by the Swiss company EMS Dental, GBT is the gold standard in dental prophylaxis because it allows the removal of bacterial plaque and tartar in a controlled and efficient manner," says Dr Felicia Velicu.

Advantages of airflow:

• quick and comfortable procedure;
• non-invasive, does not damage the enamel;
• provides immediate aesthetic results.  
   

If you want long-term results, you should know that a dental cleaning session must include all three procedures: scaling, professional brushing and airflow.  

There are significant differences between the three procedures.

In terms of depth, scaling is the most thorough of the three procedures. It acts both above and below the gum line, where hard, mineralised tartar deposits. Scaling is the only procedure capable of removing subgingival tartar, which is responsible for gum inflammation.

In contrast, professional brushing and airflow only act supragingivally, on the tooth surface. Professional brushing cleans soft bacterial plaque and smoothes the enamel, while airflow removes biofilm and pigment stains.

In terms of results, after scaling, the gums are less inflamed, bleeding is reduced, and the risk of periodontitis decreases significantly. Professional brushing offers both medical and aesthetic benefits: teeth become smoother, cleaner, and bacterial retention is reduced. Airflow has an immediate aesthetic effect, removing stains caused by smoking, coffee or tea and restoring the natural brightness of the teeth, while also helping to control bacteria.

From an indication perspective, scaling is recommended for all patients with tartar, regardless of the quality of their daily oral hygiene, as it is essential in the prevention and treatment of gingivitis and periodontitis.  

Professional brushing is recommended as a maintenance procedure after scaling and for patients who want optimal oral hygiene and a smooth tooth surface. Airflow is recommended for patients with dental stains, smokers, those who frequently consume coloured drinks, but also for those who wear orthodontic appliances, implants or prosthetic work, where classic cleaning is more difficult.

In terms of its effects on the gums, scaling can cause temporary slight sensitivity or discomfort, especially in the case of inflamed gums, but the benefits are significant: it reduces inflammation and promotes tissue healing.  

Professional brushing is gentle on healthy gums and helps to keep them in good health. Air-flow, especially when using modern powders such as glycine or erythritol, is very well tolerated and is one of the most comfortable procedures for the patient.

In terms of duration, scaling is the longest procedure, taking an average of 20–40 minutes; professional brushing takes about 10–15 minutes, and air-flow between 10 and 20 minutes. When performed together as part of a complete professional hygiene protocol, the total duration is approximately 45–60 minutes. 

Scaling is recommended for all patients, generally at intervals of no more than 6 months, or more frequently for patients who smoke or who have dental implants, prosthetic work (crowns or veneers), orthodontic appliances or periodontal disease, in which cases professional cleaning is recommended approximately every 3–4 months.

The benefits of a complete cleaning protocol: scaling + air-flow + professional brushing:

• scaling removes tartar;
• air-flow removes biofilm and stains;
• professional brushing finishes and smoothes the tooth surfaces.

"Performed together, these procedures significantly reduce bacterial load and increase the effectiveness of daily oral hygiene. No single procedure is complete on its own, and their combination is the key to effective prevention," says Dr Felicia Velicu. 

Frequently asked questions

Does scaling hurt? 

Ultrasonic scaling is usually well tolerated. Most patients find it more comfortable than manual scaling, but the sensations experienced depend on individual sensitivity, the degree of tartar build-up and gum health. If necessary, the specialist may use anaesthesia or soothing gels and will adjust the device settings and tip type to increase patient comfort.

Is air-flow abrasive? 

No, air flow is not an abrasive procedure when performed correctly and with modern powders (glycine or erythritol). These powders have very fine particles and cause insignificant abrasion to the enamel, dentine and gums, being much gentler than sodium bicarbonate.  

Can professional brushing replace scaling? 

No, professional brushing cannot replace scaling. Although they are part of the same dental hygiene session, the two procedures have different roles and complement each other.  

How long does the effect of professional cleaning last? 

The effect of professional cleaning is not permanent, but it usually lasts between 3 and 6 months. The duration depends on daily oral hygiene, eating habits, smoking and individual predisposition to tartar build-up. Professional cleaning is recommended every 5-6 months, and in certain situations, every 3-4 months. 

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