Common Problems
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Bleeding Gums and Bad Breath:
The Difference between Scaling, Polishing and Whitening
Ever so many people come in with this complaint. Many also complain of bad breath. They mostly fear seeing their dentist and avoid treatment unless they are in pain.
The most common cause is the accumulation of a hard deposit under the gums which may grow onto the tooth itself. It usually is cream-ish in colour and gets stained brown after some time. We call it calculus (No relation to Calculus in Additional Mathematics!)
The reason why the gums bleed is because the deposits are actually hardened food that was not brushed off effectively. This retained food (decaying food equals bad breath!!) hardens on the teeth due to the calcium in the saliva.
Trouble is the deposits also are mixed in with bacteria which use up the food and give off toxins which causes the gums to get swollen. Also to compound everything, the deposits no longer can be brushed off with your toothbrush!
Anything swollen has more blood supply (it’s the body’s way to get rid of germs) so when you brush your teeth, the sharp deposits scratch the swollen gums and they bleed. That’s a no brainer. huh.
So a sure sign of calculus on your teeth is if you see blood in the froth that you wash out when you brush your teeth!
The second problem is that the whole process initially doesn’t hurt and people kind of get used to seeing a little blood in the froth….. so they ignore it!
Before long the gums get more and more swollen, and the deposits get larger and sharper, and the gum bleeding is difficult to ignore! Or you start to notice people look away when you get too close because your breath could kill!
So what can you do?
Well… seeing a dentist is a good idea! We’d probably take a look and tell you that you need a scaling.
What is a Scaling?
A scaling is where the dentist examines your teeth then uses a machine that has an incredibly fast vibrating tip to knock off the deposits a.k.a. calculus. The machine makes a funny high pitched sound as it ultrasonically does its job.
There usually is a water spray that not only cools the tip but helps flush away the deposits that get knocked off the tooth. You don’t have to worry about swallowing anything as we have a vacuum tip to help you get rid of it all. I call it my power straw!!
Once we are done, the dentist will polish off any little bits still left on your teeth, together with stains that may be there with a special paste. That’s the nice part …. as you are left with a fresh feeling in your mouth and sparkling teeth!
Does it hurt? Not usually but for most people it’s awfully scary and uncomfortable. What we do for patients who have a LOT of calculus, is paint on a gel which softens the calculus so it falls away easily and fast.
The trick is to do a scaling every six months, like you bring in your car to be serviced every 5000km, then there’s very little deposits and we can get you back tip top fast and easily.
Being ‘kiasu’ when it comes to your gums really doesn’t work!! 
What is polishing?
Polishing is when the dentist uses a special paste on either a bristle brush or a rubber cup and polish off any stains off your teeth.
Polishing usually is routinely done after the scaling procedure as there may be fine deposits of calculus still stuck on your teeth making the teeth still rough (compared to the shiny slick surfaces it normally has) and retains food stuff easily.
Polishing then also gets rid of any stains: smoke stains, coffee and tea stains and yes, stains from food like egg yolk, cabbage and potatoes. There is a study that showed that certain people have a saliva composition that causes food like egg yolk, cabbage and potato to leave brown stains on their teeth!
The polishing does not harm the teeth or cause it to thin either! (Another common but mistaken belief)
Recently, there has been a special paste developed by Colgate, that claims to cause a chemical exchange on the tooth surface that makes teeth no longer sensitive for as long as 3 months after each application!
I have tested this paste and found patients do experience less sensitivity, so we now use the paste (it’s rather expensive!) when the need arises. It is not available in normal shops though … it is solely for professional use as you need to have the paste rotated onto the surface for a short period of time, so you can’t walk into your local Giant or Tesco to get a tube … sorry!
What is Whitening?
Whitening is when a gel-like substance is placed on your teeth which oxidises the surface so it appears whiter or brighter. It is actually bleaching… because the active ingredient is usually a bleach.
There are many, many types of whitening products these days. Most are professional whitening systems, which are carried out by the dentist, and there are also home-use remedies, which you can buy off the shelf and use on yourself at home.
The main difference is in the formulation of the gel-like mixture. The professional systems are of much higher concentrations than those in the home use packages.
The reason why this is so is because of several factors.
Firstly, the patient would be examined for cavities (holes), cracked teeth and leaking fillings, at the very start of the treatment as any teeth that require attention need to be attended to first! Imagine placing a bleach on an exposed tooth … it could be potentially very painful and /or damage the tooth even more!
Most people are unfortunately afraid of dentists, and avoid visiting one, so manufacturers of home-use products, very prudently, only put in a mild formulation that doesn’t have an active cycle that lasts long, (it degrades and becomes harmless in minutes) to avoid problems as much as possible.
Secondly, the home-use formulation is usually placed in a ’stock tray’, a u-shaped tray that you place the gel in, then fit in your mouth, to hold the gel onto the teeth. These trays do not exactly fit your teeth unlike those custom-made for you by the dentist, so will leak out the mixture.
Quite a bit of the home-use mixture will most probably be swallowed so has to be a rather mild concentration so be safe to sell over the counter and hence used unsupervised at home.
In the dentist’s office, the patient would be examined, then a scaling and polishing may be done first, then the initial colour of the teeth is recorded and the desired final colour is agreed upon. Only then does the procedure really start, with the patient having their gums protected by a special barrier first.
The whitening mixture is prepared and immediately placed on the teeth … this is very closely timed and the concentration of the gel mixtureis measured out exactly. The dentist then usually passes either a plasma light (a very high intensity light) or uses a UV light source, which further activates the release of oxygen from the mixture.
All this is done under very strict supervision and when the appropriate time is over, the mixture is very carefully suctioned off so you don’t swallow it.
The whole thing is repeated. Again, very strict control is exercised as to the protection of your gums from the bleach, the concentration of the mixture, the length of time it is placed on your teeth and the suctioning off of all the mixture after each application.
Once the desired shade is reached, the dentist will remove the barrier over the gums and treat the gums with Vitamin E to sooth it.
Usually we advise the patient to stay away for at least a day, from food and drink that may stain the teeth. Usually 24 hours will be more than sufficient for the teeth to remineralise from the natural saliva, after which, eating and drinking things like coffee and coke, would be fine.
In short …. whitening can be a complicated procedure and can take up to an hour or longer.
I would strongly recommend doing it in-house with a dentist supervising the whole procedure!