Cleaning or whitening: what is the real difference?

The answer in full

A cleaning works on the outside of the tooth. Every day a sticky film of bacteria called plaque forms on your teeth, and brushing removes it wherever the brush reaches. What is left behind hardens with the minerals in saliva within days and becomes tartar (calculus, if that is the word you know): a hard layer stuck to the tooth at the gum line and beneath it, which no brush or floss will shift. Tartar has a rough surface, so it grabs the stains from coffee, tea and smoking, and it makes the gum inflamed and prone to bleeding.

A cleaning at the clinic (a scale and polish, if that is the term you know) removes that layer in three steps. First, a fine tip vibrating at high speed, with a spray of water, loosens the tartar from the tooth without cutting into it, in trained hands and at the right settings. Second, fine hand instruments for what is left at the gum line. And third, a polish with a fine paste that removes the surface stains and leaves the surface smooth, so plaque does not get a grip again as quickly. If the tartar has gone deep under the gum, the cleaning is done in stages, sometimes with the area numbed, and you know that from the examination beforehand.

Whitening works inside the tooth. Whitening does not paint the tooth from the outside. The whitening agent passes into the enamel and breaks down the coloured molecules inside it, so the colour changes from within the tooth itself. So a cleaning brings back the tooth’s own colour, and whitening changes that own colour to a lighter one. Two different things, and neither is a substitute for the other.

Why so many people ask for whitening when what they need is a cleaning

Because for many people what darkens the smile is not the colour of the tooth but what sits on it. Tartar is yellow or brown, stains settle on it and along the edge next to the gum, and that is the first place it shows. When it comes off, many people find their tooth lighter than they expected. That is why we say: many people ask for whitening when what they need is a cleaning, because the stains were on the surface. And the reverse is also true: if the colour of the tooth itself is yellow or grey from within, a cleaning leaves it clean but not lighter, and that is where whitening has a point.

The downsides first

• Temporary sensitivity. Tartar was covering part of the tooth at the gum line, and once it is gone that part is exposed to cold for a few days. It usually settles on its own, and if it bothers you, ask the doctor about a toothpaste for sensitivity.
• Bleeding in the first days. An inflamed gum bleeds at the lightest touch, during the cleaning and in the first brushings after it. The bleeding comes from the inflammation that was already there, not from any cut by the cleaning, and it eases over the days as the cause goes.
• Gaps that show. Between the teeth at the gum, where there used to be tartar and a gum swollen with inflammation. The gap was there and hidden; the cleaning revealed it, it did not create it.
• Not a substitute for whitening. If your colour comes from inside the tooth, a cleaning leaves it clean and stops there.
• And not once and for all. Tartar forms again, faster in some mouths and slower in others, and the cleaning is repeated on a schedule the examination decides.

What a cleaning removes, and what it does not

Before you decide, here are two lists that save you a disappointed expectation. The first is what goes with a cleaning; the second is what stays where it is even if you had a cleaning every week.

It removes

• Tartar. Above the gum line and beneath it. What is beneath matters most, because it cannot be seen in the mirror, and it is what harms the gum and the bone that holds the tooth. If it has gone deep, the cleaning is done in stages, and that is known from the examination.
• Plaque. The soft film the brush missed, especially between the teeth, at the gum line, and behind the last molars.
• Surface stains. From coffee, tea, smoking, shisha and coloured food. These usually go with the polish, because they sit on the surface rather than inside it.
• Part of bad breath. When its cause is the bacteria living in the tartar and under the gum. Not every bad breath comes from tartar, but it is the first thing to be checked.
• Bleeding when you brush. It usually drops a great deal once the tartar is gone and you brush properly, because the cause has gone.

It does not remove

• The natural yellow. Teeth are not white by nature; their colour leans towards a light yellow, and they darken with age on their own. That is the colour of the tooth itself, and a cleaning does not change it.
• Colour that comes from inside the tooth. A tooth that darkened after a knock, or after a root canal, or teeth that have been greyish or banded since childhood, sometimes from a medicine taken back then. That does not come off with a cleaning, and sometimes not with ordinary whitening either, and it needs an examination to show its cause.
• Discoloured fillings and crowns. An old filling that has darkened, or the edge of a crown that has started to show: their colour is fixed, and a cleaning polishes them but does not bring back their original colour. Replacing them is a separate decision, talked through at the examination.
• White spots. From enamel defects, or from the very beginning of decay. They are not dirt to be removed; they are inside the enamel itself, and they have their own treatment, which the examination shows.
• Decay. A cleaning reveals it, because it removes what was covering it, but it does not treat it. And that on its own is reason enough for a cleaning to come before any whitening.

Why do your teeth look lighter after a cleaning?

Because what came off was darker than the tooth. Tartar is yellow or brown, stains are dark, and once they are gone the tooth shows its true colour again. That is a return to the original, not whitening. And the difference is worth knowing for a practical reason: a few days after the cleaning, once the gum has settled and its redness has gone, you see your true colour and decide whether you want whitening at all. And if you do, whitening on a clean tooth reaches the whole tooth, because the agent reaches the enamel rather than the tartar. Whitening at the clinic or at home.

Does removing tartar damage the teeth or the enamel?

This is one of the questions that most often puts people off a cleaning, and the answer has two halves. Tartar is a layer on the tooth, not part of it. The cleaning loosens that layer from the surface without cutting into it, and enamel is far harder than tartar. So a cleaning at the dentist removes the tartar; it does not remove the enamel, when it is done by trained hands with the right settings. And what people feel afterwards, and read as damage, has another explanation:

• “My teeth have become sensitive.” Tartar was covering part of the tooth at the gum line, and once it is gone that part is exposed. The sensitivity appears because the cover has gone, not because the tooth was cut by the cleaning, and it usually settles on its own over the days.
• “There are gaps now.” The gap was there and packed with tartar, and the gum that was swollen with inflammation goes back to its normal size once the cause has gone. The cleaning revealed the gap; it did not create it. If the gum receded long ago because of old tartar, that recession stays, and that is exactly why putting it off is what can do the harm.
• “My gums bled.” An inflamed gum bleeds at the lightest touch. The bleeding comes from the inflammation that was already there, not from any cut by the cleaning, and it eases over the days once the tartar is gone and you brush properly.
• “My teeth have become loose.” Rare, and it happens when there was a lot of tartar and the gum and bone beneath had weakened long ago. The tartar was hiding a problem that was already there, and it is the examination that tells you the state of your gum and bone from the start.

The second half: real harm comes from three directions, and all three are in your hands to avoid:

• Putting the cleaning off. Tartar that stays can work its way under the gum, and the inflammation can reach the bone that holds the tooth. Bone that is lost does not grow back with a cleaning.
• Scraping tartar off at home. The sharp tools sold online cut the gum and scratch the enamel, and they leave the tartar under the gum line where it is, which is the most harmful part.
• The acidic and abrasive mixtures. The acidic ones, lemon and vinegar, eat into the enamel, and the abrasive ones, like charcoal, scratch it; neither removes tartar in the first place, and enamel that is lost does not grow back.

Removing tartar at home: why it does not work

Because tartar is a hardened, mineralised layer stuck to the tooth, and no brush, floss or mouthwash will loosen it. What is in your hands at home is not removing tartar; it is preventing new tartar. Plaque turns into tartar within days if it stays. So brushing twice with a soft brush and flossing once, especially at the gum line and between the teeth, means less of it forms, and the next cleaning is easier and gentler.

How often should I have my teeth cleaned at the dentist?

There is no one number that applies to everyone, and any number of months you hear is an average across many mouths, not a figure for yours. In some mouths tartar forms slowly and the teeth stay clean for longer after a cleaning; in others it comes back quickly even with proper brushing. The difference is not only in cleanliness: it is in the make-up of your saliva, the arrangement of your teeth, and your habits.

What makes you need it more often

• Smoking and shisha. They stain, they speed up the build-up of tartar, and they mask gum bleeding, so the inflammation goes on in silence.
• Gums that bleed, or have been inflamed before. A gum with a history of inflammation needs closer follow-up, so the tartar does not return under the line.
• Diabetes. It makes the gum react to plaque faster and heal from inflammation more slowly, so the cleaning becomes part of looking after the condition rather than a luxury, in coordination with your physician.
• Braces. Wires and brackets collect plaque in places the brush cannot reach.
• Pregnancy. Cleaning your teeth and gums matters more in pregnancy, and the doctor may ask for cleanings more often than usual.
• A dry mouth. Saliva washes your teeth all the time. When there is less of it, because of a medicine, mouth-breathing or too little water, plaque sits longer and does more harm to the teeth and gums.
• Crowded teeth, or a lot of dental work. More corners for the brush and the floss to miss.

At the first cleaning, the doctor sees how much tartar there was and where, and the state of your gums, and tells you the schedule that suits you. At the next cleaning he sees how much has come back, and adjusts the schedule to it. So the number comes from your mouth, not from a general rule. And if you are only in Amman for a stretch, or you come and go, say so: the schedule is planned around your dates as far as the work allows.

And in pregnancy?

Pregnancy hormones make the gums swell and bleed more easily with plaque, so a cleaning eases them. What waits is whitening: whitening is cosmetic, and there is no urgency to it, so the usual practice is to wait until after the birth, and many dentists prefer to wait until after breastfeeding too, because there is not enough safety data in pregnancy. What does not wait is cleaning your teeth and gums. The full picture is in Braces during pregnancy: what waits and what doesn't.

And children?

Children have cleanings too, but the approach is gentler: a cleaning and polish along with the examination, and teaching the child and the parents how to brush, because children build less tartar, and the usual problem at that age is plaque and decay from brushing that misses, and prevention at that age often saves treatment later. Whitening for children is usually not done, because their teeth are still developing and the nerve inside is larger and closer to the surface, so sensitivity is higher. For a teenager it is decided at the examination. Children’s teeth.

What to do now

If you want a cleaner or a lighter smile and do not know where to start, these are the steps in order:

1. 1

   Be examined firstBefore any cleaning or whitening, an examination of your teeth and gums. That is where it is seen whether your colour sits on the outside or comes from inside, how much tartar there is and where, and whether there is decay or inflammation to be treated before anything cosmetic. If your last cleaning was in another clinic or another country, say so, and roughly when: it helps the doctor read how fast tartar builds up in your mouth.

2. 2

   Have the cleaningThe cleaning comes first either way: if health is all you want, it is the step. If you want whitening, it is what prepares the tooth for it, because whitening is not done over tartar or inflamed gums.

3. 3

   Wait a few days and see your true colourAfter the cleaning, the gum settles and the tooth goes back to its natural colour. Now you see whether what bothered you went with the tartar and the stains, or whether it is the colour of the tooth itself you want to change.

4. 4

   Then decide on whitening, if you still want itOn a clean tooth, and having seen your true colour, the decision is about a real need rather than a stain that would have gone with the cleaning. And whichever method suits you: Whitening at the clinic or at home.

5. 5

   The daily habitBrush twice with a soft brush and an ordinary, non-abrasive toothpaste, floss once, and rinse with water after anything dark. The aim is not only the colour; the aim is that plaque never gets as far as tartar.

6. 6

   Follow-upRegular cleaning at the clinic on the schedule the doctor sets. That is where tartar is caught before it takes on colour, and where the gum is seen early, before any recession grows. And what makes whitening stay, if you have it: Does whitening fade, and what keeps it.

When to call

A cleaning rarely leads to an emergency, so most calls about it are questions rather than cases. But some signs should not wait for the next check-up, whether you were cleaned with us or anywhere else:

• Call this week: sensitivity to cold after the cleaning that has not eased after a few days, or has grown stronger.
• Call this week: gum bleeding that has not dropped after the cleaning and proper brushing, or has increased.
• Call this week: a gum that bleeds on its own, bad breath that does not go away with brushing, or a tooth you feel has started to move.
• Call today: a swelling in the gum or the cheek, especially if it is growing or comes with pain, pus or a fever.
• Call today: sharp pain in a tooth after the cleaning that does not go. Usually that is not the cleaning itself but something that was already there and has shown itself; it needs examining.
• Call today: bleeding after the cleaning that does not stop with pressure, especially if you take a blood thinner.

Call and we will find you the earliest slot, and tell you what to do until you arrive. Before any painkiller, ask the doctor first, so it suits your case. If the swelling has reached your eye, or it has become hard to swallow or breathe, that is a hospital emergency, not an appointment. And if the pain is in a tooth that wakes you at night: Toothache: what to do right now.

Questions people ask