How often should I go to the dentist?
September 23, 2012 11:16 AM   Subscribe

How often should a "regular" dental checkup and cleaning take place?

There are really 2 questions here: about 1) checkups; and 2) cleaning.

It's hard to get an objective answer on the interwebs. And realistically I can see why: everyone's different.

I guess the scientific way to establish it for myself might be to schedule a 6-month checkup, and if nothing was wrong, schedule the next one for 7 months. And keep extending the time until something went wrong and then that interval would be the best time for me. Anyway . . . .

The Mayo Clinic says only "regular" checkups.

The NHS in Britain says:
"You may assume you should have a dental check-up every six months, but some people may not need to go so often and others may need more frequent checks. People with good oral health will probably need to attend only once every 12 to 24 months, but those with more problems will need check-ups more often. Your dentist will suggest when you should have your next check-up based on how good your oral health is."

Big difference between 6 months and 2 years.

The most realistic view is here . (Read the whole thing - there's some sarcasm.)
Excerpt: "The insurance companies like the steadiness of the 6 month recall concept. It means they have their providers, the dentists that have joined their plan, doing periodontal work for prophy (prophylaxis) fees! The insurance companies are then able to essentially reduce the utilization of the plan, which in turn increases profits. In the meantime the patient is being undertreated and the dentist is either committing malpractice or committing financial suicide.

And look at this Freakonomics blog post .
Excerpt: "The evidence was mixed, at best. For example, there is not strong evidence that hygienist cleaning reduces gingivitis."

I welcome your thoughts.
posted by feelinggood to Health & Fitness (21 answers total) 3 users marked this as a favorite
I'm not sure how getting regular checkups and cleanings is undertreatment. I like the six month cleaning, checkup, and (half) x-rays. If you have cavities develop between checkups, that means you need to schedule them more frequently and possibly change your brushing/flossing habits.
posted by wierdo at 11:27 AM on September 23, 2012 [1 favorite]

If you have cavities develop between checkups, that means you need to schedule them more frequently and possibly change your brushing/flossing habits.

This. I am not prone to cavities, and going to the dentist once per year has worked for me. My wife goes every six months because she feels her teeth and gums need attention that frequently.
posted by alms at 11:44 AM on September 23, 2012

There isn't a good answer because even if highly accurate optimal intervals could be worked out, they'd probably be too hard to remember. Six months might have been thought up by an ad agency but it works for a lot of people cleaning-wise because it's simple. A lot of people start annually, and if a person comes in annually and isn't cleaning well, the dentist will bump them up to six months. I don't know if many people are bumped from six to three but I could see it happening, especially for people who interact with many people for a living. That's where insurance becomes a problem since the standard plan only pays for two cleanings per year.

Soon, hopefully, there will be developed smart toothbrushes that can perform some diagnoses and also identify when a cleaning is due. It would be quite a useful piece of technology.
posted by michaelh at 11:45 AM on September 23, 2012

In the meantime the patient is being undertreated and the dentist is either committing malpractice or committing financial suicide.

It is a little hard to follow the argument of Mark Burhenne, the author of that post, but he appears to be writing that for many patients six months is not often enough.
posted by grouse at 12:05 PM on September 23, 2012

My dental insurance pays for check ups and cleanings every six months. If there were a less frequent interval that would still guarantee the same health outcomes, the insurance company would only reimburse for treatment at that rate and leave patients to be responsible for any additional checkups. For example, by contrast, my health insurance doesn't offer any coverage for "regular checkups" with my primary care doctor, because they feel that such treatment doesn't have a payoff in terms of better health and fewer treatment bills further on down the line. So companies whose bottom line is affected by poor choice of dental checkup and cleaning intervals seem to think that 6 months is the right number.
posted by deanc at 12:19 PM on September 23, 2012

Is there a reason why you don't want to go every six months? Travel time, time commitment, out-of-pocket expense, suspicion that insurance companies are operating in their own interests, other reason(s)?

My advice is to find a professional, honest, highly-regarded dentist and stick with them. I found my dentist through a coworker 12 years ago, and he and his staff have been great. My dentist is now on Yelp with a 5-star rating and over 20 reviews. If you have doubts about the services you receive, you can treat it like an automobile or healthcare issue and seek a second opinion from another provider.

My dental insurance plan provides for regular cleanings every 6 months, so I take full advantage of it. At one point I proposed that I get cleanings every 4 months, even if I had to pay out of pocket, but my dentist told me that it wasn't necessary in my case. Everyone has different needs, and an honest dentist is the best person to help you determine what your needs are.
posted by germdisco at 12:23 PM on September 23, 2012 [1 favorite]

There is a difference between cleanings and full- blown check- ups with x- rays. I have good teeth and haven't had a cavity since I was a child, but I despite using an electric toothbrush and flossing nightly I am prone to tartar build- up and gingivitis. So I go for cleanings every 4 month to keep my gums healthy , but only have the full on check up with x-rays every 2 years because my teeth are fine.
posted by kaybdc at 12:25 PM on September 23, 2012

...My six-month cleanings are accompanied by a teeth and gums checkup by my dentist, and I also get x-rays every two years.
posted by germdisco at 12:27 PM on September 23, 2012

I started at 6 months, but now have THREE/FOUR month recalls. This is not because I get many cavities (I get one tiny cavity every ten years or so), but because the plaque which gets left behind even by my dutiful brushing and flossing calcifies quickly.

If I had chosen to include dental insurance in my coverage, I'd be covered for just two cleanings a year (6 month recalls). However, with the discount my dentist gives for uninsured patients, it's only slightly more expensive for me to pay for three visits a year myself compared to paying for extra every month for dental insurance and only having two visits a year covered. Once I do my taxes, it's covered completely. If I go four times a year, I pay about $150 more than I do now, but given that I'm in my 50s and already have some ongoing issues, I'm willing to pay that.

In short: YMMV, but some of us need even more frequent cleanings. It's not because we're being ripped off, but because the Tooth Fairy cursed us at birth.
posted by rosebuddy at 12:30 PM on September 23, 2012

Seconding germdisco. Ask your dentist how often you need cleanings and check ups, and why.
posted by Sidhedevil at 12:32 PM on September 23, 2012

I agree with grouse, after reading that blog article, it seems that what he is trying to say is that it is very important from his perspective to get periodontal disease treated, and people may need more frequent appointments than every 6 months to get adequate treatment. I'm not sure I agree with his article that insurance companies like the every 6 months model because it's predictable - an annual visit model would be predictable too, and would result in half the visits/cost! My viewpoint is you should get as many visits as you can get them to pay for out of your insurance. You're not hurting anyone but yourself by taking advantage of your benefits.

Note that the blogger dentist ends by urging the reader to take periodontal disease and prevention seriously, as seriously as they take cancer prevention.

Personally I would not want to sacrifice my own teeth in the name of science by seeing how far I could space out my visits until "something goes wrong." As the blog author dentist noted, periodontal disease is not just about your teeth - it's associated with cardiovascular health and healthy pregnancy as well.
posted by treehorn+bunny at 12:33 PM on September 23, 2012 [3 favorites]

Sorry, that should read "you're not hurting anyone but yourself by NOT take advantage of your benefits."

I probably could have phrased that more clearly by saying "take advantage of your benefits!"
posted by treehorn+bunny at 12:35 PM on September 23, 2012

How often should a "regular" dental checkup and cleaning take place?

As often as your insurance will pay for it with the following caveat: if you're not prone to cavities and other issues, once a year is often enough; twice a year is good if you are prone to problems.

I have good teeth and rarely have an issue yet I still go twice a year because my insurance covers it. It's better to be safe than sorry, as the saying goes.
posted by deborah at 2:00 PM on September 23, 2012

// my health insurance doesn't offer any coverage for "regular checkups" //

Not to derail - but "Obamacare" requires that insurance covers preventive care with no out of pocket expense (off the top of my head annual checkups, women's health, and mammograms are covered). I'm pretty sure that provision has already gone into effect. My insurance started waiving the co-pay on annual physicals last year.

On subject - my wife goes to the dentist every 4 months. Insurance only covers ever six months so we end up paying for one cleaning out of pocket. I've found the 6 mo interval seems to work well for me, the cleanings are fairly gentle as they don't have to work at removing plaque / calcification. Given the pain and expense of major dental work, this is one place I'd rather err on the side of caution.
posted by COD at 2:24 PM on September 23, 2012 [1 favorite]

Thanks to a combination of genetics and lots of flouride as a kid I have really good teeth - no cavities and no more than the normal wear and tear that comes with age (I'm 30). I had a dentist let slip a few years ago that if I've gotten to my age without any dental problems, whatever I'm doing is clearly working and I probably don't need to go to the dentist that often.

These days I go every few years, and so far nothing's been picked up that would have necessitated going more frequently.
posted by Silentgoldfish at 3:11 PM on September 23, 2012

So companies whose bottom line is affected by poor choice of dental checkup and cleaning intervals seem to think that 6 months is the right number.

Poor choice. Ha! Insurance companies decline to pay for things for all kinds of reasons. The most common reason is "they don't want to" not, "you don't need it."

I've managed dental offices. Lots of patients need cleanings more often than 6 months. Some patients don't need them as frequently. Imagine if the average bra size for a woman was the only one that bra insurance companies would pay for. Would it make sense to tell a woman with much larger or smaller breasts that since the insurance company would pay for a 34C that's what she must need?

Exactly. That's absurd. Go to the dentist. Get everything they find taken care of as quickly as you can (I know). Make your follow up appointment, attend it, and check in about timing. Maybe they'll want you in sooner, maybe they'll tell you that 7 months is ok. If you don't trust the dentist you choose, select another for your 6 month check up. If you feel like your care provider is trying to take advantage of you, then the relationship is not a good fit.

The biggest prod I can give people to going often is oral cancer. Most GP doctors don't find your oral cancer. It's not something you want sitting in your mouth untreated for a long time. Dentists look in mouths all day long and have a pretty good handle on what is normal and what needs to be biopsied. As an office manager, the saddest cases I saw were having to refer out for oral cancer that was caught very late.
posted by bilabial at 3:16 PM on September 23, 2012

I think that for most people every 6 months for a cleaning and a quick check up with the dentist after each cleaning is perfect. As for X-rays...I don't really think you need those more then once every 2 years...if that. Be careful with dentists. There's a lot of dentists who will recommend that you have work done just to make a buck. Or they'll always find cavities even when you might not have them. There are plenty of good dentists out there but you've gotta do your research. The best sign of a good dentist is one who's approach is "less is more". Also you don't want someone who makes a big deal out of every little thing. Hope this helps.
posted by ljs30 at 4:14 PM on September 23, 2012

I don't have any sort of dental insurance (I'm in Australia, where that isn't normal) so a check up costs me around $200. I've never had a cavity (I'm now in my mid-thirties) and while I was brought up to go every six months, I kind of let it slip longer and longer between checks. At first I left it a year, then a year and a half, then a couple of years. All of those were fine. Then I left it five years. Still no cavities, but for the first time ever, the cleaning (descaling) hurt like a m***f****. I'm going back to two years between checks from now on.

So a warning that leaving it longer and longer until you have a problem is something you might regret!
posted by lollusc at 5:51 PM on September 23, 2012

This of course is all pretty much anecdotes isn't it?

I've been going approximately annually since an adult, and never need anything done, so when the dentist every time suggests I need to come back in six months, I figure that that is bill padding.
posted by wilful at 9:05 PM on September 23, 2012

I don't see how this is different from a physical. To be clear on the merits of an annual physical, here's my anecdote: after my mother died of a heart attack when she was 57, I mentioned it to my GP during my annual physical. He gave me a call the next day to let me know that my cholesterol was high, even though I was running regularly and generally pretty healthy. Since then, I've known that I have to keep an eye on my cholesterol. It's manageable at this point but I may have to consider going on a statin in the future. However, I would have had no idea that my cholesterol was up had it not been for that particular physical.

Similarly, while I was in college, I went years without a teeth cleaning. Soon after I got my first real job and had health insurance, an impacted wisdom tooth became infected. I went to a dentist for the first time in years and he put me on antibiotics for the infection, scheduled a surgery to take the tooth out and a teeth cleaning for after the surgery. I was miserable with pain the weekend before seeing the dentist and the cleaning was brutal. That was my incentive not to let my dental health go ever again.

Also, there are several ways in which your mouth is an early warning system for health problems in the rest of the body.

Personally, I've never had a cavity in my life but I like going for a cleaning and check-up every six months because for whatever reason, I get calcium accumulation really easy, despite my brushing and flossing efforts. And I think there's a psychological benefit to getting a regular check-up also - it makes you think about your health.

If you go to the dentist twice a year, that's two times a year the insurance company has to pay the dentist. If the dentist catches something early like oral cancer, it will cost the insurance company less to treat than if it had been caught later. But that benefits the patient too so I don't really understand the argument against that - it seems to me like that's one of the rare beautiful times that the incentives of the patient and the health insurance company align. Plus, if you have dental insurance, you're already paying for this so why not use it?
posted by kat518 at 7:07 AM on September 24, 2012

Annual physical WTF? I haven't been to the doctor since, um, .... no idea, at least ten years.
posted by wilful at 4:24 PM on September 25, 2012

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