5 Reasons a Dental Cleaning Should NOT be Your First Appointment

image of operatory room

Switching dentists can be a stressful ordeal.  Perhaps you’re looking to switch because your insurance changed.  Or perhaps you moved to a new area and want a dentist closer to home. It’s never easy walking into an unfamiliar office for that first appointment.  And, let’s be frank, it’s also never easy to allow relative strangers to put their fingers and sharp instruments in your mouth!

When many people move to a new dentist, one of the first things they say is “I’d like to come in and just get my teeth cleaned.”  This makes sense from the patient’s perspective for a number of reasons.

Mostly, a cleaning is a procedure that carries a degree of familiarity from office to office.  It’s a procedure many patients have experienced dozens of times. Everything else about your visit is unfamiliar, so why not have some aspect that is at least a little bit in your comfort zone?

But, I would present the idea that your first appointment in a new dental office should NOT be a cleaning.  Rather, I am of the opinion that your first visit should be a complete exam with your new dentist. Here are 5 reasons why.


#1: Get to know your new dentist

When you see the dentist every six months, most of your appointment time will be spent with a hygienist.  But ultimately, a dentist is the one who is dictating your treatment. Therefore it makes sense to have some face-to-face time with the person who will be making treatment recommendations and decisions.

By having an exam first, you get to spend one-on-one time with your new dentist to evaluate what kind of future experience you will have in their office.  Have you walked into the office of a dentist that is going to recommend a lot of treatment you don’t need? Or have you entered an office where the dentist is willing to spend time with you to ensure he/she has your best interests at heart?  This first appointment is your chance to find out!


#2: Find out what type of cleaning you need

What most patients don’t know is there are multiple types of cleanings. Each has different fees and different degrees of insurance coverage.  When you’re new at a dental office, your dentist doesn’t know what type of cleaning you need. Therefore, it’s more difficult to give you an accurate fee quote and estimate of benefits.


Most people will need a regular cleaning, what we refer to as a “prophy”.  If you take care of your teeth at home, are free of gum disease, and go to the dentist every six months to have your teeth cleaned, you will most likely receive a prophy.  Normally, insurance will predictably cover a prophy at 90-100%.

Deep Cleaning

Some patients will be going to the dentist for the very first time.  They may never have had their teeth cleaned, but have never had any dental pain so have never been to see a dentist.  Many times these patients have a disease of the gums called periodontal disease. Your first appointment exam will catch gum disease if you have any.

Patients with periodontal disease need a deep cleaning to remove the bacterial colonies deep in the gum pockets. Once initial therapy is complete, a series of follow-up appointments will be scheduled to monitor the healing process.  Patients being treated for periodontal disease will also need to make more frequent return visits, most of the time every 3 or 4 months.


Many patients will say “I go to my dentist every six months and I’m trying to get back into the routine.”  Too often, the reality is they haven’t been in 2 years.

In that time, large deposits of tartar have built on their teeth.  Often times this tartar is thick enough where we cannot evaluate the gums properly. These patients often need what’s called a debridement.

Debridements are more expensive and are less predictable with insurance than a prophy. Sometimes insurance plans will cover 100%, other times 80%, sometimes 50%, or not at all.  After your debridement, an additional appointment will be made to finish cleaning your teeth, properly evaluate your gums, and schedule follow-up treatment if needed.

If you have an exam with the dentist first, you will get a much more accurate picture of what your insurance will cover and what your out-of-pocket expenses will be at your cleaning.


#3: Your first cleaning appointment will be shorter

When a dental practice receives a new patient, several things need to happen.  First, we need to chart all dental work, evaluate the gums, take diagnostic x-rays, and formulate a treatment plan.  If we add a cleaning on top of that, it can turn into a long appointment! Especially if the patient unexpectedly needs more than a “regular cleaning”.

Having a complete exam with your dentist will help save your time at the next appointment.


#4: Documentation of health history

We hear all the time, “Why do you need to know all this stuff about my heart?”  Or, “why do you need to know what I take for osteoporosis?” A patient’s health history can dramatically affect how dental treatment is provided.

For example, if a patient has a heart pacemaker, we don’t want to use the ultrasonic scaler to clean their teeth.  Or, if a patient has a prosthetic heart valve, the American Heart Association mandates those patients receive a specific dose of antibiotics before having their teeth cleaned.  These are all things we need to know BEFORE we clean a patient’s teeth!

It is frustrating for patients and staff alike for a patient to come for a cleaning appointment only to find out we can’t clean their teeth because they haven’t had their pre-op antibiotics.  By having a complete exam with your dentist, they can appropriately plan dental treatment in conjunction with your health history. Our staff can only be properly prepared to deliver personalized treatment to you if they have the full picture in advance!


#5: You may have other higher priority dental needs

Often times patients come in because they “just want their teeth cleaned” but we discover they also have five or more cavities. One of these cavities might be deep and may need a root canal if left untreated.  In such cases, patients often prefer to wait on the cleaning and take care of the deep cavity first to avoid a root canal.

If it’s been a few years since you’ve been to the dentist, a cleaning may not be the highest priority item for your mouth.  Both dental decay and gum disease tend to not hurt until the advanced stages, so most patients are unaware of them in the early stages.  Therefore, a complete exam with your dentist is a smart move to ensure your mouth is healthy.



There are many reasons why a complete exam appointment before a cleaning can make your transition easier.  It helps to know what you need and what your insurance will cover before you walk in the door. Observing the complete health history and documenting other existing dental disease allows a tailored, comprehensive approach to your oral healthcare.

Finally, we at Rathke Family Dentistry believe good dentistry starts with relationships.  Being a good dentist is about much more than knowledge and hand skills, although these are very important.  It’s also about building trust and confidence with our patients. We want to start building that relationship with you from your first appointment.

If you’re ready to become part of our patient family, please contact us today!

9 thoughts on “5 Reasons a Dental Cleaning Should NOT be Your First Appointment

  1. I like what you said about your first cleaning appointment with a new dentist being shorter. My sister has been telling me about how she wants to move soon, so she’ll need a new dentist. I’ll share this information with her so that she can look into her options for professionals who can help her with this.

  2. I disagree. It takes sometimes a year to complete the plan of treatment and then you are in trouble with other teeth that needed to be cleaned.

  3. Yes BUT a lot of Americans cannot afford the subsequent treatments following this “proper procedure” unfortunately…everytime when I had insurance i would go through with what the dentist recommended and afterward the bill came and my insurance company would say they would pay 100% of what THEY thought was reasonable even though the bill was double that amount. I realized besides the co-pay amount PLUS what the insurance paid it wasn’t the deal as paying cash for things….again when you need a lot of work yes but for the majority of older people that need a twice yearly check – up it is just not worth is to have insurance….

  4. I’m glad you brought that up! Yes, sometimes when we finish the initial treatment plan, more problems surface afterwards. This is why I think it’s important that 2 critical items be included in your treatment plan. First, and most important, discover WHY the dental problems are occurring. It does no good to fix 10 cavities if you first don’t ask the question why the cavities are there in the first place. Lifestyle changes such as diet, medications, and hygiene can make a huge difference in a person’s risk for oral disease. It’s important to treat the effects of the disease (cavities), but even more important to stop or slow the disease cycle itself. Second, a check-up program has to be considered. If it takes a year to complete the initial treatment plan, that patient should have already had at least 1 regular check-up appointment at the 6 month mark. That way we can observe if any hygiene and dietary change attempts by the patient are working. The goal is health, and I find the most important way I can find a person’s pathway to health through dentistry is spending the appropriate amount of TIME at that first visit to uncover that patient’s specific needs. A one-size-fits-nobody approach never works!

  5. If a patient comes in and wants a basic cleaning and is willing to pay for it, he or she should be able to get it, period. There are many reasons why people can be temporarily living or working away from their primary dentists and just need a cleaning. The corporate model doesn’t fit many people and it’s proving very difficult to get around it.

  6. You made a good point that it’s important to also have the proper documentations done when planning to undergo dental cleaning. I’d like to know more about how to find such services because I want my teeth to appear whiter. before undergoing any sort of whitening process, I might need to get some cleaning done first.

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