Just over half of Australian adults^[1] saw a dental practitioner in the past 12 months, most commonly for a check-up^[2].

But have you been told you should get a check-up and clean every six months^[3]? Perhaps your dental clinic’s or health insurance policy’s default is to ask you to book these services twice a year.

Let’s look at whether this advice is based on evidence or opinion.

Why do you need regular check-ups and cleans?

A regular oral health checkup usually involves a dentist or oral health practitioner (dental therapist, dental hygienist, oral health therapist) examining the teeth, gums and surrounding structures of the mouth. This helps identify signs of tooth decay or gum disease, in addition to any changes to soft tissues.

In most instances, you will have your teeth professionally cleaned in the same visit, with a “scale and clean”, along with dental x-rays to identify issues that aren’t visible to the eye.

Regular brushing with fluoride toothpaste and cleaning between teeth (for example, by flossing) at home can’t reach all the surfaces of the teeth and gums. Professional cleaning is needed to remove the remaining plaque and tartar (calcified dental plaque) and the bacteria they contain, which cause tooth decay and gum disease.

What does the research evidence say?

Not all research is equal: some types of evidence are more reliable than others.

Cochrane systematic reviews are the most trusted because they use rigorous methods to collect and evaluate all available research evidence on a specific health question. These reviews judge how strong the evidence is and whether the studies might be affected by bias.

For adult oral health check-ups, a 2020 Cochrane review^[4] found strong evidence that six-monthly check-ups did not offer any additional benefit in preventing tooth decay or gum bleeding, compared to those whose frequency of check-ups was risk-based.

Risk-based means dental practitioners set the time between dental check-ups depending on the individual’s risk of dental disease.

The review, which looked at data over four years, also found there wasn’t enough good research to know how different dental check-up schedules affected children’s and teenagers’ teeth and gums.

On the issue of six-monthly professional cleaning, a 2018 Cochrane review^[5] found strong evidence that having regular professional cleaning made little or no difference to signs of gum disease (gingivitis or bleeding gums), or to levels plaque deposits, compared to adults with less regular professional cleaning.

There was a small reduction in tartar levels, however it’s unclear if this is meaningful to consumers and dental practitioners.

Participants who had six- or 12-monthly cleans reported their teeth felt cleaner than those who didn’t have scheduled cleans, but there was no difference between groups in reports of quality of life.

Based on these reviews, six-monthly visits and cleans don’t seem to consistently lead to better oral health for adults compared to check-ups and cleans based on individual risk.

So can you forgo six-monthly visits?

Regular professional dental check-ups are important^[6] throughout life, starting from the eruption of the first tooth.

But everyone has different oral health needs and risk levels which should be reflected in the frequency of their check-ups.

Some people who are at high risk of oral disease do need to see a dental practitioner more regularly: every six months or even more often – such as every three months – to treat severe gum disease or tooth decay.

Those with good oral health might only need to visit a dental practitioner every year or two years.

Others still may be willing to pay^[7] for six-monthly check-ups and cleans for peace of mind, despite their lower oral health risk profile.

How else can I keep my teeth and gums healthy?

Maintain your oral health by brushing twice a day with fluoridated toothpaste. The evidence shows children and adults who brush less than twice daily are at high risk of tooth decay^[8].

Cleaning between your teeth can also help reduce gum problems and dental plaque – more than brushing alone. You can use traditional dental floss or a flossing tool. Interdental brushes, which have a tiny bristled head that fits between teeth, can also be more effective than flossing^[9].

For people who lack manual dexterity and for children, water flossers can be an effective alternative to traditional flossing.

Finally, avoiding sugars^[10] added to foods and drinks, as well as the sugars naturally found in honey, syrups and fruit juices, helps protect teeth from tooth decay.

References

1. ^{^} Australian adults (www.aihw.gov.au)
2. ^{^} check-up (www.aihw.gov.au)
3. ^{^} every six months (www.bupadental.com.au)
4. ^{^} 2020 Cochrane review (doi.org)
5. ^{^} 2018 Cochrane review (doi.org)
6. ^{^} important (doi.org)
7. ^{^} willing to pay (doi.org)
8. ^{^} high risk of tooth decay (doi.org)
9. ^{^} flossing (doi.org)
10. ^{^} avoiding sugars (doi.org)