Of course you can refuse a deep cleaning at the dentist because without your consent, they're not legally able to perform treatment on you. It is your right to refuse and they can't touch you unless you permit them to.
However, it may not be in your best interest to put off the scaling and root planing if you truly need it. There will be consequences and your overall health of your mouth will suffer as a result of not getting it treated.
Consent takes priority
The main reason that you can refuse a deep cleaning from your dentist is because your consent comes before all else. No one can do anything to you if you don't consent to it, that includes not only your dentist but also other healthcare providers as well.
If they do perform treatment on you when you've blatantly refused them, you can legally sue them. You will most likely win the legal case if it were to ever happen.
Don't forget when you first registered as a new patient at the office, there was most likely a consent form that you signed which permits your dentist to perform treatment. As a matter of fact, you will usually need to sign a consent form for most root canals and tooth extractions.
However, you will always reserve the right to revoke your consent at any point in time. When you say NO, it means NO and they must respect that. You can also get up from the chair and walk out if you have to. No one will be able to stop you from doing so.
Is a deep cleaning really necessary?
A deep teeth cleaning is necessary if your periodontal condition warrants it because undertreating it can have repercussions. Yes, we are aware that a lot of patients are wary about dentists pushing deep cleanings over regular ones.
That is why we'll give you some signs and symptoms to look out for to let you know that you truly need it. You don't want to undertreat your periodontal condition.
Signs of needing a deep cleaning:
Significant tartar buildup on your teeth aka Calculus bridge.
Severe teeth staining that doesn't come off.
Bad breath that won't go away no matter how much you brush or floss.
Gums bleed easily.
It's been years since your last dental check up.
Teeth feel loose.
Generalized gum recession.
If you have any of the above, there is a good chance that you may need it done.
How your dentist can tell
The two major signs that your dentist looks for in determining if you need a deep teeth cleaning are bone loss on the x-ray and significant calculus build up.
If your periodontium has bone loss on the x-ray it could only mean one thing, periodontitis which is the advanced stage of gum disease. It means you've progressed beyond gingivitis and a regular prophy is now insufficient.
Below is an x-ray of what normal periodontium looks like.
Now you can compare that to an x-ray with bone loss AND tartar build up.
There is less bone around the teeth and you can see white (radioopaque) objects in between the teeth where you floss.
The x-ray above has circled the tartar build up to show you what they look like. As you can see, they're mostly in between the teeth where you normally floss through. A lot of people don't like the flossing part of their oral hygiene which is why the in between is a common spot.
Consequences of never getting deep cleaning
If you refuse the deep cleaning and only get a regular one, your dentist/hygienist will only remove plaque and tartar from above the gum line. They will leave the tartar and plaque that are located below the gum line uncleaned.
Ultimately your teeth will not be completely nor thoroughly cleaned because of your refusal.
Consequence of leaving tartar underneath the gums:
Gum inflammation will not go away. Your gums will still be inflamed and feel loose despite the cleaning. They will look red and irritated constantly.
Periodontal disease will continue to progress. The calculus underneath the gums will continue to grow larger and the inflammation will continue to cause bone loss.
Gums won't stop bleeding. You'll still have bleeding gums when you brush and floss. It may even be bleeding when you spit out or rinse.
Bad breath will continue. If halitosis was bothering you before, it'll still be there waiting for you since you didn't get the deep cleaning.
Your teeth will eventually become loose. In due time with enough bone loss the teeth will become loose. They will essentially fall out on their own and you'll lose them to periodontal disease and not tooth decay.
Basically your gum condition will continue to get worse despite the cleaning. The reason for that is because you're under treating your gum disease. Honestly, there really aren't any disadvantages to getting it.
Takeaway
It is your legal right to refuse any and all treatment that is recommended by your dentist which includes a deep cleaning. Although if you really need it and you refuse, there will be consequences for not getting it, namely your periodontal condition may worsen.
Advanced stage or late stage periodontitis is not something you'd want to have because the end result is usually full dentures. Yes, tooth decay isn't the only way that people can lose their teeth. Gum disease can cause them to be loose and fall out on their own.
If you are really unsure about whether you need scaling and root planing, you can always get a second opinion from a different dentist. Everyone probably has a distant friend who is a dentist that they can ask for a favor.
