My yearly cleaning involves the use of nitrous oxide and topical anesthetics. At this time and for the last couple of years, I only do one cleaning a year as its all I can take. I do load up on meds a couple of days ahead of time and the morning of my appointment. In the interim, I use toothpastes for sensitive teeth and flouride rinses, such as Act. I also use a surgical tooth brush that is softer than anything available in stores and soak it in hot water before using. My periodontist gives them to me. I don't currently have any gum disease, but I'm at risk for it because of all this. This last go around, they gave me some disolvable pills that increase the flow of saliva as one of my medications is causing dry mouth and that further increases the risk. They didn't tell me the name of these things, but they do seem to be working. Biotene also makes several products which do the same thing and they are available over the counter.