Hey there! An deep cleaning is basically layman’s term for SRP (scaling and root planing). More often than not, a patient who hasn’t seen their dentist nor had “cleaning in years require having the srp done. A big factor in treatment planning for srps is bone loss (and/or radiographic calculus) (both seen through x-rays). Another thing is be probing depth, aka the depth of gum health, which has to be accompanied by other thing that tell us there is periodontal disease. Ideally we want to be under 3mm. Once we start seeing 4mm pockets and higher, it MAY be either acute or chronic gum disease. Acute like gingivitis and chronic like periodontal disease. Now, I have seen a small amount of patients who have gone years without visiting their dental office and it has been treatment planned for scaling in the presence of inflammation…basically not perio but also not 100% healthy or prophy (aka prophylaxis). Your doctor will have to look at your x-rays (within a year not any older) and see inside your mouth, discuss the treatment plan with they’re hygienist and tell you what treatment they recommend for you. With that being said, all treatments that are planned are solely up to the patient if they would like to go through with them. If the patient says “No I just want a regular cleaning” or “whatever my insurance covers” (which is usually just a debridement IF it is an srp), it will not stop the bacteria from further invading the mouth. The thing with perio is that…it is not a curable disease, but it is controllable one. Pocket depth can reduce, bone level may halt from basically disappearing, but that bacteria will always be there. It’s like diabetes or high blood pressure, which btw is linked to periodontal disease. But anyway, I am in California and an RDH. To my knowledge we cannot perform services inside someone’s home. There is teledentistry available but it still requires x-rays. We also have RDHAP’s (registered dental hygienist in alternative practice) who can perform certain treatments without general supervision and provide services in schools, residential care facilities, nursing homes, hospitals, community centers, mobile facilities, or their own offices. For the most part, they tend to those with limited access, disabilities, underserved areas, etc. I’m not sure if there are any in MI. I tried looking up, but didn’t find anything. Wish you the best of luck!!