Dental Polishing Procedure & Benefits

Intended Learning Outcomes

• Students will be able to define the procedure of polishing.
• Students will be able to describe the benefits of polishing (any modality).
• Students will be able to discuss the equipment used during a conventional polishing session.
• Students will be able to demonstrate patient preparation for a polish.
• Students will be able to demonstrate safe clinical practice when undertaking a polish.
• Students will be able to demonstrate assessment of polish and provide appropriate advice to prevent stain occurrence.

GDC Learning Outcomes 2013

• Oral diseases and their relevance to prevention, diagnosis and treatment can be described.
• Abnormalities of the oral cavity and the rest of the patient can be recognized, and concerns raised where appropriate.
• Risks around the clinical environment can be recognized and managed in a safe and efficient manner.
• Advice can be given on and a range of preventive materials and treatment applied as appropriate.
• Non-surgical treatments can be undertaken to remove hard and soft deposits stains using a range of methods, under prescription where appropriate.

Assessment

• Formative assessment includes quiz, practical, and class discussion.
• Summative assessment includes the FCSP handbook.

Dental Stain Recall

• Consider how stains adhere to the tooth.
• Classify dental stains by location.
• Consider which class of stains can be removed.

Polishing

• A technique used to remove plaque and stains from the coronal surface of teeth.
• A polishing handpiece, rubber cup, and abrasive agent are used.
• The most common method of stain removal.

Benefits of Polishing

• Stain removal
• Smooth surface easier to clean.
• Slows formation of new deposits.
• Patient motivation.
• Fluoride is better accepted by enamel.

Main Ways Of Polishing

• Conventional
• Air-Flow

Conventional Polishing Equipment

• Polishing Handpiece
• Rubber Cup
• Bristle Brush
• Polishing paste
• Gauze
• Floss

Rubber Cup vs Bristle Brush

• Rubber Cup: soft rubber and webbed inside.
• Bristle Brush: natural (animal hair) or synthetic (nylon).

Polishing Process

• The rubber cup's web moves down, splaying and compressing paste between the web and tooth.

Control

• Consider how to overcome issues of saliva, all surfaces, infection control
• Do you need any tools?

Considerations

• Use of brushes can cause severe gingival trauma so must be used with care.
• Brushes are not recommended for use on cementum or dentine.
• Brushes are often necessary for heavy stains (tobacco and chlorhexidene), or on pits and fissures in enamel surfaces and with individuals who have a latex allergy.

Abrasives

• Abrasives are available in extra coarse, coarse, medium, fine, and extra fine.
• The coarser the agent, the more abrasive the surface.
• Even a fine-grit agent removes small amounts of the enamel surface.
• Use the abrasive agent that will produce the least amount of abrasion to the tooth surface.
• The more agent used, the greater the degree of abrasion
• The lighter the pressure, the less abrasion
• The slower the rotation of the cup, the less abrasion

Patient Preparation

• Check the patient's medical history for any contraindications.
• Drape the patient with a waterproof bib.
• Ask the patient to remove any dental prosthetic appliance he or she may be wearing.
• Provide the patient with protective eyewear.
• Explain the procedure to the patient and answer any questions.

Technique

• Fulcrum use provides stability for the operator and must be placed in such a way as to allow for movement of the wrist & forearm.
• The fulcrum is repositioned throughout the procedure as necessary.
• Fulcrums may either be intraoral or extraoral.

Polishing Strokes

• Fill the polishing cup with the polishing agent.
• Establish a finger rest and place the cup almost in contact with the tooth.
• Stroke from the gingival third toward the incisal third.
• Use the slowest speed and then apply the revolving cup lightly to the tooth surface for 1 to 2 seconds.
• Use light pressure to make the edges of the polishing cup flare slightly.
• Use a patting, wiping motion and an overlapping stroke.
• Stroke from the gingival third with just sufficient pressure to make the cup flare.

After Polishing

• Flossing removes abrasive or debris lodged in contact point.
• Evaluation of polish includes teeth that are glossy and reflect light and areas with no evidence of trauma.

Patient Education

• For most patients, removal of stain is the reason they attend.
• Educate patients on cause of stain.
• Advise on how to keep stains away.
• Refer for intrinsic stain.