Dental Polishing Procedure: GDC Outcomes & Application

• At the end of this lecture, students should be able to define, demonstrate, and describe dental polishing.
• This procedure includes discussing equipment, patient preparation, and stain prevention.
• This lecture recalls the dental stains lecture.

GDC Learning Outcomes 2013

• Describe oral diseases and relevance to prevention, diagnosis, and treatment.
• Recognize abnormalities of the oral cavity, raise concerns where appropriate
• Recognize risks around clinical environment, and manage these in a safe and efficient manner.
• Advise on and apply a range of preventative materials and treatment as appropriate
• Undertake non-surgical treatments, where appropriate, to remove hard and soft deposits stains.

Assessment

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

How to Remove Dental Stains

• Stains need classifications by location.
• It is helpful to be aware of how stains adhere to the tooth.
• To know which class of stains is removable.

Polishing Defined

• It is a technique that removes plaque and stains from the coronal surface of teeth.
• This involves a polishing handpiece, rubber cup, and abrasive agent.
• It is the most common method of stain removal.

Benefits of Polishing

• Smooth surface easier to clean.
• Stain removal is important.
• It slows the formation of new deposits.
• Patient motivation is aided.
• Fluoride is better accepted by enamel.

Types of Polishing

• Conventional polishing.
• Air-flow polishing is also possible.

Conventional Polishing Equipment

• Polishing handpiece.
• Rubber cup.
• Polishing paste.
• Gauze.
• Floss.

Rubber Cup vs. Bristle Brush

• A rubber cup is soft rubber, with webbed inside.
• A bristle brush is natural animal hair substance or synthetic nylon material.

Polishing Process

• The rubber cup splays, and the web moves down.
• In this motion, the paste compresses between the web and tooth.
• How to overcome saliva, all surfaces, order, and infection control should be known.

Disadvantages of Bristle Brushes

• Brushes are not recommended for use on cementum or dentine.
• They can cause severe gingival trauma, so they must be used with care.
• With heavy stains like tobacco or chlorhexidene, brushes may be needed.
• They are needed for Pits and Fissures in enamel surfaces.
• If a patient has a latex allergy.

Abrasives

• Abrasives are available in extra coarse, coarse, medium, fine, and extra fine.
• A fine-grit agent removes small amounts of the enamel surface.
• The coarser the polishing agent, the more abrasive the surface
• The abrasive agent that produces the "least" amount of abrasion to the tooth surface should be the choice.
• The more agent used, the greater the degree of abrasion.
• Lighter pressure causes 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.
• Provide the patient with protective eyewear.
• Explain the procedure to the patient and answer any questions.

Safety

• A fulcrum is a finger rest.
• It provides stability for the operator, allowing for movement of the wrist and forarm.
• The fulcrum is repositioned throughout the procedure, as necessary.
• This fulcrum 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, apply the revolving cup lightly to, and polish 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 helps to remove abrasive or debris lodged in the contact point.
• Teeth are glossy and reflect light from the evaluation of the polish.
• The evaluation includes insuring that there is no evidence of trauma
• Stain removal is the reason most patients attend.
• This includes education on the cause of stain.
• Advice on how to keep stains away.
• Referral for intrinsic stain may be necessary.