Dental Polishing Procedures

• Students should be able to define polishing procedures upon completion of this session

• Students should be able to describe the benefits of polishing (any modality) upon completion of this session

• Students should be able to discuss the equipment used during a conventional polishing session upon completion of this session

• Students should be able to demonstrate patient preparation for a polish upon completion of this session

• Students should be able to demonstrate safe clinical practice when undertaking a polish upon completion of this session

• Students should be able to demonstrate assessment of polish and provide appropriate advice to prevent stain occurrence upon completion of this session

• It is important to describe oral diseases and their relevance to prevention, diagnosis, and treatment

• It is important to recognise abnormalities of the oral cavity and the rest of the patient and raise concerns where appropriate

• It is important to recognise the risks around the clinical environment and manage these in a safe and efficient manner

• It is important to advise on and apply a range of preventive materials and treatment as appropriate

• It is important to undertake non-surgical treatments, under prescription where appropriate, to remove hard and soft deposits stains using a range of methods

Assessment Notes

• Formative assessment includes Quizzes, Practical work, and Class Discussion
• Summative assessment includes the FCSP handbook

Dental Stain Removal

• Stains adhere to the tooth in different ways
• Dental stains are classified by location
• Only certain classes of stains can be removed

Polishing

• Polishing involves removing plaque and stains from the coronal surface of teeth via a specific technique
• Polishing requires the use of a polishing handpiece, rubber cup and abrasive agent
• It is a common method of stain removal

Benefits of Polishing

• Stain removal is achieved through polishing
• Polishing results in a smooth surface easier to clean
• It Slows formation of new deposits
• Patients gain motivation
• Fluoride is better accepted by enamel

Main Polishing Types

• Conventional polishing
• Air-Flow polishing

Conventional Polishing Equipment

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

Rubber Cup vs Bristle Brush

• Rubber cups are soft rubber and webbed inside
• Bristle brushes are made of natural (animal hair) or synthetic (nylon) materials

Polishing Process

• Rubber cup splays
• Web moves down
• Paste is compressed between the web and the tooth

Considerations for Polishing

• Saliva
• All Surfaces
• Order
• Infection Control

Considerations for Brushes in Polishing

• Heavy Stains (tobacco and chlorhexidene)
• Pits and Fissures in enamel surfaces
• Latex allergy
• Brushes can cause severe gingival trauma so must be used with care
• Brushes are not recommended for use on cementum or dentine

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
• Lighter pressure results in less abrasion
• Slower rotation of the cup reduces 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 polishing procedure to the patient and answer any questions

Safety and Stability Enhancement

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

Polishing Technique

• Fill the polishing cup with the polishing agent
• Use a finger rest and place the cup 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

After Polishing

• Floss to remove abrasive or debris lodged in the contact point
• Check that evaluation of polish results in teeth which are glossy and reflect light
• Confirm there is no evidence of trauma
• For most patients, removal of stain is the reason they attend appointments
• Educate patients on cause of stain
• Advise on how to keep stains away
• Refer patients for intrinsic stain conditions