Cosmetic Polishing Procedures PDF

Cosmetic Polishing Procedures Clinic II Lab Megan Ciacci Petrella, MSDH, RDH, CDA Coronal Polishing  Coronal polishing is a cosmetic procedure designed to remove extrinsi...

Cosmetic Polishing Procedures Clinic II Lab Megan Ciacci Petrella, MSDH, RDH, CDA Coronal Polishing  Coronal polishing is a cosmetic procedure designed to remove extrinsic stains from the enamel surfaces of the teeth. https://www.google.com/url?sa=i&url=https%3A%2F%2Fdental.ohio.gov%2Fwps%2Fportal%2Fgov%2Fdent%2Flicensing-and-renewal%2F004- coronal-polishing%2F004-coronal- polishing&psig=AOvVaw22FEazSyXxEPHk38HB4s8A&ust=1675177887808000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCMCz44_K7_wCF QAAAAAdAAAAABAD Cosmetic vs. Therapeutic A therapeutic procedure is a dental procedure used to maintain health or treat disease to restore health. https://www.google.com/url?sa=i&url=https%3A%2F%2Fblog.studentrdh.com%2Findications-and-contraindications-for-coronal- polishing%2F&psig=AOvVaw22FEazSyXxEPHk38HB4s8A&ust=1675177887808000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCMCz44_K7_w CFQAAAAAdAAAAABAQ Cosmetic vs. Therapeutic A cosmetic procedure is a nonessential procedure undertaken for esthetic reasons--to improve the appearance. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.bishopsgatedental.co.uk%2Fblog%2Fhow-can-i-prevent-staining-in-my- teeth%2F&psig=AOvVaw2nj_DeJkeXj_dfbjmb6lrd&ust=1675178241162000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCKDZv7rL7_wCFQAA AAAdAAAAABAI No There is NO therapeutic benefit to coronal polishing because dental Therapeutic stains do not directly contribute to periodontal disease, dental caries, or Benefit any other oral disease. Historically Unfortunately, many Historically, all teeth patients falsely believe were polished at the that the important completion of the oral (therapeutic) part of a prophylaxis. prophylaxis is polishing.  However,…. In fact, over time, Researchers suggest that polishing can remove coronal polishing is not tooth structure causing necessary on a routine morphological changes basis. in the teeth.  The ADHA and the American Academy of Periodontology include tooth polishing in their definitions of the term “oral prophylaxis.” Types of Stains Extrinsic Stain Extrinsic stains occur on the external (outer) surfaces of the teeth. The most common extrinsic stains are chlorhexidine stain and tobacco stain. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.paradisedentistry.com.au%2Fwhat-stains-our- teeth%2F&psig=AOvVaw2nj_DeJkeXj_dfbjmb6lrd&ust=1675178241162000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCKDZv7rL7_wCFQAA AAAdAAAAABAQ Chlorhexidine Stain Tobacco Stain Intrinsic Stain What should we consider when polishing? https://www.google.com/url?sa=i&url=https%3A%2F%2Fquizlet.com%2F562387365%2Fcoronal-polishing-flash- cards%2F&psig=AOvVaw22FEazSyXxEPHk38HB4s8A&ust=1675177887808000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCMCz44_K7_wCF QAAAAAdAAAAABAY  The adverse effects of coronal polishing include: Aerosol production and splatter Precautions Creation of bacteremia Iatrogenic damage to tooth surfaces Aerosol Production Dental aerosols are invisible airborne particles dispersed into the surrounding environment by dental equipment such as dental handpieces and electronically powered instruments. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.uei.edu%2Fblog%2Fdental-assistant-vs-registered-dental- assistant%2F&psig=AOvVaw1FPqpUVzmy5camzf7Tn9Yk&ust=1675179310974000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCNCy- bnP7_wCFQAAAAAdAAAAABAD Spatter Spatter consists of airborne particles that land on people and objects. Polishing splatter is composed of polishing paste, microorganisms, and saliva. Contraindications Power-driven equipment should not be used for a patient with a known communicable condition that could be spread by aerosols.  Power-driven equipment should be used with care for a patient with high susceptibility to infection such as individuals with respiratory/ pulmonary disease, immunocomprised, or debilitated individuals. Caution  Patients and clinicians need eyewear to protect their eyes from splatter. Constituents of prophylaxis pastes may include various chemicals that can cause a severe inflammatory response in the eye. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.burkhartdental.com%2Fpremiers-aeropro-cordless-prophy-handpiece- system%2F&psig=AOvVaw1X0vwpJXZmbEH- pFctNX2w&ust=1675180285314000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCOjPnZDT7_wCFQAAAAAdAAAAABAD Creation of Bacteremia Bacteremia is the presence of bacteria in the bloodstream. Bacteria from the oral cavity are introduced into the blood stream during hand or powered instrumentation and coronal polishing. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.perio.org%2Ffor-patients%2Fgum-disease-information%2Fgum-disease-and- other- diseases%2F&psig=AOvVaw3AfH2fILUs9PFOfBEWFZIX&ust=1675180111568000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCPi4nbrS7_wC FQAAAAAdAAAAABAD  Examples of individuals who are susceptible to bacteremia include: those with damaged or abnormal heart valves prosthetic heart valve Bacteremia prosthetic joint replacement rheumatic heart disease congenital heart disease cardiac bypass surgery within the last 6 months dialysis patients Iatrogenic Damage to Tooth Iatrogenic is a term used to describe a problem brought on by something that a clinician does. Other considerations  Stain removal with an abrasive agent removes the surface layer of enamel where the fluoride content is greatest and most protective Tiny amounts of enamel are removed when polishing Must do all possible to minimize the amount of tooth structure removed https://www.google.com/url?sa=i&url=https%3A%2F%2Fdentistry.co.u k%2F2021%2F08%2F02%2Fdoes-your-fluoride-varnish- deliver%2F&psig=AOvVaw1SDfP3czmvwWTpEOnvnLDw&ust=16751813 55043000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCMDy- oPX7_wCFQAAAAAdAAAAABAY  Polishing areas of demineralization is contraindicated so not to interrupt enamel surface remineralization. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.goldenstatedent istry.com%2Fblog%2Fwhite-spots-on-teeth-causes-treatment-and- prevention&psig=AOvVaw155OkkDtaiC0SmIfDYFI64&ust=1675181887305000& source=images&cd=vfe&ved=0CA8QjRxqFwoTCIC55pHZ7_wCFQAAAAAdAAAAA BAP  Polishing generates heat. Care must be taken to use a wet polishing agent with minimal pressure at a low speed to prevent overheating the tooth. Primary teeth have large pulp chambers that make these teeth particularly vulnerable to the heat generated during polishing. https://www.google.com/url?sa=i&url=https%3A%2F%2Fdirectad ental.com%2Fproducts%2Fprophycare%2Fprophycare- hap&psig=AOvVaw0EaPWlt5IMnFp2zsPx06o4&ust=16751815218 86000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCLDWptHX 7_wCFQAAAAAdAAAAABAG  Coronal polishing can cause injury to the gingiva when incorrect techniques are used It is recommended: Coronal polishing should not be done on patients with inflamed, enlarged, and bleeding gum tissue Abrasive agents can cause more inflammation Action of polishing can traumatize tissue https://www.google.com/url?sa=i&url=https%3A%2F%2 Fwww.teethtalkgirl.com%2Fdental- health%2Fgingivitis&psig=AOvVaw1RDR8FR75N6PK09XM T4t9U&ust=1675181716942000&source=images&cd=vfe &ved=0CA8QjRxqFwoTCIjiprfY7_wCFQAAAAAdAAAAABA D  https://www.google.com/url?sa=i&url=https%3A%2F %2Fwww.researchgate.net%2Ffigure%2FIncisal- edges-transformed-into-incision-surfaces-with- dentin-exposed-in-inferior- incisors_fig5_322293881&psig=AOvVaw2exxVylsXov5 Hdz0r56nmz&ust=1675182122366000&source=imag es&cd=vfe&ved=0CA8QjRxqFwoTCNjZ9PDZ7_wCFQA AAAAdAAAAABAD Polishing of exposed cementum and dentin is contraindicated. Tooth sensitivity may be likely in these areas. https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.nadlerd entistry.com%2Fphoto-gallery%2Fcrowns%2Fcrowns-case- 1069%2F&psig=AOvVaw0ZXZPpl2wG3KiV7YOAHRTJ&ust=16751820735 46000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCMCxut_Z7_wCF QAAAAAdAAAAABA_ Polishing Procedures  Clinical Application Patient education on how to control stain Drinks and foods Tobacco cessation Toothpastes Proper brushing and flossing Scaling the stain Polish with appropriate agents and techniques Polishing agents Abrasive in nature Created by the shape, hardness, strength, and size (grit) of the particles that comprise the polishing paste Course grit to fine grit (range) Use the least abrasive paste necessary to achieve desired results! Enhancements to polishing agents Remineralization Hypersensitivity Whitening agents https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.supplyclinic.com%2Fitems%2Fpremier-dental- 9007608&psig=AOvVaw3FwyityFXkD8S6DGvFu9vB&ust=1675182990244000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCIC_zI3d7_wCFQA AAAAdAAAAABAI Rubber Cup Method  A rubber cup filled with polishing agent is used to remove extrinsic stain from the crowns of the teeth.  1. Dental handpiece Components 2. Prophylaxis of Polishing angle System 3. Cup attachments Dental Handpiece and Angle The handpiece is air driven and attaches to the dental unit slow-speed line. Angle is used to hold a rubber cup or other attachment Handpiece Hose For neutral hand position, the handpiece hose should be straight. The hose attachment should align the hose with the long axis of the handpiece. Types of Prophy Angles Reusable Right-Angle A right-angle has a straight shank. This angle can be reused; it must be autoclaved after each use. Types of Prophy Angles Disposable Right-Angle This right-angle is disposable and should be discarded after a single use Types of Prophy Angles Contra-Angle A contra-angle has a bent shank that facilitates neutral wrist position. Types of Prophy Angles Latch Type Design A latch secures the attachment to the angle. Types of Prophy Angles Threaded Head The attachment screws into the angle head. Angle Attachments “The Working-Ends” Webbed Cup Cup divided with webbed interiors Webbed cups are flexible and hold less abrasive paste than ribbed cups. Ribbed Cup Ribbed interior cup design allows the cup to flex and follow the tooth contours Petite Webbed Cup A petite cup is shorter than a standard cup. Facilitates access in hard to reach areas and for use on children  Brushes https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.youngspecialties.com%2Fproduct%2Fdisposable-prophy-angle-with-tapered- https://www.google.com/search?q=prophy+brushes+angle+attachments&tbm=isch&ved=2ahUKEwjZtcyP3-_8AhVyu3IEHczoCiQQ2- brush-72- cCegQIABAA&oq=prophy+brushes+angle+attachments&gs_lcp=CgNpbWcQA1AAWPAIYNUJaABwAHgAgAE6iAGkA5IBATiYAQCgAQGqAQtnd3Mct%2F&psig=AOvVaw2aaTW0e09VYwfyAkv3PeN6&ust=1675184092594000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCKjwhZvh7_wCFQA td2l6LWltZ8ABAQ&sclient=img&ei=M_TXY5nQD_L2ytMPzNGroAI&bih=577&biw=1263&rlz=1C1GCEA_enUS968US968&hl=en AAAAdAAAAABAm Types of Prophy Angles with Attachments Disposable all-in-one angle https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.mwdental.com%2Fnupro-freedom-dpa-lavender- sft.html&psig=AOvVaw3H- Obxl_LO9JJe1XUHDV_3&ust=1675183539256000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCPjqp5jf7_wCFQA AAAAdAAAAABAG Cup Adaptation  Cup should be adapted parallel to the tooth surface being treated  The rubber cup should be applied using just enough pressure to make the rim of the cup flare slightly.  The rubber cup should rotate at the slowest speed possible, using only enough speed to keep the cup moving Adapt the rubber cup onto the mesial & distal surfaces. https://www.google.com/url?sa=i&url=https%3A%2F%2Flists.osu.edu%2Fpipermail%2Fdenthy16%2Fattachments%2F20141112%2Fbba7c612 %2Fattachment- 0001.pdf&psig=AOvVaw3LBsMsBP4ko0c1FCgEon9S&ust=1675195705396000&source=images&cd=vfe&ved=0CA8QjRxqFwoTCPjQ872M8PwCF QAAAAAdAAAAABAD  Be sure to rinse the patient May be multiple times during the procedure Full mouth rinse at the end Floss https://www.google.com/url?sa=i&url=https%3A%2F%2Fwww.healthsoothe.com%2F10-basic-prophylaxis-tray- setup%2F&psig=AOvVaw0FAMlEgd9cvaf1BspVt3k1&ust=1675195953150000&source=images&cd=vfe&ved=0CBAQjRxqFwoTCKDAmbiN8PwCF QAAAAAdAAAAABAD  Apply sufficient amount of paste to 2-3 teeth at a time, applying more as progressing through the mouth Adapt the cup carefully to all surfaces during use Cup is parallel to surface working on Rim of cup is slightly flared Polishing Maintain adaptation of cup and keep cup in contact with Procedure tooth surface during use Mesial, direct, and distal Be sure to include occlusal surfaces Maintain a slow, constant speed Complete in a logical sequence using appropriate seating positions, illumination, retraction, saliva ejector to control aerosols Rinse the patient periodically for patient comfort Fluoride Treatments Varnish and Trays Fluoride Varnishes Fluoride Trays *Do not need to use the cotton rolls *I like to separate the trays and put mandibular in first then maxillary *Be sure to pull patient’s lips around the tray so the fluoride is in contact with the teeth Any Questions?