01: Polishing and Topical Fluoride Application

Question 1

What is the goal of polishing?

Answer 1

To remove extrinsic stain from coronal surfaces

Question 2

Areas/Patients at Risk for Caries

Answer 2

Demineralized areas
Rampant Caries
Xerostomia
Head/Neck Radiation Patients

Question 3

What are Indications for Polishing?

Answer 3

Extrinsic Stain Removal following scaling

Prep of Enamel Surfaces prior to placing sealants

Question 4

What instruments are used to polish?

Answer 4

A prophylaxis angle

Slow speed handpiece

Question 5

What tips will be used in the prophy angle?

Answer 5

Disposable cup

Disposable bristle brush

Question 6

What are some of the polishing compounds to be used?

Answer 6

Fine grit paste
Dentifrice
Tin oxide or Whiting
Pumice

Question 7

What aides can supplement the polishing?

Answer 7

Dental Floss

Polishing Strips

Question 8

What other supplemental items will be needed?

Answer 8

Saliva ejector
Safety glasses for patient
Lubricant for patient’s lips
Disclosing agent

Question 9

What are the first three steps to take prior to the actual polishing?

Answer 9

1. Explain procedure to patient
2. Lubricate patient’s lips
3. Pre-procedural rinse (antiseptic mouthwash)

Question 10

Does the cup ever go under gingival margin?

Answer 10

No, but you can apply pressure in order to flare the cup edges out and into sulcus.

Question 11

How many surface areas should posterior teeth be divided into?

Answer 11

6 each on buccal and lingual

Question 12

In what order do you proceed to polish the posterior teeth?

Answer 12

First the cervical portion from proximal to proximal then the occlusal portion from proximal to proximal

Question 13

What teeth do you start with first?

Answer 13

Lingual of the mandibular teeth

Question 14

What is the maximum amount of time you can hold a cup in the same area

Answer 14

2 seconds

Question 15

What tooth tissue must you avoid using abrasives on?

Answer 15

Root cementum

Question 16

What is the only dental tissue we can use the brush on?

Answer 16

Enamel

Question 17

What materials are we to use fine grit abrasives on?

Answer 17

Gold
Porcelain
Composite Resin

Question 18

When you switch abrasives, what else should you switch?

Answer 18

You should get a fresh cup or brush to avoid contaminating a fine grit with a coarse grit

Question 19

After polishing, what should be done to all of the proximal spaces?

Answer 19

They should be flossed

Question 20

What can be done to remove abrasive particles from the gingival margins?

Answer 20

Gentle irrigation

Question 21

What is an abrasive

Answer 21

any material composed of particles that have enough hardness or sharpness to cut or scratch softer materials

Question 22

What is abrasion?

Answer 22

Wearing away of surface material by friction

Question 23

What are the pros and cons of polishing?

Answer 23

It produces a smooth and glossy surface that reflects light but it also produces tiny scratches on a surface too

Question 24

What are 3 types of abrasives

Answer 24

Finishing
Polishing
Cleansing

Question 25

What are 2 examples of Finishing abrasives

Answer 25

Fine agent OTC Toothpaste (Creates a Smooth Surface)

Question 26

What are polishing abrasives used for?

Answer 26

Light to moderate staining | More abrasive than the finishing type

Question 27

Which abrasives remove moderate to heavy extrinsic stain

Answer 27

Cleansing Abrasives

Question 28

What are the 4 Application Factors of Abrasive Action?

Answer 28

Speed Grit Quantity of Abrasive Agent Pressure

Question 29

When is fluoride a good idea?

Answer 29

After rubber cup polishing After etching C&B prep After home bleaching

Question 30

What does topical fluoride treatment accomplish?

Answer 30

Reduces enamel solubility Enhances remineralization Bacteriocidal/Static Reduces Caries Rate and indidence

Question 31

What Fluoride Preparation is used at VCU?

Answer 31

Topical Varnish

Question 32

What should be done to determine need for varnish treatment?

Answer 32

Discuss rationale for application | Obtain patient consent

Question 33

What are the patient instructions after varnish application?

Answer 33

No brushing for 4 hours | Patient can eat/drink right away

Question 34

What is the documentation for patient chart?

Answer 34

5% Neutral Sodium Fluoride (Brand Name) varnish applied. No adverse effects noted. Patient instructed not to brush/floss or eat hot/crunchy foods for 4-6 hours.

Question 35

What RPM must the handpiece be kept under?

Answer 35

10,000 RPM

Question 36

Which teeth can you use the bristle brush on?

Answer 36

Occlusal and Lingual Surfaces of Sextants 2 and 5

Question 37

Why do we need to floss after cleaning?

Answer 37

To get extra abrasives from the interproximal area