Coronal Polishing Flashcards
A complete prophylaxis is completed by who?
Only by a licensed dentist or RDH
What is the goal of coronal polishing?
Remove soft deposits, plaque, and extrinsic stains w/ minimum patient discomfort and trauma to the tissues
What is a legal consideration to be taken when coronal polishing?
Coronal polishing includes only the removal of soft deposits and stains. Should any hard deposits be found, an RDH or dentist must be informed.
What are the qualifications required in order to coronal polish?
1) must be an RDA
2) must complete a board approved polishing course
3) must have polishing certificate
4) must complete polishing course to maintain RDA licensure
5) must provide polishing course completion with RDA application
The qualified RDA may perform coronal polishing when?
Under direct supervision of a licensed dentist
What are some indications for coronal polish?
1) oral hygiene- plaque and stain removal
2) prior application of topical fluoride
4) prior to rubber dam placement
5) prior cementation of orthodontic bands
6) prior application of acid etching solutions
7) after removal of dressings and packs
What are the constituents of plaque?
1) saliva
2) bacteria
3) cellular debris
4) materia alba
Why remove plaque?
- Number one cause of dental disease (periodontal disease and decay)
- increase caries susceptibility
What is disclosing and why do we do it?
Method of plaque detection by use of dye to stain the plaque and make it visible
What is the main ingredient in disclosing tablets?
Erythrosine die
What are some disclosing solutions?
1) plaque-chek
2) trace solution
3) iodine solutions
5) plaque-lite
What is calculus?
Hard calcified mass “tartar” usually yellow or dark brown
Where are the heaviest accumulations of calculus found?
Buccal surfaces of the upper posterior teeth and lingual surfaces of the lower anterior teeth
Calculus can only be removed by who?
A licensed dentist or RDH
Calculus is removed before or after coronal polishing?
Before
When can an RDA use a scaler?
To remove cement and calculus on a denture
What are the 4 classifications of stains?
1) extrinsic
2) intrinsic
3) exogenous
4) endogenous
What is the most common type of extrinsic stain?
Yellow stains
What is the second most common extrinsic stain?
Tobacco stains
Where are green stains primarily found?
Children’s maxillary anterior teeth at the cervical line
What stains are found more often in females and in children?
Black line stains
What can be done for intrinsic stains?
Bleaching, veneers or a crown
What is dental fluorosis and how do you get ?
Hypocalcification from ingestion of excessive fluoride
When can tetracycline discoloration appear in children?
3rd month of pregnancy, infancy or early childhood
Irregular alignment of tooth or teeth
Malocclusion
What systemic conditions affect coronal polishing?
1) heart-kidney disease
2) hepatitis
3) diabetes
4) epilepsy
What does pumice consist of?
Volcanic origin made of silicates of aluminum, potassium and sodium.
What conditions may cause pain and discomfort during coronal polishing?
Exposed roots, herpes, or gingivitis
What are some common agents?
1) pumice
2) tin oxide
3) commercial premixed preparations
What types of abrasives are there?
Silex, chaulk, and aluminum oxide
What is the purpose of a prophy brush?
They are used on the occlusal surface to remove stains from pits and fissures on the enamel.
What position are the rotary instruments held in?
Modified/pen grasp using a fulcrum
Why fulcrum?
Stabilize the hand and prevent injury
Where should you NOT fulcrum?
On the patient’s face (lips, chin, or cheeks)
Abrasive
Agent capable of scratching a surface
Plaque
Sticky substance of saliva, bacteria and food debris that adheres to teeth
Extrinsic stain
Stains on external surface of teeth that may be removed by polishing techniques
Pellicle
Clear thin matrix of insoluble mucoproteins from saliva which sticks to teeth
Materia Alba
Mass of food debris and bacteria that sticks to teeth and provide the source of plaque build up
Intrinsic stain
Stains on the side of the tooth structure that are not removable by polishing
Prophylactic antibiotic therapy
Antibiotic therapy prescribed to prevent transient bacteria, given pre and post treatment
Prophylaxis
Complete professional removal of calculus, debris, stains and plaque from the teeth
Subgingival
Below the gingival tissue- gumline
Supragingival
Above the gingival tissues- gumline
Cellular debri
Second stage of plaque formation occurring when bacterial colonies merge to cover large surfaces of the teeth
Exogenous stain
Develops from external sources and may be extrinsic or intrinsic
Endogenous stain
Develops from within teeth and are always intrinsic
What is plaque composed of?
Microcolonies embodied in the pellicle
What does the pellicle come from?
Bacteria and saliva
Where does bacteria accumulate in the oral cavity?
Around the surface of teeth, interproximally and sulcular.
What is the second stage of plaque formation?
Cellular debri
Which disclosing solution would you NOT use on a patient with diabetes?
Iodine solutions
Which two disclosing solutions both have erythrosine dye as their main ingredient?
Plaque – chek and Trace solution
What does Plaque–Lite use that can only be seen with a special light?
Fluorescein sodium
What precautions should be taken for all disclosing methods?
Staining of clothes, face, lips and hands
What are the two classifications of calculus?
Supragingival (above gumline) and Subgingival (below gumline)
What is calculus composed of?
- 80% in organic- 2/3 hydroxyapatite matrix, salts and minerals
- 20% organic- matrix, bacteria, carbohydrates, proteins, cellular debris
What type of stain would be in example of an exogenous stain?
Tobacco stains
What establishes the degree of staining?
State of oral hygiene, surface texture of the tooth, contour of the tooth
What are some extrinsic stains?
Yellow, tobacco, green, black line, orange or red and metallic stains
What are some intrinsic stains?
Stains in pulpless teeth, drugs and metals, dental fluorosis, tetracycline, dentinogenesis and amelogenesis
Which Heart–Kidney diseases may require pre-and post anabiotic therapy?
Rheumatic heart disease, congenital heart disease and nephritis
What condition requires strict adherence to universal precautions and infection control?
Hepatitis
Why should you avoid tissue trauma on a patient with diabetes?
Their tissue healing is impaired
What can Dilantin due to a patient with epilepsy?
The anticonvulsant drug may produce hyperplastic gingival (overgrowth)
What agent can accomplish both cleaning and polishing?
Zirconium silicate
What is the least abrasive pumice used to remove stains from enamel in the form of wet paste?
Pumice flour or superfine pumice
Which polishing agent is used for teeth and metallic restorations?
Tin oxide mixed with water or glycerin
What is a superfine abrasive agent used for heavy stain removal?
Silex (silicone dioxide)
Chaulk
A.k.a. whitening, precipitated calcium carbonate used as polishing agent and whitener
Type of abrasive available in strips for interproximal surface usage
Aluminum oxide
