Stain Removal and Polishing Flashcards
What is coronal polishing?
Esthetic procedure to remove extrinsic staining. Very little therapeutic benefit
ADHA recommends polishing only when needed
What is selective polishing?
Removal of a soft deposit not removed by scaling/root planing
Includes the selection of polishing agent to be used- least abrasive possible to reduce wear
What is therapeutic polishing?
Polishing the root surfaces that are exposed during surgery to reduce endotoxin and microflora on the cementum
What does two-body mean?
Prophy cup with the paste already in the cup
What does three-body mean?
Prophy cup that needs to be manually filled with prophy paste
Loose particles move in a space between the tooth and application device
What is bacteremia?
When bacteria is introduced into the blood stream
Can occur even with very little manipulation of the gingiva like toothbrushing
Can you polish a patient who needs pre-medication? Why?
Yes, but only if they have taken the medication. Polishing that may interact even minorly with the gingiva can cause bacteria to enter the blood stream
Effects of polishing; environmental factors
Aerosols- produced by hand-piece, extended in air. Put US at risk, as well as future patients and other employees
Spatter- Patient and operator must wear protective eyewear
Negative polishing effects on the teeth
Removal of tooth structure
Demineralized areas are lost faster
Smear layer over dentin can be removed- sensitivity can occur
Paste can cause scratches on restorations
Too much pressure for too long without water can increase heat
What happens with removal of tooth structure?
Coarse abrasive may remove a few microns of fluoride rich outer enamel
What happens when polishing causes demineralized areas to be lost faster?
Can interrupt remineralization
How can sensitivity occur from polishing?
Thin enamel/exposed dentin is very vulnerable. Smear layer over dentin can be removed
Effects of polishing on the gingiva
Trauma at higher speeds
Surface epithelium at margins is vulnerable
Can make gumline sore, reducing patient compliance with brushing/flossing
Can force polishing particles into gum tissue
No polishing after perio/gingival treatment
Body can react to abrasives as foreign bodies and slow healing
Working with the patient to remove their extrinsic stain
Discuss the stain with the patient. Explain where it comes from and based on their diet/lifestyle/habits whether it will come back, if it is inside or outside the tooth, and whether or not we will be able to remove it.
Remove stain as much as you can carefully with instrumentation
Preparing teeth for caries prevention agents
Some DHCP use polishing with pumice beforehand. This is not necessary, a dry toothbrush is adequate before fluoride treatments
Contraindications for polishing
No stain High risk for caries Tooth sensitivity Demineralization Amelogenesis/dentinogenesis imperfecta Respiratory problems Restorations Exposed dentin/cementum Newly erupted teeth Acute periodontal infection
When to postpone polishing treatments
Following perio surgery/SRP
If patient has an active communicable disease
If they are immunocompromised
If the gingiva is spongy
Proper polishing technique
Use as little time as possible Use light pressure Low speed Most minimal abrasive possible Use water for minimal heat production Rubber cup at 90 degrees
