Coronal Polishing Study Guide (DEN 104)

What is prophylaxis?

the complete removal of calculus, debris and plaque

What instruments are used during prophylaxis?

hand and ultrasonic scalers may be used

What instructions are given during prophylaxis?

oral hygiene instructions

Is flossing completed during prophylaxis?

yes

Does prophylaxis include a coronal polish?

coronal polishing MAY or MAY NOT include a coronal polish

Does a polish have to be completed in order for a prophylaxis to be billed?

no

What is SCP?

selective coronal polishing

What is selective coronal polishing?

procedure in which plaque and extrinsic stains are removed from the coronal surfaces but ONLY to those teeth involved

What can produce the same effect as polishing?

brushing and flossing

Continuous polishing can do what to the tooth structure?

can abrade tooth structure

Can a DAI be legally certified to coronal polish?

no, a DAI is not legally certified to coronal polish

Can a DAII legally polish after passing program specifications?

yes

What must a DAII complete in order to be able to legally polish (use a SSHP with rubber cup or bristle brush attachment)?

complete a course in coronal polishing of at least 7 hours

Who is qualified to recognize need and have services billed for a polishing procedure as a part of the prophylaxis?

ONLY a RDH or Dentist

When should selective coronal polishing be performed?

only as needed

What is removed through polish?

fluoride-rich outer layers of enamel is removed

Is polishing considered to have health benefits?

no, not anymore

After a DAII performs this function (coronal polishing) it must be cheked by who?

must be checked by the dentist before the patient is dismissed

Is the removal of soft deposits necessary for fluoride uptake?

research indicates that removal of soft deposits is not necessary for fluoride uptake

What is the most common way to remove extrinsic stains?

rubber cup polishing

How do you utilize the rubber cup while polishing?

apply rubber cup to tooth surface for 3-5 seconds with light touch and gentle flare

How are more extensive stains usually removed?

usually they have to be removed with more means other than rubber cup polishing like hand scalers, ultrasonic scalers, or air polishers

Acquired Pellicle

thin film of salivary materials that coats the tooth surface and can be brushed off but reforms in a few minutes

Plaque Biofilm

slim-producing bacterial communities that harbor fungi and algae

Sticky, soft, fuzzy-like deposit

plaque biofilm

Where can plaque biofilm be found?

supragingival and subgingival

When does plaque biofilm begin to form?

within one hour after removal

When does plaque biofilm become well established?

within 12-24 hours

What does plaque biofilm attach to?

attaches to acquired pellicle

Calculus/Tartar

calcium and phosphate salts in saliva that become mineralized and stick to the tooth surfaces

Can calculus and tartar be removed with rubber polishing cup?

no

Stains

discoloration that accumulated on the tooth surface

What are the two main classifications of staining?

• exogenous

• endogenous

Endogenous

occurs during tooth development (can NOT be removed by polishing)

Examples of Endogenous Staining

• tetracycline staining

• fluorosis (mottled enamel/appears as brown spots)

• prolonged jaundice

• systemic conditions (hypoplasia: thin enamel)

Exogenous

acquired after eruption

Examples of Exogenous Staining

• dental amalgam

• endodontic treatment

• tobacco

• food/drink

Types of Exogenous Staining

• intrinsic

• extrinsic

Intrinsic Exogenous Staining

• can NOT be removed by polishing

• built in to patients enamel matrix

• usually the only remedy is composite fillings/veneers/crowns

Extrinsic Exogenous Staining

• can be removed by polishing if not too intense

• sometimes requires use of a scaler if not too tenacious

Examples of Extrinsic Exogenous Staining

• yellow, green, black line

• tobacco/brown staining

Contraindications for Polishing

• calculus still present

• no extrinsic stain or other deposits

• severe xerostomia (dry mouth)

• rampant decay

• enamel hypoplasia

• severe tooth sensitivity

• newly erupted teeth

• have not completely mineralized

• decalcification

• extreme inflammation

• presence of restorations

How does decalcification effect polishing?

polished away three times more quickly

Should hygienists polish after deep periodontal therapy?

NO, should wait 4-6 weeks out

Systemic Contraindications

• patients with communicable diseases

• respiratory problems (creates aerosols)

• allergy to polishing products

Armamentarium for Coronal Polishing

• SSHP

• rubber cup (prophy cup)

• bristle brush (often used if doing sealants to get in pits and grooves)

• prophy paste

• disclosing agent/solution

• vaseline

• floss

• cotton tip applicator

• 2X2 gauze

What is the disclosing agent/solution used for?

• used to stain plaque so it is visible to operator

• used to show patients areas they need to focus on when brushing

What is the vaseline used for?

lubricate lips especially on corners

What is the floss used for?

to clean between teeth

What is the 2X2 gauze used for?

• used to clean prophy cup

• clean patients face

What is the ideal prophy paste?

one that has high polish and low abrasion levels

What is the cotton tip applicator used for?

to apply the vaseline

What abrasive material is used in air polishers?

sodium bicarbonate