Tooth Polishing and Whitening

Flashcards about tooth polishing and whitening

Rubber-Cup Tooth Polishing

Uses a low-speed dental handpiece, a prophylaxis angle with rubber cup and bristle brush, and prophylaxis paste; Effective for removal of extrinsic tooth stains; Good patient acceptance and Easy to learn and perform.

Five variables influence tooth structure loss during rubber cup polishing:

Abrasiveness of the prophylaxis paste, Quantity of abrasive agent, Contact time on the tooth surface, Speed of the rubber cup, and Applied pressure on the tooth surface.

Adverse Effects of Improper Polishing

On teeth—root surfaces, newly erupted teeth, white spots; On restorations—rough surfaces; On soft tissues—irritation, trauma, heat generation, discomfort; On the environment—aerosol production, clinician occupational injury

Hand-Activated and Sonic or Ultrasonic Scaling

Designed primarily for calculus removal; can also be used for extrinsic stain removal; As much stain as possible should be removed during scaling and debridement. Sonic and ultrasonic instruments remove less of tooth structure but leave a rough surface

Air Polishing

Efficient and effective method of extrinsic stain removal, including pits and fissures before placement of sealants; Requires less time than traditional rubber cup polishing and Removes stain three times as fast as hand scaling; Creates less operator fatigue.

Effects of Air Polishing on oral and dental tissues:

Intact enamel surfaces are not damaged; Prolonged use on cementum and dentin can remove significant tooth structure; Gingival bleeding and abrasion; Taste

Appropriate prophy powder options:

Sodium bicarbonate, Calcium carbonate, Aluminum trihydroxide, Calcium sodium phosphosilicate, Glycine, Erythritol

Most common soft-tissue effects of air polishing:

Gingival bleeding and Abrasion

Patient concerns with Air Polishing Safety Issues:

Systemic problems from absorption of sodium bicarbonate prophy powder; Respiratory difficulties and potential infection from inhaling contaminated aerosols; Stinging of the lips from concentrated spray; Eye problems from spray entering eyes.

OTC whitening products such as Toothpaste:

Toothpaste containing mild abrasive to remove extrinsic stains and prevent stain formation; Toothpaste containing a bleaching agent; Toothpaste containing titanium dioxide, which covers extrinsic stains

OTC whitening products such as Whitening kits:

Poor or improperly fitted trays; Seepage of oxidizing gel out of tray can harm soft tissues; Acidic prerinse can damage enamel; Laypersons may not know how to deal with side effects; Laypersons may ignore oral disease such as caries

Side Effects of Tooth Whitening

Mild thermal tooth sensitivity and gingival irritation; Occasionally: sore throats, tooth pain, tingling of tissues, headaches, slight morphologic changes in enamel; Overuse: can decrease enamel hardness; Some restorations are more likely to experience alterations

Restorative Management of Stained Teeth:

Veneers and Full-coverage crowns

Legal and Ethical Aspects of Tooth Whitening

Nonmaleficence requires that all recommended guidelines on the safe use of rubber-cup, air polishing, and tooth bleaching systems must be followed; Patients must be informed of and consent to procedures before they are performed; Patient education includes advantages, disadvantages, risks, and potential adverse effects of treatment.