coronal polishing

Anterior

Front teeth (canine to canine)

Posterior

Back teeth (molar/premolars)

Incisal

Biting surface of anteriors

Occlusal

Biting surface of posteriors

Mesial

Side closest to midline

Distal

Side farthest to the midline

Interproximal

When two teeth touch one another creating a “hallway.”

Line angles

Vertical edges of a tooth / were tooth curves

Embrasure

Triangle shaped space between teeth near gum line

Papilla

Soft tissue that fills the embrasure space

Enamel

The outer surface layer covering the crown of the tooth.

Dentin

Layer below the surface layers (enamel, cementum). Dentin is next to the pulp.

Cementum

Outer surface layer covering the root

Gingival margin

Part of soft tissue that hugs the tooth

Gingival sulculus

A valley around the tooth. Great place for bacteria to hide causing inflammation and disease.

Percentage of calcification of Enamel

94%

Percentage of calcification of Dentin

70%

Percentage of calcification of Cementum

50%

What is the number 1 cause of periodontal disease?

Biofilm (plaque)

Process of biofilm and calculus formation

Pellicle forms —> it becomes plaque —> plaque hardens and it becomes calculus.

Purpose of disclosing solution?

Disclosing is a dye that temporarily stains plaque so it can be seen easily.

What other methods to make plaque visible?

Spraying air

Use of dental mirror

Light up the area

What areas are prone to having more plaque?

• proximal surface

• cervical margins

• buccal of maxillary molars

• lingual of mandibular molars

Extrinsic Stains

• outside stain

• can be removed through professional cleaning.

• caused by foods, beverages, tobacco, bacteria, and mouth rinses.

• yellow, orange, red stains

Orange/red stains

Chromogenic Bacteria

Brown stain

Tobacco, heaviest in root exposed surface.

Green stain

Chromogenic bacteria, hard to remove.

Metallic stain

Caused by inhaling/consuming meds that has meta properties..

Intrinsic stain

• incorporated within tooth structure

• cannot be polished

• pulpless tooth can turn gray

• tetracycline is an antibiotic that causes horizontal band of discoloration.

• tobacco and amalgam can be intrinsic stain

Hypoplasia

Less enamel than normal

Hypocalcification

Enamel doesn’t harden properly

Fluorosis

Too much fluoride

Why is a pt’s health history important?

Reviewing pt’s HH helps identify medical conditions, allergies, or meds that could impact the safety and effectiveness of dental procedures.

How often should HH be updated?

Health history should be reviewed at each appointment.

What is the purpose of coronal polishing?

Aimed at removing plaque and stains from outer surface of the teeth. It also enhances appearance of teeth while contributing to better OH.

What not to do while polishing?

Never hold trophy cup in one place on a tooth to avoid overheating.

Prophylaxis

Is a comprehensive procedure that includes the removal of hard deposits by a Hygienist or dentist.

Polishing

When you remove surface stains/smooth teeth.

Indications for polishing

• plaque removal

• smooth tooth/restoration surface

• remove extrinsic stains

• prep for sealants and fluoride

• prep for ortho work

• enhance appearance and pt motivation

Contradictions for polishing

• pt with respiratory issues or infectious disease

• severe gingival inflammation

• tooth sensitivity

• demineralize areas

• newly erupted teeth

• calculus

• restorative materials

• recession

What is selective stain removal?

Conservative approach in which only teeth with extrinsic stain are polished according to the needs of the pt

List of possible negatives effects of polishing

• loss of tooth structure

• trauma to gingiva

• bacteremia

• slowed healing of inflamed gingiva tissue

• generation of heat which could damage the pulp

• microscopic scratches on tooth surfaces, implants, and other restorations.

What is a prophy paste?

Pre mixed paste distributed in unit dose cups or tubes.

Non-abrasive agents

Used on sensitive surface such as esthetic restorations.

Fine grit

Least abrasive grit. Best used for healthy enamel and light stain.

Medium grit

Used for moderate stain that can’t be removed by fine grit

Coarse grit

Most abrasive grit. Should be reserved for use for the heaviest stains.

3 ways a moth mirror should be used

1. Retraction of cheeks, lips, tongue

2. Reflection of light to illuminate teeth

3. Indirect vision so clinician can maintain good posture

Why is fulcrum so important?

Fulcrum is a point of stability that support the hand and hand piece during coronal polishing. Fulcrum increases control, enhances efficiency, and reduces muscle fatigue.

Carries process

Caries form when acid producing bacteria feed on sugars leading to demineralization as essential minerals are stripped from tooth enamel.

Fluoride role

Remineralization can occur when fluoride and saliva work together to restore and strengthen enamel.

4 actions of fluoride

Slows demineralization

Increases remineralization

Reduces acid production by carcinogenic bacteria

Decrease root sensitivity.

Where is the highest concentration of fluoride found in tooth?

Enamel

Systemic

Fluoride is swallowed in food, water, supplements. It spreads throughout the body and becomes a part of developing tooth.

Topical

Fluoride is applied to surface of an erupted tooth in the form of toothpaste, gels, varnish

Less fluoride

Too low: concentration of .7ppp of fluoride in water is too low to strengthen teeth

Too much fluoride

2.0 ppm in water causes fluorosis

Caries risk gators and how they impact fluoride therapy?

• sugar diet

• - genetic health

• poor oral hygiene

• active decay

Low risk fluoride recommendation

None

Moderate risk fluoride recommendation

Every 6 months

High risk fluoride recommendation

3-6 months

What is dental hypersensitivity? What are tx options for it?

Dental hypersensitivity is a sharp tooth pain that comes and go quickly. OTC toothpaste, fluoride, or restorations are recommended for tx options.

How many years has fluoride been studied and recommended?

Over 70 years