Coronal Polishing-10/30

Polish- to make smooth and glossy usually by friction; the act or process of making a model smooth or flossy

Why do we do it?

  • procedure that removes plaque and stain

  • a smooth surface is less likely to retain plaque

Extrinsic stain

  • caused by

    • heavy smokers

    • coffee

    • tea

    • red wine

    • chromogenic bacteria

Intrinsic stain

  • caused by:

    • over absorption of fluoride in tooth development (fluorosis)

    • tetracycline

    • internal resorption

Indications

  • extrinsic stain

  • plaque

  • placement of sealants

  • placement of orthodontic appliances

  • * not everyone need to be polished

Contraindications

  • exposed root surfaces/root caries

  • newly erupted teeth

  • sensitivity

  • inflamed, spongy gingiva

  • xerostomia

  • respiratory problems/disease

  • infectious disease

Polishing restorations

  • coarse abrasives can create scratches on restorative material allowing microorganisms to collect and colonize

  • POLISHING PASTE IS NOT INTENDED ON

What you need

  • prophy slow- speed handpiece

    • to polish teeth with prophylaxis/prophy cup or brush attachment

  • look at weight of handpiece for ergonomics

Steps

  1. observe where stain removal is needed

  2. apply polishing agent with rubber cup only where necessary

  3. using a pen grasp, establish a fulcrum and bring rubber cup almost in contact with the tooth surface before activating power sources

  4. apply revolving cup light to tooth surface for 1 to 2 seconds, using LIGHT pressure to flare the edges of the cup

  5. Start with distal surface of the most posterior tooth of a quad. and move forward toward the anterior

  6. for each tooth work from the gingival third toward the incisal third of the tooth

  7. irrigate teeth several times with water to remove abrasive particles

Cup adaptation

  • dabbing, up and down, overlapping strokes, a LITTLE bit of pressure

Aerosols

  • dispersion of particles of debris, polishing agents, calculus, and water that are contaminated by the pts oral ploral

  • aerosols are created when using a prophylaxis handpiece

  • aerosols can cause disease transmission to dental professionals as well as the pt.

  • use of power driven instruments is limited when the pt has a communicable disease, respiratory disease, or is immunocompromised

  • standard PPE is used

Different heads for polishing

  • disposable right angle prophy angle with rubber cup

    • flex. and adapts to proximal surfaces

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Prophy paste

  • consists of a mix of abrasives, binders, humectants, water, coloring, and fluoride

  • selected based on pts individual needs

  • if you only have 1 kind of prophy paste, you have to request others?

Fine paste

  • used on pts that have light plaque and do not have a lot of extrinsic stain

Medium- used on moderate stain

Coarse- generalized stain everywhere; large particles, abrasive

FLUORIDE Varnish

  • varnish- safe and effective, fast and easy to apply, and pt acceptance is good. makes their teeth feel a little weird afterwards; higher concentration of fluoride than the gel or foam

  • Varnish

    • sets very quickly and remains on the teeth for a number of hours

      • benefit lasts for hours then it gets absorbed

    • Releases fluoride into the pits and fissures, prox. surfaces, and cervical areas of the tooth

    • application is recommended at least every 3-4 months per year for individuals at an elevated risk for dental caries

    • APPLY BASED UPON THE RISK

    • Varnish is effective in reversing active pit and fissure enamel SOMETHIN

    • effective in reducing demineralization around orthodontic brackets

    • may be used for dentin hypersensitivity

    • only professional topical fluoride to be used for children under the age of 6 years

    • only standard 55 NaF varnish formulSOMETHIN

Varnish Application

  • dispense varnish ( if dispensed from a tube discard any clear varnish)

  • instruct pt. to avoid hot drinks and alcoholic beverages, smoking; hard sticky, or crunchy food (some products say 2 hours some say 4 hours, depends on product)

  • Instruct pt not to brush or floss for 4-6 hours or until the next morning

  • varnish is removed by the pt using toothbrushing or flossing

Tray technique

  • gel

  • foam

  • APF not to be used on tooth-colored restorations

    • scratches

  • No eating/drinking for 30 minutes after application

  • prepare pt for the 4 minute timing

  • explain the need not to swallow but to expectorate immediately after the tray is removed

  • coverage of all exposed root surfaces

  • max. and man. trays may

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