Calculus
Calcium and phosphate salts in saliva that become mineralized and adhere to tooth surfaces.
Coronal polishing
Technique used to remove plaque and stains from the coronal surfaces of the teeth
Endogenous stains
Stains developed from within the structure of the tooth.
Exogenous stains
Stains developed from external sources.
Extrinsic stains
Stains that occur on the external surfaces of the teeth that may be removed by polishing.
Fulcrum
Finger rest used when one utilizes an instrument or handpiece for a specific intraoral purpose.
Intrinsic stains
Stains that occur within the tooth structure that may be removed by polishing.
Oral prophylaxis
The complete removal of calculus, debris, stain, and plaque from the teeth.
The idea of using compressed air, water, and an abrasive to polish the teeth originated in a device developed by Dr. Robert Black in 1945. The device was marketed by SS White beginning in 1951 as a means of preparing the teeth without ...
anesthesia. Dr. Black's Airdent unit never gained commercial acceptance for reasons related to its inability to perform in a manner required by restorative materials of the day. It wasn't until the 1970s that this concept was applied to polishing the teet
Dr. Black would be gratified to learn that his desire to use air abrasion for restorative dentistry has been realized in the last decade or so. New restorative materials have been ...
introduced that work well in conjunction with a tooth that has been prepared by air abrasion.
Without meticulous oral hygiene, teeth accumulate plaque and stain. If allowed to remain on the teeth, the plaque can ...
calcify and become calculus, and the stain can become permanently embedded in the tooth structure.
Removal of all calculus and plaque (and any stain not permanently embedded in the enamel), a process called oral prophylaxis, is the job ...
of the dental hygienist in most municipalities.
The coronal polishing procedure is but one part of oral prophylaxis and is considered an expanded function that can be assigned to the dental assistant in some locales. Coronal polishing is the procedure that ...
removes plaque and surface stain from the crowns of the teeth.
One would think that polishing the crowns of the teeth would not be controversial, but it is a matter of some debate. Polishing is advisable in some situations, ...
such as before acid etching of the enamel (before sealant placement or composite resin restorations, for example) and cementation of crowns and orthodontic bands.
Other times, the advantages and disadvantages of tooth polishing have to be weighed. If no stain is present and the pt is happy with the appearance of their teeth, should polish be performed? Before you answer, consider that polishing the teeth with an ab
tooth's surface and that the outermost enamel is the most fluoride-rich, strongest enamel of the tooth. Why polish away enamel if there are no stains?
Selective polishing involves polishing only those teeth that exhibit stain. By doing so, the enamel is preserved on unstained teeth. This desirable goal of preserving enamel by only polishing teeth that are stained runs counter to a lifetime of expectatio
who has always had all of your teeth polished as part of your cleaning. Now imagine that your dentist's new assistant indicates that she is only going to polish some fo your teeth. You can see how this may cause concern for pts.
This discussion of selective polishing falls into the realm of your dentist's philosophy and preference. Discuss this topic with your dentist and hygienist and follow their lead. Be sure to discuss with your pt the advantages of selective polishing so as
polishing removes enamel ever time it is performed. This can lead to tooth sensitivity in areas of thin enamel or in recently erupted teeth. Preservation of enamel is vital to maintaining teeth for a lifetime.
An attractive smile is valued by the vast majority of your future pts. White teeth are the central feature of an attractive smile. Unfortunately for some individuals, staining of the teeth can detract from ...
an otherwise pleasant smile. Is coronal polishing the solution for their stained teeth? To answer that question. it is helpful to understand the two primary types of staining: endogenous and exogenous staining.
Endogenous staining involves stain that occurs during the formation of the tooth structure itself; this stain cannot be removed by polishing, Examples of endogenous stains include:
1. Dental fluorosis (white or brown stains caused by too much fluorosis)
2. Tetracycline staining (caused by tetracycline ingestion during the tooth formation stage of development).
****The terms endogenous stain and intrinsic stains are used interchangea
An exogenous stain is a stain that adheres to the external tooth surface. Some exogenous stains can be removed by ...
polishing (extrinsic stains), whereas other exogenous stains cannot.
Can be removed:
1. Food stains, such as those caused by coffee or wine, can be removed by polishing.
2. Stains left by oral hygiene products; even some effective oral hygiene products are capable of causing an extrinsic stain. For example, chlorhexidine rinses, which are
Cannot be removed:
Some exogenous stains cannot be removed by polishing; they can be caused by a number of factors including tobacco use. If a stain is allowed to remain on the tooth surface for an extended period of time, it may become incorporated into the tooth's surface
Two primary methods for performing a coronal polishing procedure are:
1. Rubber cup (or bristle brush) polishing in a rotary handpiece
2. Air-powder polishing
Both methods accomplish the same goal-- removing plaque and stain from the clinical crown of the teeth, but ...
by different means.
Coronal Polishing Procedure:
1. Prepare armamentarium for procedure.
2. Apply disclosing agent to expose plaque.
3. Begin with pt's maxillary right quadrant from 9:00 position.
4. Have the pt to raise chin.
5. Fill prophy cup with polishing paste.
6. Retract cheek with mouth mirror a
The rubber cup polishing method uses a slow-speed handpiece and right angle attachment (often called a prophy angle) to rotate a rubber cup (or bristle brush) containing an abrasive polishing paste against the surface of the tooth. In the past, ...
prophy angles were durable, autoclavable metal attachments for the slow speed handpiece. Disposable, plastic, single use prophy angles have largely replaced the reusable variety, though both varieties are still marketed to the dentist.
Although a polishing cup is well suited for removing stains and plaque from smooth surfaces, it is quite ineffective at doing so in the pits and fissures of the teeth. A bristle brush placed in a prophy angle is better able to perform this task.
Disposable prophy angles fitted with bristle brushes are also marketed, as are brushes made of both natural and synthetic materials. These brushes are to be used on enamel surfaces and not dentin or cementum.
The type of polishing (or prophy) paste employed depends on the degree of staining present:
1. More abrasive pastes (coarse or extra coarse) are used on pts with heavily stained teeth.
2. Pastes with a mild abrasives (fine and extra fine) are used where limited staining is present.
Most dental offices use premixed prophy pastes either in single-use cups or in larger containers from which a quantity is removed for each pt. All polishing pastes ...
remove some enamel, so use the least abrasive paste possible that will remove the stain present on the pt's teeth.
The air-powder polishing method uses a special handpiece that sprays warm water and prophy powder against the teeth under pressure. This method is particularly effective ...
in removing stains from teeth (including pits and fissures) in a fraction of the time of a rotary cup in a handpiece.
You should be aware of some concerns raised by the use of polishing method before you employ it:
1. Aerosols created by air-powder polishing travel a great distance. Use a well-fitted mask to prevent inhaling the aerosol. Have the pt perform a procedure rinse with chlorhexidine to reduce bacteria in the oral cavity. Also, disinfect (or cover) surface
Gentle pressure on the foot pedal prevents the rotation of the prophy cup ot brush at an excessive speed that will overheat the tooth. This is a ...
common error that new assistants make that can cause permanent damage to the pulp of the tooth.
Just as a fast rotation of the prophy cup can overheat the tooth, so can applying too much pressure on the tooth with the cup. Gentle, intermittent pressure and constant movement of the instrument can prevent overheating. Remember, ...
the stiffness of the cup or brush and the abrasiveness of the paste can also generate heat. Reserve the stiffer instruments and more abrasive pastes for those limited areas of the mouth where stain removal is a challenge.
Another common mistake is the failure to maintain a fulcrum when working in the pt's mouth. Although this is often a difficult skill to learn, it is absolutely vital to performing dentistry safely and effectively. When performing a coronal polish, ...
maintain a finger rest (third or ring finger) intraorally as close as possible to the area where you are polishing, preferably on the same arch. Occasionally missing teeth or anatomical variations may make an intraoral fulcrum impossible. In these cases,
Why use a fulcrum? The fulcrum serves two purposes:
1. Working without a fulcrum leaves you at the mercy of any sudden motions that the pt may make. By resting on the pt's tissues, any movement by the pt is transferred to you, the operator, and safely is better ensured.
2. A fulcrum enhances ergonomics for
Because esthetic restorative materials are hard, a coarse polishing paste is recommended for them. True or False.
False. Many of them are actually very soft and will scratch if coarse paste is used. It is recommended to use a fine paste with these.
Exposed dentin and cementum stain easily, so they require an aggressive polishing with a coarse paste. True or False.
False. Avoid polishing these areas.
To remove stubborn stains from teeth, a dry cup at high rotational speed is recommended. True or False.
False.
The use of a fulcrum is recommended to reduce operator fatigue and increase pt safety. True or False.
True.
Polishing of Bobby's teeth will involve the use of 1. ............. for the smooth surfaces of the teeth and 2. ................ for the pits and fissures.
1. Prophy cup
2. Bristle brushes
1. ................... prophy paste would be used where Bobby has dark stain from drinking too much grape juice. This type of stain is called
2 ............... stain.
1. Coarse
2. Extrinsic
Because of the pulp in primary and new permanent teeth is large,
1. ............... prophy cups and 2. ................. pressure should be used.
1. Soft
2. Light
The careful use of a .............. reduces hand fatigue and increases the safety of dental procedures, including a coronal polish.
Fulcrum.
After completing the coronal polish, the assistant uses .............. to remove paste from between the teeth.
Dental floss.
An alternative to the prophy cup and brush is ............ polishing.
Air-powder.
Using ............... helps the assistant to visualize where the plaque is located and can be used to provide oral hygiene instruction to the pt.
Disclosing agents.
Proper ........... of the pt and the operator ensures both comfort and efficiency.
Positioning.
1. ............ handed operators begin the procedure at the 9:00 position; for 2. .......... handed operators, 3:00 is preferred.
1. Right
2. Left