Tooth polishing with prophy paste was introduced by the father of modern dentistry, Pierre Fauchard, and is still one of the most common procedures dental hygienists perform. Today, the procedure is based on removal of biofilm and extrinsic stain prior to bringing back a smooth, shiny surface for aesthetic appeal. While stain removal is an important part of polishing, damage to the surface of the tooth can easily occur if an incorrect polishing agent is chosen. As most hygienists know, large, coarse particles remove stain more quickly but can create scratches on the tooth surface, ultimately creating more stain and attracting more biofilm. Polishing agents made of finer particles produce a smoother surface but can be less efficient as the process may take extra time and pressure to accomplish. Stain removal from tooth surfaces results from a combination of rotations per minute (rpm) of the rubber cup, coarseness of the prophy paste, pressure or “load” on the rubber cup, and time spent with each stained area. Rotation of the rubber cup and “load” may be difficult to determine, even though manufacturers recommend 3,000 rpm as optimal. Recent literature suggests that lower settings are necessary, as abrasion increases as rpm increase. Because of the abrasion factor in prophy pastes, coarse to fine commercial toothpaste can be a useful polishing agent. The load factor in polishing can be controlled by applying just enough pressure to flare the ridges of the rubber cup and polish away the stain. In addition, contact with the tooth surface for 5 to 30 seconds per tooth can cause loss of tooth surface over time. Reduced time and friction reduces tooth surface abrasion. The American Dental Hygienist’s Association has published a statement on polishing, which indicates that hygienists need to “assess each patient for the amount, type, and location of stain present to determine the need for polishing.” Newly erupted teeth, cosmetic restorations, and sensitive surfaces are contraindicated for polishing. Due to the fact that polishing removes the fluoride-laced surface enamel from the teeth, fluoride treatments are suggested as a means to remineralize the enamel after polishing procedures.
(Source: Dimensions of Dental Hygiene, June 2007)
