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52 Cards in this Set
- Front
- Back
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Coronal polishing |
is a technique used to remove plaque |
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Polishing the crowns of the teeth is considered mainly______, but there are instances in which coronalpolishing has ______ value as well |
cosmetic, therapeutic |
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Selective polishing |
is a procedure in which only those teethor surfaces with stain are polished |
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The purpose of selective polishing |
is to avoid removingeven small amounts of surface enamel |
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In some individuals, stain removal may cause _________ during and after the appointment |
dental hypersensitivity |
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selective polishing |
• Coronal polishing and fluoride application – Historically, teeth were polished to remove all soft deposits andstains before the application of fluoride because it was believedthat there would be greater uptake of the fluoride into theenamel – As scientific knowledge has evolved, it has been shown thatpolishing does not improve the uptake of professionally appliedfluoride |
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Benefits of Coronal Polishing |
• Polishing prepares the teeth for the placement of dental sealants • Smooth tooth surfaces are easier for the patient to keep clean • The formation of new deposits is slowed • Patients appreciate the smooth feeling and clean appearance • Polishing prepares the teeth for the placement of orthodontic brackets and bands |
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There are other treatment options for patients with stainsthat cannot be removed |
– Include professional and at-home bleaching procedures, enamelmicroabrasion, and cosmetic restorative procedures such aslaminate veneers and composite restorations |
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Endogenous stains |
originate within the tooth as a result ofdevelopmental and systemic disturbances |
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Exogenous stains |
originate outside the tooth in response toenvironmental agents |
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Exogenous subdivide |
extrinsic or intrinsic |
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Extrinsic stains |
stains on the exterior of the tooth that can beremoved |
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Intrinsic stains |
caused by an environmental source butcannot be removed because the stain has become incorporatedinto the structure of the tooth |
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Intrinsic stains |
Examples are tobacco stains from smoking, chewing, or dipping, andstains from dental amalgam that has become incorporated into thetooth’s structure |
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Air polishing |
The air polishing technique involves the use of a speciallydesigned handpiece with a nozzle that delivers a high-pressurestream of warm water and sodium bicarbonate |
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Rubber cup polishing |
– This is the most common technique for removing stains andplaque and polishing the teeth – A rubber polishing cup is rotated slowly and carefully by meansof a prophylactic angle attached to the slow-speed handpiece |
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Polishing cups |
– Soft webbed polishing cups are used to clean and polish thesmooth surfaces of the teeth – The polishing cup is attached to the reusable prophylaxis angleby means of a snap-on or screw-on attachment |
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Bristle brushes |
– Bristle brushes, made of natural or synthetic materials, may beused to remove stains from deep pits and fissures of the enamelsurfaces – Bristle brushes can cause severe gingival lacerations and must beused with special care – Brushes are not recommended for use on exposed cementum ordentin because these surfaces are soft and are easily grooved |
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prophy angle |
this attaches to the slowspeed handpiece |
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The reusable prophy angle must be properly ________ after each use |
cleaned and sterilized |
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disposable angle is manufactured with a _______________ already attached |
polishing cupor a brush |
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The handpiece and prophylaxis angle are held in a ______ with the handle resting in the _____ area of thehand between the thumb and index finger |
pen grasp; v shaped area |
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Use a ___-speed handpiece that operates to a maximum of______ rpm |
low; 20,000 |
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fulcrum |
provides stability for the operator and must beplaced in such a way as to allow for movement of the wrist andforearm |
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The fulcrum may be either ____ or ______ , depending on a variety of circumstances such as |
intraoral or extraoral – The presence or absence of teeth – The area of the mouth being polished – How wide the patient can open his or her mouth |
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Dental abrasives (polishing materials) are used to |
remove stain and to polish natural teeth, prosthetic appliances, restorations, and castings |
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They are available in |
extra-coarse, coarse, medium, fine, andextra-fine grits. |
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The______ the agent, the more______ thesurface. |
coarser; abrasive |
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Even a ____gent removes small amounts of the enamel’s surface. |
fine grit |
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Coarse polishing paste, use of acidulated phosphate fluorides,and even hard brushing with abrasive toothpaste can bedestructive to the surfaces of restorative materials |
j |
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A _________________________toothpaste shouldbe used for these restorations |
diamond, aluminum oxide, or low-abrasion |
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Factors That Influence the Rate of Abrasion |
• The more agent used, the greater the degree of abrasion • The lighter the pressure, the less abrasion • The slower the rotation of the cup, the less abrasion |
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Coronal Polishing Steps |
Polishing stroke – Fill the polishing cup with the polishing agent and spread it over severalteeth in the areas to be polished – Establish a finger rest and place the cup almost in contact with thetooth – The stroke should reach from the gingival third to the incisal third of thetooth – Using the slowest speed, lightly apply the revolving cup to the toothsurface for 1 or 2 seconds – Use light pressure to make the edges of the polishing cup flare slightly – Use a patting, wiping motion and an overlapping stroke |
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Positioning the patient |
– Adjust the dental chair so that the patient is approximatelyparallel to the floor, with the back of the chair raised slightly – Adjust the headrest for patient comfort and operator visibility – For the mandibular arch, position the patient's head with thechin down – When the mouth is open, the lower jaw should be parallel to thefloor – For access to the maxillary arch, position the patient's head withthe chin up |
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Positioning the Operator |
• The operator should keep his or her feet flat on the floor and the thighs parallel to the floor • The operator's arms should be at waist level and even with the patient’s mouth • When performing a coronal polish procedure, the right-handed operator generally begins by seating himself or herself in an eight to nine o’clock position • When performing a coronal polish procedure, the left-handed operator generally begins by seating himself or herself in the three to four o’clock position |
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Sequence of Polishing |
• Full-mouth coronal polishing must be performed in apredetermined sequence to be certain that no area is missed • Best sequence is based on operator's preference and theindividual needs of patient • Esthetic and porcelain restorations should be polished first, thenthe remaining teeth may be polished with the use ofappropriate methods for any stain that is present – This reduces the possibility that a coarse abrasive will remain in therubber cup when esthetic restorations are being polished • Positions and fulcrums described in the following slides are for aright-handed operator |
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Patient Preparation |
• Check patient's medical history for any contraindications tocoronal polishing procedure • Seat patient and drape him or her with a waterproof napkin • Ask patient to remove any dental prosthetic appliances he orshe may be wearing • Provide patient with protective eyewear • Explain the procedure to patient and answer any questions • Inspect oral cavity for lesions, missing teeth, tori, and so on • Apply a disclosing agent to identify areas of plaque |
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Maxillary Right Posterior Quadrant, BuccalAspect |
• Sit in the eight to nine o’clock position • Have the patient tilt the head up and turn slightly awayfrom you • Hold the dental mirror in your left hand • Use it to retract the cheek or for indirect vision of the moreposterior teeth • Establish a fulcrum on the maxillary right incisors |
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Maxillary Right Posterior Quadrant, LingualAspect |
• Remain seated in the eight to nine o’clock position. • Have the patient turn the head up and toward you. • Hold the dental mirror in your left hand. Direct vision inthis position and the mirror provide a view of the distalsurfaces. • Establish a fulcrum on the lower incisors and reach up topolish the lingual surfaces. |
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Maxillary Anterior Teeth, Facial Aspect |
• Remain in the eight to nine o’clock position • Position the patient’s head tipped up slightly and facingstraight ahead • Make necessary adjustments by turning the patient's headslightly either toward or away from you • Use direct vision in this area • Establish a fulcrum on the incisal edge of the teethadjacent to the ones being polished |
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Maxillary Anterior Teeth, Lingual Aspect |
• Remain in the eight to nine o’clock position or move to theeleven to twelve o’clock position • Position the patient’s head so that it is tipped slightlyupward • Use the mouth mirror for indirect vision and to reflect lighton the area • Establish a fulcrum on the incisal edge of the teethadjacent to the ones being polished |
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Maxillary Left Posterior Quadrant, BuccalAspect |
• Sit in the nine o’clock position • Tip the patient's head upward and turn it slightly towardyou to improve visibility • Use the mirror to retract the cheek and for indirect vision • Rest your fulcrum finger on the buccal occlusal surface ofthe teeth toward the front of the quadrant • Alternative: Rest your fulcrum finger on the lowerpremolars and reach up to the maxillary posterior teeth |
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Maxillary Left Posterior Quadrant, LingualAspect |
• Remain in the eight to nine o’clock position. • Have the patient turn the head away from you. • Use direct vision in this position. Hold the mirror in yourleft hand and use it for a combination of retraction andreflecting light. • Establish a fulcrum on the buccal surfaces of the maxillaryleft posterior teeth or on the occlusal surfaces of themandibular left teeth. |
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Mandibular Left Posterior Quadrant, BuccalAspect |
• Sit in the eight to nine o’clock position • Have the patient turn the head slightly toward you • Use the mirror to retract the cheek and for indirect visionof distal and buccal surfaces • Establish a fulcrum on the incisal surfaces of themandibular left anterior teeth and reach back to theposterior teeth |
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Mandibular Left Posterior Quadrant, LingualAspect |
• Remain in the nine o’clock position • Have the patient turn the head slightly away from you • For direct vision, use the mirror to retract the tongue andreflect more light to the working area • Establish a fulcrum on the mandibular anterior teeth andreach back to the posterior teeth |
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Mandibular Anterior Teeth, Facial Aspect |
• Sit in either the eight to nine o’clock position or in theeleven to twelve o’clock position • As necessary, instruct the patient to make adjustments inhead position by turning either toward or away from youor by tilting the head up or down • Use your left index finger to retract the lower lip • Both direct and indirect vision can be used in this area • Establish a fulcrum on the incisal edges of the teethadjacent to the ones being polished |
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Mandibular Anterior Teeth, Lingual Aspect |
• Sit in either the eight to nine o’clock position or the eleven to twleve o’clock position. • As necessary, instruct the patient to make adjustments in head position by turning either toward or away from you or by tilting the head up or down. • Use the mirror for indirect vision, to retract the tongue, and to reflect light onto the teeth. Direct vision is often used in this area when the operator is seated in the twelve o’clock position, but indirect vision can also be helpful. • Establish a fulcrum on the mandibular cuspid incisal area. |
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Mandibular Right Quadrant, Buccal Aspect |
• Sit in the eight o’clock position. • Have the patient turn the head slightly away from you. • Use the mirror to retract tissue and reflect light. – The mirror may also be used to view the distal surfaces in thisarea. • Establish a fulcrum on the lower incisors |
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Mandibular Right Quadrant, Lingual Aspect |
• Remain in the eight o’clock position • Have the patient turn the head slightly toward you • Retract the tongue with the use of the mirror • Establish a fulcrum on the lower incisors |
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Flossing After Coronal Polishing |
• Dental floss and tape have two purposes after coronal polishing • The first is to polish the interproximal tooth surfaces • The second is to remove any abrasive agent or debris that may be lodged in the contact area • Place abrasive on the contact area between the teeth and work the floss or tape through the contact area, using a back-and forth motion • A floss threader can be used to pass the floss under any fixed bridgework to gain access to the abutment teeth |
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Evaluation of Polishing |
• There is no remaining disclosing agent on any of the toothsurfaces • The teeth are glossy and reflect light from the mirroruniformly • There is no evidence of trauma to the gingival margins orany other soft tissues in the mouth |
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Patient Education |
• Most patients are self-conscious about stains on theirteeth and appreciate any tips you can give them on how tokeep their teeth as white as possible • It is important to educate patients about the causes ofstains • When stains are intrinsic, the dentist may want you todiscuss possible cosmetic dental care options to satisfytheir desire for attractive and stain-free teeth |
