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Tooth Polishing and Whitening (Abrasives used for Rubber-Cup Tooth…
Tooth Polishing and Whitening
Rubber-cup Polishing
removal of extrinsic tooth stains after scaling using a low-speed dental handpiece
also known as Coronal Polishing
technique focuses on the crowns of the teeth
Five Variables that influence the Efficiency, Effectiveness, and Tooth structure loss during extrinsic tooth stain removal with Rubber Cup
abrasiveness of the prophylaxis paste used during the procedure
quantity of abrasive agent
contact time of the rubber cup or bristle brush on the tooth surface
speed or revolutions per minute (rpm0 of the rubber cup or bristle brush
applied pressure or force of the rubber cup or bristle brush on the tooth surface
Selective Polishing
focuses on the tooth surfaces with visible stains after scaling and debridement is complete
also known as Selective stain removal
Abrasives used for Rubber-Cup Tooth Polishing in DH Practice
Aluminum silicates
Mohs Hardness Value= 2
used as a polishing agent, has no excessive abrasion, and is compatible with dental fluoride compounds
Calcium carbonate (chalk or whitening)
Mohs Hardness Value= 3
is used as a polishing agent, has no excessive abrasion, and is compatible with dental fluoride compounds
Superfine pumice (flour of pumice)
Mohs Hardness Value
6
Used as a cleaning agent in prophylaxis paste for oral biofilm and stain removal, and for polishing enamel, gold foil, dental amalgam and acrylic resin
Tin Oxide (putty powder, stannic oxide)
Mohs Hardness Value= 6-7
used for polishing teeth and metallic restorations, and is mixed with water or glycerin to form a mildly abrasive paste
Silica or sand (silex [silicone dioxide])
Mohs Hardness Value= 6-7
used for heavy stain removal, its effectively cleans tooth surfaces with low abrasion and high cleaning capability
Zirconium silicate (zircon)
Mohs Hardness Value= 6.5-7.6
Used in dental prophyaxis pastes and to coat abrasive discs and strips
Corundum (aluminum oxide [alumina])
Mohs Hardness Value= 9
used for polishing composites, highly filled hybrid composites, acrylic resin, and porcelain restorations and custom trays; is bonded to discs or paper strips and impregnated into rubber wheels and points
Diamond
Mohs Hardness Value= 10
used in polishing paste and on ceramic, porcelain, and resin based composite materials and metal-backed abrasive strips and furcation files
Contraindications and Precautions to Rubber-Cup Polishing
Contraindications
Abscence of extrinsic stain
Newly errupted teeth, especially primary teeth
enamel hypocalcification or hypoplasia
enamel demineralization and active unrestored caries lesions
areas of recession where cementum or dentin is exposed
areas of dentinal hypersensitivity
acute gingival or periodontal inflammation
allergy to ingredients in paste
Precautions Needed
use a special polishing agent on restored tooth surfaces, such as composite, bonding, glass ionomer, porcelain, gold, or titanium
consider particle impaction risk immediately after deep scaling, periodontal debridement or root planing when gingival tissues may be irritated
Principles to prevent damage to teeth, restorations, and soft tissues:
use proper technique to reduce unnecessary abrasion. control the time, speed, and pressure during tooth polishing procedures
select the least abrasive polishing agent that will remove the stain and remaining plaque biofilm after self-care demonstration, scaling, and debridement
avoid polishing when contraindicated
Air Polishing Techniques
Supragingival
with standard air-polishing handpiece to remove stain and biofilm
shallow subgingival (up to 4mm)
with a standard handpiece using glycine or erythritol powders and angled toward the sulcus for biofilm removal
subgingival (probing depth of up to 9 mm)
with a subgingival nozzle using glycine or erythritol powder
Air Polishing Powders
Sodium Bicorbonate
Calcium Carbonate
Aluminum trihydroxide
calcium sodium phophosilicate
glycine
erythritol
Tooth Whitening
viable alternative for stain management for intrinsic stains
also known as bleaching
Contraindications to Tooth Whitening
pregnant and breast-feeding women
allergy to any of the ingredients
certain medications
large, defective restorations
recession (with certain powders)
cervical erosion ( with certain powders)
cervical erosion (with certain powders)
enamel cracks
tooth sensitivity
dental caries