Dental plaque, a biofilm adhered to the tooth surfaces, is the primary etiological factor in caries and periodontal disease. Microbial biofilms are complex communities of bacteria and the nature of the biofilm enhances the component bacteria’s resistance to both the host’s defense system and antimicrobials. Understanding the nature and characteristics of plaque is important to implementing proper management strategies of controlling it. Although dental biofilm cannot be eliminated, it can be reduced and controlled through daily oral care. A daily regimen of thorough mechanical oral hygiene procedures, including tooth brushing and interdental flossing, is key to controlling biofilm accumulation.
Oral prophylaxis is a procedure in which bacterial plaque and tartar is removed from the surface of the teeth with the help of scaling and polishing. It is not the same as teeth whitening or coronal polishing because it is mainly performed to prevent decay and other oral complications rather than for aesthetic reasons. The dental prophylaxis should be used as part of a comprehensive prevention programm designed to improve children’s ability to maintain their oral health. The use of dental prophylaxis should be considered as an educational tool to allay patient fears regarding the manipulation of oral tissues. A periodic professional prophylaxis should be performed to: 1. instruct the caregiver and child or adolescent in proper oral hygiene techniques; 2. remove microbial plaque and calculus; 3. polish hard surfaces to minimize the accumulation and retention of plaque; 4. remove extrinsic stain; 5. facilitate the examination of hard and soft tissues; 6. introduce dental procedures to the young child and apprehensive patient. In addition to establishing the need for a prophylaxis, the clinician should determine the most appropriate type of prophylaxis for each patient. The practitioner should select the least aggressive technique that fulfills the goals of the procedure. A patient’s risk for caries and periodontal disease, as determined by the patient’s dental provider, should help determine the interval of the prophylaxis. Patients who exhibit higher risk for developing caries and/or periodontal disease should have recall visits at intervals more frequent than every 6 months.
There are several reasons for integrating polishing in an oral prophylaxis. Polishing produces smooth surfaces on the teeth and restorations, thereby reducing the adherence of oral accretions: dental plaque, extrinsic stains, and calculus. During the process of tooth polishing, there are few things that dental clinician should take care of, such as using proper technique to reduce unnecessary abrasion of the enamel and dentin surfaces, and selecting a least abrasive polishing agent that will remove dental plaque and stains. Also, it is very important to control the time, pressure and speed during the procedure. Speed and pressure, which are operator controlled, increase the rate of abrasion and create heat, which can initiate or worsen dentinal hypersensitivity and should be kept to a minimum. When speed is increased, pressure should be decreased and vice versa. It is important to understand the patients’ expectations when considering tooth polishing. Patients prefer this procedure instead of debridement with instruments for many reasons. An important factor is that patients respond positively to the smooth and clean feel that polishing produces. Furthermore, it is less painful and stressful than scaling; and easier for the patient to understand and tolerate. Polishing produces tangible benefits, which the patients can see and feel. Patients expect to have their teeth polished when they have their teeth “cleaned” and they expect to have that “smooth” feeling when leaving the oral prophylaxis appointment. Dental hygienists are responding to patient expectations of having their teeth polished as part of an oral prophylaxis, which is demonstrated by the amount of polishing products sold by dental manufacturers and distributors each year. They simply like the look and feel of polished teeth.
There are differences in polishing pastes, such as grit size — fine, medium-fine, medium, coarse, and extra coarse. Patients have been known to complain of excessive grittiness, which can be deflating for hygienists striving to provide the best possible experience. Coarse grit polishing pastes may remove stain quickly, but at a price. Coarse grit polishing pastes can produce hypersensitivity, rough tooth surfaces, and accelerate staining and the retention of dental plaque and calculus. The surface characterization of esthetic dental restorations can be highly damaged by polishing pastes. This can be avoid by using the fine (Gentle polishing and cleansing), medium-fine (specially designed for plaque removal and polishing of children’s teeth) and medium (normal polishing, cleansing and plaque removal) polishing pastes. When choosing a prophy paste, flavor and aroma preference are as important as the grit selection. Days of tasteless pastes have been replaced with products that have superior taste and smell. The handling characteristics, consistency and flavor quality of the paste can influence both professional and patient acceptance. Hygienists seek a low-splatter, flash-rinsing paste that leaves a clean surface, while patients look for a fresh, clean, smooth mouth feel, a pleasant taste experience and shiny, stain-free teeth. Experiencing the paste’s performance in their hands and taking time to assess their patients reaction to the taste and feel of the paste can be key to providing predictable and desirable clinical outcomes. When asking a patient for flavor preference, hygienists know that most adults choose mint and most people love it for the sweet flavor and cool, refreshing taste it leaves in the mouth. Then there are flavors that are targeted primarily to children like chocolate, bubblegum and strawberry. Younger patients in particular can enjoy the wide selection of flavors, leaving them with a positive feeling about their dental visits for many years to come. It is very important that the child must feel safe, relaxed and comfortable while entering into a dentist office to get the best possible dental care and because the children are much less tolerant to a bad tasting products than adults, the visit can go in opposite way if the prophylaxis paste tastes awful. Making a child’s first dental appointment, the “happy visit,” stress-free and a happy experience, can set a child up for a lifetime of dental health without apprehension of the dental office.
It is important for oral health professionals to communicate to their patients that both dental caries and periodontal disease are infectious diseases resulting from dental plaque biofilm accumulation. Each of these diseases requires specific strategies for prevention and treatment. Tooth polishing is an essential part of keeping your oral health in check. Professional dental cleaning will remove the build-up of plaque that normal brushing cannot reach and ensures no further complications from plaque develop. This is why it is essential to have your teeth cleaned once every 6 months and to maintain good preventative dental measures at home in between visits. This is a treatment that is performed during a normal dental check up so it shouldn’t take any extra time or multiple appointments. Teeth cleaning can be used on its own or as the first step to many dental treatments including cosmetic dentistry. Clean teeth ensure that you are ready to receive any further treatment and are the first step towards a bright and beautiful smile.