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August 2007
Dr Gerhard Steenkamp
It is always recommended to polish the tooth surface after it has been cleared of plaque / calculus
through manual / sonic / ultrasonic scaling.
a) Why should you polish teeth after scaling them?
b) What instrumentation is needed for this procedure?
c) What type of paste/gel should be used?
Memo
a) After a tooth has been scaled, the enamel surface is not as smooth as it was and this may
attract more plaque and calculus after the procedure, which may accumulate quicker. Secondly,
it is impossible to remove all plaque through scaling the teeth, and polishing the tooth will
remove any residual plaque.
b) A soft rubber cup (polishing cup) attached to a polishing hand piece (±5000 revolution per
minute [rpm]) is ideal. If the speed increase so does the heat generated by the
procedure. Ordinary hobby drills are often used by practitioners, but these tend to turn at
around 20 000rpm, which is not ideal. Polishing bristles instead of cups can also be used, but tend
to get the bristles dislodged and they may penetrate subgingivally. A third method of
polishing the teeth is by making use of a powder polisher. These polishers work like small
sandblasters where the polishing powder is added into a container and then sprayed onto the tooth
surface under pressure. Simply brushing the teeth with a toothbrush after scaling them is
inadequate to polish teeth.
c) Polishing pastes contain abrasives like silica or calcium carbonate to help smooth the
tooth surface. Depending on the size of the particles in the paste it can be classified as
fine, medium or coarse. Furthermore, many contain fluoride to help restore the mineral
balance in the enamel after a scale and polish. Polishing pastes may also contain
flavourants.
For everyday practice, fine – medium coarseness is sufficient, with fluoride.
To prevent heat necrosis of the pulp, practitioners should apply polishing paste liberally so that
there is always a protectant between the polishing cup and the tooth surface. Care should be
taken not to over polish a tooth and once the crown of a tooth has been covered with polishing
paste, while polishing, the clinician should move on to the next tooth
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