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Stains on teeth and relation to the disease
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Stain removal... why
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CLINIC DHY1
Extrinsic Stain Removal/ Selective Polishing
| Question | Answer |
|---|---|
| Stains on teeth and relation to the disease | stains on teeth do not cause disease or the progression of disease |
| Stain removal... why | the removal of dental stains is purely aesthetic |
| Negative effect polishing can have on teeth | polishing teeth can have potentially detrimental effects (polishing teeth w/ abrasive can potentially damage the teeth overtime) |
| Selective polishing in pt's txt plan is based on | profession judgment based on patient need determines inclusion of selective polishing in the treatment plan |
| Bacteremia during polishing | Bacteremia can be created during the use of power-driven stain removal instruments (slow-speed handpieces) |
| Bacteremia when polishing results from... | results from the manipulation of gingival tissues |
| Avoid use of rubber cup near (where) when polishing | avoid use of rubber cup near acutely inflamed tissue that bleeds easily upon probing |
| Coronal Polishing. Is premedication needed? | patients who require prophylactic antibiotics must be premedicated prior to polishing procedures |
| Environmental Factors when Polishing | 1)Aerosol Production; 2)Spatter |
| Due to aerosol production avoid or limit use of polishing on what patients? | avoid/limit use on patients with a known communicable disease (avoid using rotary instrument due to aerosol production) |
| Coronal Polishing and Aerosol Production (why negative?) | biological contaminants are suspended for long periods and provide a means of disease transmission |
| Spatter in Coronal Polishing, what is pt's and operator's PPE | operator and patient need to wear protective eyewear (no need to wear face shield when polishing) |
| Polishing: Effects on Teeth | 1)Pumice removes tooth structure; 2)removal of the fluoride rich surface layer of tooth structure; 3)increased roughness (esp. w/coarse abrasives); 4)avoid areas of demineralization; 5)avoid areas of thin enamle; 6)heat production |
| polishing for 30 seconds with a pumice paste may remove how much of the tooth's surface? | as much as 4 microns of the outer tooth enamel (equals ~ .016 of an inch) (U’ll never hold a rubber cup on the tooth for more than 30 seconds |
| Coronal Polishing and Removal of tooth structure in areas of recession | areas of recession – greater amounts of dentin and cementum are removed |
| What areas on the teeth should be avoided when polishing? | exposed root surfaces and areas of decalcification or Demineralization should be avoided when polishing!!! |
| how much tooth structure is removed depends on what? | how much tooth structure is removed depends on the speed of the handpiece and abrasiveness of the material) |
| Removal of the fluoride rich surface layer of tooth structure, why negative | more important than the enamel lost during polishing is the loss of the outermost layer of tooth structure containing the greatest amount of fluoride |
| what is more important than the enamel lost during polishing? | more important than the enamel lost during polishing is the loss of the outermost layer of tooth structure containing the greatest amount of fluoride |
| Why topical fluoride application following selective polishing with an abrasive should be included in the treatment plan? | because the outermost layer of tooth structure containing the greatest amount of fluoride is lost during polishing |
| What MUST be included in the treatment plan following selective polishing? | topical fluoride application following selective polishing with an abrasive should be included in the treatment plan |
| Effects of polishing on teeth: Increased roughness, characterize: | Coarse abrasives may leave a tooth surface rougher than it was prior to polishing. (There is no reason to use coarse abrasives – can remove stains better by scaling!!! May create grooves and scratches in the tooth surface |
| Effect of Polishing on teeth: Increased Roughness, why negative | coarse abrasives may leave a tooth surface rougher than it was prior to polishing; microorganisms collect and colonize on a rough surface much more rapidly than on a smooth surface |
| Polishing. Avoid areas of demineralization. WHY? | more surface enamel removed when polishing in these areas than when polishing intact enamel; *enamel surface layer is thin over subsurface demineralization polishing demineralized areas can interrupt remineralization |
| Polishing and its effect on remineralization? | When polishing demineralized areas, it can interrupt remineralization |
| Polishing. Avoid Areas of thin enamel, exposed dentin and areas of recession. WHY? | Avoid areas of thin enamel – polishing can cause sensitivity |
| Removal of smear layer results in what.... and causes what | Smear layer - is the coating over the tooth; removal of smear layer results in exposing of dentinal tubules and therefore sensitivity |
| Thin enamel is characteristic of what condition? | Amelogenesis imperfecta |
| The coating over the tooth is called, characterize | Smear layer, fluoride rich surface coating over the tooth |
| Polishing and Heat Production, describe; How to avoid too much heat production | too much heat production can cause discomfort for the patient; (HEAT: Make sure prophy cup is filled, will make it more comfortable for the pt) |
| Heat and damage to the pulp | has not been documented |
| Children and heat production when polishing | children have large pulps and may be more sensitive to heat |
| Polishing and Effects on Gingiva | *High speed and excessive pressure and application time to tooth can cause tissue trauma; *Particles of polishing agent can be forced into the subepithelial tissues and create a source of irritation may also create a bacteremia |
| Polishing is contraindicated following what treatment? | polishing following gingival or periodontal surgery, deep periodontal debridement contraindicated on the same day of treatment |
| What factors can cause gingival tissue trauma in polishing? | high speed and excessive pressure and application time to tooth can cause tissue trauma |
| What can create tissue irritation during polishing? | particles of polishing agent can be forced into the subepithelial tissues and create a source of irritation may also create a bacteremia |
| After polishing restoration what MUST be included in the same day treatment? | must apply fluoride to tooth surface after polishing restorations |
| Polishing and its Effect on Restorations | can leave a rough surface on older, existing restorations |
| Effects of Polishing on restorations; Careful management of abrasives around what areas is important? | careful management of abrasives around margins of crowns, restorations, etc. |
| Polishing agents and their effects on newly erupted teeth? | polishing agents may damage newly erupted teeth |
| Black line stain has been identified as a .... How should the black line stain be removed? | black line stain has been identified as a type of calculus and should be removed by scaling |
| Black line stain most commonly found in... what type of compound... txt | most commonly found on children’s teeth newly erupted teeth are more porous and less mineralized ferric sulfide (iron) compound polishing agents may damage newly erupted teeth |
| To remove stain not removed by toothbrushing and scaling... | choose the least abrasive paste available that will adequately remove the stain may be OTC toothpaste (over-the-counter) |
| Stain and Discussion w/pt | discuss etiology of stain with patient (what is causing the stain, and what to do to avoid it; If pt is not going to give up the habit, using the Sonicate TB will help to control the stain) discourage habits associated with the development of stains |
| To Prepare the Teeth for Caries Preventive Agents pit and fissure sealants | plain fine pumice/water slurry to clean tooth surface prior to etching air-powder polishing most effective (before u etch the tooth, polish the tooth w/PLAIN pumice; sealant 1st, then FL treatment) |
| professional application of fluoride solutions or gels. Does pellicle need to be removed before application. | the pellicle does not act as a barrier to fluoride; polishing is not required prior to application of topical fluorides – tooth brushing and flossing is adequate for plaque removal |
| Indications for Stain removal with polishing: | 1)To remove stain not removed by toothbrushing & scaling: 2)to prepare teeth for caries preventive agents (pit& fissure sealants, prof applic of fl solutions or gels); 3)to contribute to patient motivation |
| Contraindications for Stain Removal | 1)No extrinsic stain present; 2)Pts at risk for dental caries; 3)pts w/respiratory problems; 4)tooth sensitivity; 5)restoration; 6)newly erupted teeth |
| Why polishing is contraindicated in pts at risk for dental caries? | Don’t remove the fluoride rich outer layer of enamel on patients at increased risk for tooth decay rampant (caries, nursing caries, root caries, demineralized areas xerostomia for any reason (Use OTC toothpaste for polishing;) |
| Why polishing is CI in pts w/respiratory problems? | Patients with Respiratory Problems production of an aerosol detrimental for patients with respiratory conditions – i.e., asthma, emphysema |
| Why polishing is CI in pts with tooth sensitivity? | Tooth Sensitivity uncovers ends of dentinal tubules in areas of thin cementum or dentin |
| Why polishing may be CI in pts with restorations? | Restorations may scratch titanium implants, resins and porcelain restorations |
| Why polishing may be CI in pts with newly erupted teeth? | Newly Erupted Teeth enamel surface is not completely mineralized |
| Postpone Selective Polishing, if: | POH instrctn not givenor ptnot demnstrtd adequate biofilm cntrl*tissue inflamed(soft/spongy/bleedseasily*U prfrmd deep subg debrdmnt prcdr abrve prtcls canget embdd inpocket wall& intrfre w/healing *Pthas commncble disease thatcanb transsmitd via aeroso |
| If the stain is primarily tobacco stain, what should be done? | tobacco cessation counseling should be provided if the stain is primarily tobacco stain |
| It is suggested that the stain is removed when and how, and why? | whenever possible remove stain during instrumentation procedures often there is supragingival calculus underlying the stain |
| It is suggested to use, MINIMAL POLISHING TECHNIQUES, describe... | *low-abrasion paste *low-speed handpiece *minimal heat production *rubber cup at 90° to tooth surface with intermittent (скачкообразный, прерывистый) light application |
| Is polishing required prior to application of topical fluorides? | polishing is not required prior to application of topical fluorides – tooth brushing and flossing is adequate for plaque removal |
Created by:
EdmondDantes