Overview of Teeth Polishing
Tooth polishing is a dental procedure that makes the surface of your teeth smooth and shiny, helping to cut down on plaque buildup and support the health of your gums. Often, when you hear about tooth polishing, it’s part of a combined cleaning and polishing process, though technically, these are two separate actions. Cleaning involves removing any unwanted substances from your teeth, while polishing aims to make the tooth surface smooth and shiny.
As stated by the American Academy of Periodontology, tooth polishing helps to remove plaque, hard tartar (also known as calculus), and stains, both from the parts of your teeth that you can see and those that are under the gum line. The aim is to prevent irritation caused by these substances. However, because too much polishing can wear down the surface of your teeth, dental professionals today often polish teeth based on each patient’s individual needs, not as a standard routine. This approach is what’s known as selective polishing. In other words, your dentist won’t polish areas of your teeth that don’t have any visible stains and will only polish your teeth after they have finished scaling (removing hard tartar) and performing a thorough oral clean.
Anatomy and Physiology of Teeth Polishing
Extrinsic teeth stains, or external discoloration that appear on the surface of your teeth, can look different depending on what caused them. These stains may be brown, green, orange, or black.
Brown teeth stains are often due to tobacco use, or drinking beverages like tea, red wine, and coffee. An antiseptic mouthwash called chlorhexidine, when used excessively, can also lead to brown stains.
Black teeth stains are generally caused by specific chemicals like silver, iron, and manganese. Chewing betel quid, an Asian plant traditionally used in culture and rituals, are also known to cause black stains.
If your teeth have green stains, it might be because of exposure to metals such as copper and nickel. On the other hand, orange stains are typically linked to chromogenic bacteria—these are bacteria that produce pigments, leading to the discolored appearance on your teeth.
Why do People Need Teeth Polishing
Teeth polishing can help remove stains that are on the surface of your teeth, known as extrinsic stains. These types of stains can come from various lifestyle factors and habits such as smoking tobacco, chewing betel nuts, or frequently consuming coffee, tea, or wine.
However, another type of stain, known as intrinsic stains, can’t be removed through teeth polishing. These stains occur from within the tooth during its development and can be caused by various factors, including certain medications or environmental conditions.
There are specific areas of the mouth, such as the furcation areas (where the roots of a tooth split), near dental restorations (like fillings or crowns), root proximities, and around orthodontic brackets, which may require polishing. In such situations, dentists use different types of devices to cater to each individual’s needs.
When a Person Should Avoid Teeth Polishing
There are certain conditions that may prevent a dentist from doing a tooth polishing procedure. One reason could be stains on the teeth that are caused by either growth abnormalities or environmental factors, including medication side effects. These situations might include:
- Enamel hypoplasia, which is when the tooth’s enamel is not thick enough.
- Hypomineralization, a condition where the teeth don’t have enough minerals.
- Dentinogenesis imperfecta, a type of genetic disorder that causes teeth to be discolored and weak.
- Amelogenesis imperfecta, a rare genetic condition affecting the appearance and structure of the tooth enamel.
- Dental fluorosis, a condition resulting from consuming too much fluoride which impacts tooth color.
- Tetracycline stains, which are dark stains on the teeth caused by the antibiotic tetracycline.
Also, tooth polishing may not be ideal if you’re experiencing the following:
- Severe diseases in the gums or the structures which secure the teeth.
- Gingival recession, when the gums have pulled back from the tooth, exposing its root.
- Highly sensitive teeth.
- Newly emerged teeth that are not fully matured yet.
- Xerostomia, or as it’s commonly known, dry mouth.
- Allergic reactions to ingredients in the polishing paste.
Equipment used for Teeth Polishing
Abrasive agents, or substances that can help rub off the outer surface, are used in dental care to polish teeth and make them shiny and smooth. You might find these substances in toothpastes or specially designed polishing pastes. However, the polishing pastes generally contain larger particles than those found in toothpaste.
Polishing pastes often contain additional ingredients to make them more pleasant to use such as binders to hold the paste together, humectants to keep it moist, flavorings to improve the taste, coloring agents for visual appeal, and preservatives to extend shelf life. These extras aren’t there just for show – they’re meant to help encourage patients to take better care of their teeth! Polishing pastes come in different sizes – ranging from those with coarse, large particles to those with fine, smooth, small particles.
The advantage of pastes with small particles is that they can make the teeth even smoother and cleaner, which makes it harder for plaque, a substance that can cause tooth decay, to build up. It’s also important that the paste is not harder than the teeth it’s going to polish, otherwise it can do more harm than good to the tooth surface.
Different kinds of pastes are used for different purposes:
- Feldspar works on natural teeth as well as dental restorations or repairs.
- Pumice polishes tooth enamel and other dental materials but can be quite abrasive and offers an average polish as compared to other agents.
- Calcium carbonate is gentler than pumice, minimizing scratches and creating a shiny surface.
- Perlite contains fluoride, a mineral used to strengthen teeth.
- Aluminum silicate is a good stain remover that tastes good and releases fluoride.
- Xylitol-containing products aid saliva production, reducing dry mouth and decay while also helping to reduce acid and biofilm, a layer of microorganisms, in the mouth. These can be used by children as well and come in different sizes.
- Novamin-containing products can help to reduce sensitivity and aid in stain removal.
- Zirconium silicate is used in discs, strips, and polishing pastes for preventive care.
Polishing tools can be manually operated or engine-driven and require special handpieces to use.
Preparing for Teeth Polishing
When it comes to cleaning your teeth, it’s important to do it with care. You should use the right method to avoid scratching the surface of your teeth. The amount of pressure, the length of time you spend, and how fast you do it all matter.
You should always use a toothpaste that is not too harsh but is still able to remove any food or drink stains on your teeth. Additionally, if you have any dental work like fillings or crowns, you should use a toothpaste that is softer than the material of the dental work to avoid damaging it.
How is Teeth Polishing performed
Selective polishing is often the preferred method when taking care of oral hygiene because bacteria have a harder time sticking to smooth and shiny tooth surfaces. Regular tooth polishing involves a traditional method of using a rubber cup and a special paste which slightly erodes the enamel’s outer layer. The tooth’s outer layer takes about 3 months to redevelop, but bacteria land on the enamel surface within 30 minutes, polished or not. So, selective polishing should ideally be done only on those tooth surfaces that still show stains after cleaning with specialized instruments.
There are several devices which are used for this purpose:
Manual Devices
Porte Polisher: This device uses a specific abrasive material that’s rubbed against the tooth using a point made of orange wood. It’s a quiet device that produces minimal splatter, is portable, and can reach various areas of the teeth. It’s suitable even for misaligned teeth and creates very little heat. However, it would need more time and force compared to other devices.
Polishing Strips: These strips are designed to polish between the teeth and their angled edges. Given their abrasive nature, care must be taken to protect the soft tissues between the teeth. They come in different colors and sizes based on the level of abrasiveness required.
Engine-Driven Devices
These devices need a handpiece and are widely used in dental practice. They’re either attached with a rubber cup or a polishing brush, and usually operate at a speed between 2500 to 3000 revolutions per minute (rpm).
Air-Powder Polishers: This type of device is generally used to remove plaque on the visible part of the teeth as they can reach inaccessible areas such as furcations (where the tooth roots divide), and crowns of the teeth. They use a mixture of water, sodium bicarbonate, and other abrasive agents under air and water pressure.
The main benefit of air-powder polishers is their ability to remove biofilm (a layer of bacteria) effectively without harming the periodontal tissues or tooth structures. This method is faster, saving time, and is more comfortable for the patient.
However, as these devices use sodium bicarbonate, they should be used carefully on patients who are prescribed restricted sodium diets. Also, they should be used cautiously in patients with respiratory, renal, or metabolic diseases, as well as children or those with infectious diseases.
Lastly, a system known as the Vector System may be used. This method involves a polishing fluid that causes minimal damage to the cementum surface, which is the protective skin of the tooth’s root. The fluid contains hydroxyapatite or an abrasive fluid containing silicon carbide, which along with a resonating device, deflects forces directed towards the tooth, therefore protecting it. The plaque is removed by the fluid’s movement, helping to control inflammation effectively.
Possible Complications of Teeth Polishing
When using tooth polishing pastes with large or medium-sized particles, they might scratch your tooth enamel and cause some damage. This can make your teeth look less shiny and smooth, and can also make it easier for plaque, which is a sticky film of bacteria, to build up on your teeth.
Using manual tooth polishing tools can take quite a lot of time and effort. There’s also no way to control how much pressure is applied when using these tools, so you have to be careful not to do it too hard. Plus, you need to do this regularly to see results, which means you need to be committed and disciplined.
Using electric-powered tooth polishers can also have some drawbacks. They can potentially create a lot of spray, which could be a concern especially during a pandemic. They can also create heat, and if not used properly, they could hurt your gums or other soft tissues in your mouth.
What Else Should I Know About Teeth Polishing?
Extrinsic stains are common issues seen by dentists. These stains can be caused by habits such as smoking tobacco or regularly drinking beverages like coffee or tea. The way we tackle these stains is by using tooth polishing tools that we choose specifically for each patient’s situation. Our goal is to create a treatment plan that meets the needs of the patient while still taking care to not harm teeth and gums.
What’s interesting is that extrinsic stains can significantly affect how we evaluate the color of a patient’s teeth. This is important when we’re about to perform work like placing a composite or ceramic crown on a tooth, especially for front teeth. To improve the success of these treatments, we often carry out a professional cleaning of the teeth to remove such stains beforehand.