The gritty material used to polish teeth during a professional cleaning is called prophylaxis paste, or prophy paste. Whether this paste contains fluoride is conditional, as it is manufactured in both fluoridated and non-fluoridated versions. Dental professionals choose the version based on the patient’s specific needs and the procedure being performed. The inclusion of fluoride changes the paste from a purely mechanical cleaning agent to one that offers an initial therapeutic benefit.
The Primary Role of Prophy Paste
The fundamental purpose of prophy paste is mechanical cleaning, acting as a specialized abrasive agent to prepare the tooth surface. It is designed to remove dental plaque, calculus, and extrinsic stains that build up over time and are not fully removed by routine brushing. The paste contains abrasive materials, often pumice or calcium carbonate, which physically polish the enamel.
This abrasive quality is categorized by different grit levels—fine, medium, and coarse. The hygienist selects the appropriate grit based on the severity of the staining and the condition of the patient’s teeth. The polishing action leaves the tooth enamel smooth, making it more difficult for new plaque and bacteria to adhere to the surface immediately following the cleaning.
Understanding Fluoridated vs. Non-Fluoridated Options
The primary difference between formulations is the presence of a mineral compound intended to strengthen the enamel. Fluoridated pastes contain a high concentration of fluoride (4,000 to 20,000 ppm), often as sodium fluoride or acidulated phosphate fluoride (APF). This ingredient aids in remineralization, replenishing the tooth’s surface concentration after the abrasive action of polishing temporarily removes the outermost enamel layer. Dentists select this option for patients at moderate risk for cavities, providing a minor therapeutic benefit during the cleaning.
Conversely, non-fluoridated paste is necessary before procedures like the placement of pit and fissure sealants. Fluoride remnants can create a barrier that interferes with the bonding agents used to secure the sealant material. Many clinicians prefer the non-fluoridated option to ensure optimal adhesion, even though some studies suggest the effect on bond strength may be minimal. Non-fluoridated pastes are also used for patients who request to minimize their fluoride exposure.
Fluoride Application Beyond the Paste
The fluoride in prophy paste is generally not the primary defense against tooth decay. Although the paste contains a high concentration of fluoride, its contact time on the tooth surface is very short, limiting the actual uptake into the enamel. The most effective and concentrated fluoride treatment is usually a separate, subsequent step in the dental cleaning appointment. This involves applying a high-dose product, such as a fluoride varnish, gel, or foam. Varnish, for example, can contain up to 22,600 ppm of fluoride, which is designed to remain on the surface for a longer period, maximizing remineralization and anti-cavity benefits.