A registered dental hygienist (RDH) performs a professional dental cleaning, known as prophylaxis, to remove hardened deposits and surface stains that regular brushing cannot eliminate. This routine procedure is a preventative measure designed to maintain the health of the teeth and gums. To accomplish this thorough cleaning, the hygienist employs specific instruments and technology for systematic assessment and decontamination.
Diagnostic and Assessment Instruments
The cleaning process begins with a thorough assessment of the mouth’s current condition. The dental mirror is a fundamental instrument, used to reflect light and provide indirect visibility to surfaces at the back of the mouth and behind the teeth. This allows the hygienist to survey all areas for potential issues and identify calculus deposits before active cleaning starts.
An explorer, a slender, fine-tipped instrument, is then used to gently check the enamel surfaces for any areas of softness, which could indicate decay or small defects. This tool also helps to locate hardened plaque, or calculus, both above and slightly below the gumline. To measure the health of the gum tissue, the periodontal probe is employed, which features precise markings to determine the depth of the gum pockets surrounding each tooth.
Primary Calculus Removal Tools
The core function of the appointment is removing the calcified deposits that adhere firmly to the tooth structure. This removal is accomplished using a combination of powerful devices and manual hand instruments. The ultrasonic scaler is typically used first for the bulk removal of deposits.
This device operates by utilizing high-frequency vibrations to mechanically shatter the hard calculus. A continuous stream of water flows from the tip, serving to cool the instrument and simultaneously flush away the dislodged debris and bacteria. The rapid movement of the tip also creates acoustic energy and shockwaves, known as cavitation, which can disrupt bacterial cell walls and colonies.
Following the initial pass with the ultrasonic device, the hygienist refines the cleaning using manual instruments. Hand scalers are designed with pointed tips to scrape away deposits from the crown surfaces above the gumline. Curettes are metal tools with rounded, spoon-shaped working ends, specifically designed for reaching below the gumline and smoothing the root surfaces. Manual instruments, such as Gracey curettes, have area-specific designs that allow for precise, detailed cleaning in complex areas that powered tips cannot fully access.
Polishing and Stain Removal Methods
After the hard calculus has been removed, the focus shifts to polishing the tooth surfaces and eliminating extrinsic stains. The hygienist uses a slow-speed handpiece with an attached rubber cup, known as a prophy angle, to perform this step. This rotating cup holds a specialized polishing paste, often referred to as prophy paste.
The paste contains fine abrasive agents, commonly made of materials like pumice or calcium carbonate. The hygienist selects a specific grit level based on the amount of stain and the patient’s needs, ensuring minimal abrasion to the enamel. This mechanical action buffs away surface discoloration from coffee, tea, or tobacco, creating a smooth finish. Finally, specialized dental floss is used to polish the tight contact points and side surfaces that the rubber cup cannot effectively reach.
Final Protective Treatments
The final stage of the professional cleaning involves applying a topical protective agent to strengthen the enamel structure. This is most commonly a concentration of fluoride, delivered as a varnish, gel, or foam. Fluoride is a naturally occurring mineral that plays a direct role in the process of remineralization.
It works by attracting and incorporating lost calcium and phosphate ions back into the weakened enamel structure. This process strengthens the tooth and makes the enamel surface more resistant to future acid attacks from bacteria. Varnish, a highly concentrated form, is painted directly onto the teeth and hardens almost instantly, allowing absorption over several hours. Alternatively, a gel or foam form may be placed into a tray that the patient holds in their mouth for approximately four minutes. For patients with a high risk of developing new decay, the hygienist may also recommend or apply specialized antimicrobial rinses, such as chlorhexidine.