Professional dental cleaning is a multi-stage procedure designed to remove deposits that cannot be eliminated through routine brushing and flossing. While initial steps focus on clearing hardened material, the final procedure involves polishing. Polishing refines the tooth surface, giving it a smooth finish. This practice is far more than cosmetic; it serves distinct preventative purposes that enhance long-term oral health.
Distinguishing Polishing from Scaling
The difference between scaling and polishing rests entirely on the type of deposit each process targets. Scaling, sometimes called debridement, is the removal of calculus (hardened plaque or tartar) from both above and below the gumline. This process uses specialized instruments, such as ultrasonic devices or hand scalers, to physically chip away these calcified deposits. Scaling focuses on treating or preventing periodontal disease by eliminating these hard irritants.
Polishing, conversely, is a gentler procedure that removes softer materials, including residual plaque, acquired pellicle, and extrinsic stains. The goal is not to remove calculus, but to refine the surface after scaling is completed. Polishing utilizes a rotating rubber cup or brush and an abrasive paste. Scaling is considered a necessary treatment, while polishing is a preventative finishing step.
The Primary Goals of Smoothing Tooth Surfaces
The main purpose of polishing is to create a microscopically smooth enamel surface, which directly impacts how quickly new plaque accumulates. Even after scaling, minute irregularities remain on the tooth surface, serving as anchor points for bacteria to form a new biofilm. By smoothing these surfaces, polishing reduces the total surface area where bacteria can easily adhere and colonize. This makes it harder for plaque to build up between dental visits and easier for the patient to clean at home.
Polishing is also highly effective at removing extrinsic stains caused by dietary factors like coffee, tea, red wine, and tobacco use. These superficial discolorations are embedded in the outer layer of the enamel and are not removed by scaling alone. The controlled abrasion of the polishing paste buffs away these stains, enhancing the aesthetic appearance. A clean, smooth surface is optimally prepared to receive a topical fluoride treatment, which is often applied immediately after polishing.
How the Polishing Paste Works
The polishing effect is achieved using a prophylaxis paste, a specialized material containing various abrasive agents. These pastes typically contain ingredients such as pumice, fine silica, or calcium carbonate, suspended in a binder. The paste is applied using a small rubber cup or brush attachment connected to a slow-speed dental handpiece. The mechanical action of the rotating cup or brush gently rubs the abrasive particles against the tooth surface, causing controlled abrasion.
Different prophylaxis pastes are formulated with varying degrees of coarseness, referred to as grit. Dental professionals select the least abrasive grit necessary to remove the patient’s specific level of staining. Using a coarse paste followed by a finer paste ensures the smoothest final surface. This controlled abrasion process removes surface stains and roughness without causing wear to the underlying enamel.
Is Polishing Always Required
Modern dental practice follows the principle of “selective polishing,” recognizing that the procedure is not mandatory for every patient at every visit. Polishing is generally performed only on tooth surfaces that display visible extrinsic staining after scaling. If a patient maintains excellent oral hygiene and has no visible surface stains, the polishing step may be omitted. This selective approach minimizes the removal of the outermost, fluoride-rich layer of the enamel.
There are several clinical situations where polishing is modified or skipped to avoid potential damage or discomfort. Patients with exposed dentin or cementum, such as those with gum recession, may experience increased sensitivity or wear if polished. Polishing is also avoided on new restorations, such as composite fillings or crowns, because abrasive agents can scratch the material. This scratching leads to a rougher surface that attracts more plaque. Patients with acute gingival inflammation or significant tooth sensitivity are typically not polished until those conditions are resolved.