Ask the Expert - Dimensions of Dental Hygiene

I have seen prophylaxis pastes advertised that claim to whiten teeth while polishing. Are these worth a try?

By Van B. Haywood, DMD and Erin Boyleston, RDH, MS On Nov 9, 2016 0

QUESTION: I have seen prophylaxis pastes advertised that claim to whiten teeth while polishing. Are these worth a try?

ANSWER: Many types of pastes are available for coronal polishing. While a large selection is helpful, trying to find the right one for each patient can be a daunting task. “Enhanced” prophylaxis pastes contain additives that provide a specific function, such as boosting the enamel surface, reducing sensitivity, or providing whitening benefits.

The American Dental Association Council on Scientific Affairs defines “whitening” as any process that makes teeth appear whiter. This can be achieved through the use of a bleaching product that contains peroxides to change the natural or inherent tooth color or the use of a nonbleaching product to remove extrinsic stain.¹ The purpose of coronal polishing is to remove biofilm and extrinsic stain.² By definition, polishing whitens tooth surfaces. As such, all prophylaxis pastes can be considered whitening because one of their purposes is to remove stain.

An important consideration when choosing any polishing paste is its abrasiveness. Prophylaxis paste is available in various grits, and the least abrasive grit needed to remove the stain should be chosen. Most whitening toothpastes and polishing pastes are generally more abrasive than nonwhitening pastes. Selection should be based on the type and amount of stain and the type of restorations present.^2,3 More abrasive products have a higher Mohs hardness value (Table 1)³ and create more scratches on the tooth surface, possibly compromising the esthetics of some restorations.^2,4 When polishing surfaces with restorations, select a cleaning or polishing agent recommended by
the manufacturer. Often, these products are fine or ultrafine in particle size and will clean without roughening the restoration’s surface.^2–4

The bottom line is that clinicians must carefully investigate marketing claims and ask for published research to support such claims when selecting products.

REFERENCES

American Dental Association. Statement on the Safety and Effectiveness ofTooth Whitening Products. Available at: ada.org/en/about-the-ada/adapositions-policies-and-statements/tooth-whitening-safety-and-effectiveness. Accessed October 4, 2016.
Wilkins EM. Clinical Practice of the Dental Hygienist. 12th ed. Philadelphia:Lippincott Williams and Wilkins; 2009:779–797.
Barnes CM. The science of polishing. Dimensions of Dental Hygiene.2009;7(11):18–22.
Barnes CM. Polishing esthetic restorative materials. Dimensions of DentalHygiene

The Ask the Expert column features answers to your most pressing clinical questions provided by Dimensions of Dental Hygiene’s online panel of key opinion leaders, including: Jacqueline J. Freudenthal, RDH, MHE, on anesthesia; Nancy K. Mann, RDH, MSEd, on cultural competency; Claudia Turcotte, CDA, RDH, MSDH, MSOSH, on ergonomics; Van B. Haywood, DMD, and Erin S. Boyleston, RDH, MS, on esthetic dentistry; Michele Carr, RDH, MA, and Rachel Kearney, RDH, MS, on ethics and risk management; Durinda Mattana, RDH, MS, on fluoride use; Kandis V. Garland, RDH, MS, on infection control; Mary Kaye Scaramucci, RDH, MS, on instrument sharpening; Stacy A. Matsuda, RDH, BS, MS, on instrumentation; Karen Davis, RDH, BSDH, on insurance coding; Cynthia Stegeman, EdD, RDH, RD, LD, CDE, on nutrition; Olga A.C. Ibsen, RDH, MS, on oral pathology; Jessica Y. Lee, DDS, MPH, PhD, on pediatric dentistry; Bryan J. Frantz, DMD, MS, and Timothy J. Hempton, DDS, on periodontal therapy; Ann Eshenaur Spolarich, RDH, PhD, on pharmacology; and Caren M. Barnes, RDH, MS, on polishing. Log on to dimensionsofdentalhygiene.com/asktheexpert to submit your question.

From Dimensions of Dental Hygiene. November 2016;14(11):60.