Prophylaxis Paste and Teeth Whitening

There are numerous types of pastes that are available for coronal polishing. While it is good to have a large selection, occasionally finding the right one for each patient becomes a daunting task. “Enhanced” prophylaxis polishing pastes contain additives that provide a specific function, such as enhancing the enamel surface, reducing sensitivity, or whitening. The American Dental Association Council on Scientific Affairs defines “whitening” as any process that will make teeth appear whiter. This can be achieved through the use of a bleaching product that contains peroxide(s) that can change the natural or inherit tooth color, or by a nonbleaching product that will remove extrinsic stains only.1 The purpose of coronal polishing is to remove biofilm and extrinsic stain.2 By definition, this means polishing “whitens” tooth surfaces, so technically speaking, all types of prophylaxis paste can be considered “whitening” pastes because their purpose is stain removal. Always ask for published research for a claim when selecting products. An important consideration when choosing any polishing paste is its abrasiveness. Prophylaxis paste is available in various grits and the clinician should select the least abrasive grit needed to remove the stain. Most “whitening” toothpaste or polishing pastes are generally more abrasive. Selection should be based on the type and amount of stain and the types of restorations present.2,3 Products that are more abrasive have a higher Mohs Hardness Value (Table 1)2 and create more scratches in the tooth surface and may compromise 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 surface of the restoration.2,4 The bottom line is that clinicians must carefully investigate marketing claims when selecting products. References

1. Barnes CM. Polishing esthetic restorative materials. Dimensions of Dental Hygiene. 2010;8(1):24–28.
2. American Dental Association. Statement on the Safety and Effectiveness of Tooth Whitening Products. http://www.ada.org/en/about-the-ada/ada-positions-policies-and-statements/tooth-whitening-safety-and-effectiveness. Accessed September 16, 2016.
3. Wilkins EM. Clinical Practice of the Dental Hygienist. 12th ed. Philadelphia: Lippincott Williams and Wilkins; 2009:779-797.
4. Barnes CM. The science of polishing. Dimensions of Dental Hygiene. 2009;7(11):18–22.