officer evaluate the tissue condition if any questions
Tooth polishing removes plaque or stains
remaining on the teeth after thorough scaling.
Improper use of a prophy cup and abrasive paste can
have harmful effects on the teeth including: loss of
tooth structure, removal of fluoride-rich surface
enamel, thermal injury to the pulp, and trauma to soft
Materials and Equipment
A typical tooth polishing setup (fig. 3-25) includes
a mouth mirror, slow-speed handpiece with a
prophylaxis angle attachment, rubber polishing cup,
tapered bristle brush, dental floss, and prophylaxis
Many different types of prophylaxis (sometimes
abbreviated as "prophy") angle attachments are
available. Disposable or single-use prophy angles are
recommended; however, sterilizable prophy angles are
equally effective, can be more economical, and are
widely used in the Navy. There are latch and screw-
type rubber polishing cups. Ensure that the prophy
angle and the type of rubber cup you select are
compatible. Follow the manufacturer's instructions
for use and maintenance of handpiece and prophy
The use of single-unit prophylaxis paste prevents
waste and cross contamination. Commercially
prepared pastes containing fluoride are commonly
used in the Navy and are available in popular flavors.
Pastes are also available in fine, medium, coarse, and
coarse grits. Select the abrasiveness appropriate for
removal of the stains present. A fine paste will not
efficiently remove heavy stain. A coarse paste will
Figure 3-25.Tooth polishing setup.
needlessly remove enamel when treating fine stains. A
tapered bristle brush may be used to polish the occlusal
surfaces of the teeth.
You must be careful when you use the handpiece
and prophylaxis attachment. Neither a polishing cup
nor bristle brush should contact soft tissue. Such
contact could injure the tissue. Only use the bristle
brush on occlusal surfaces of teeth, well away from the
You must also be careful to avoid friction between
the cup or brush and the tooth. Friction causes heat,
and heat can harm the tooth pulp and cause pain to the
patient. For this reason, always run the handpiece at
the slowest of the slow speeds. The speed of the
handpiece is controlled by a foot-operated rheostat.
Use firm pressure when applying the rubber cup to the
surface that needs polishing. You will know that you
have applied sufficient pressure when you see the cup's
edge flare slightly. Don't bounce the cup on and off the
tooth. Keep the cup in constant motion while in
contact with the tooth. To avoid splattering paste,
bring the cup almost in contact with the tooth before
the cup starts turning. Follow all safety precautions.
You should always wear protective gloves, glasses,
and mask. Drape the patient to protect his or her
You should polish the patient's teeth according to a
definite sequence. A typical sequence would start with
the maxillary arch and polish the teeth as follows:
All facial surfacesfrom the right quadrant to
the left quadrant.
All lingual surfacesfrom the left quadrant to
the right quadrant.
All occlusal surfacesfrom the right quadrant
to the left quadrant.
As you polish, begin at the gingival margin of the
tooth and work toward the occlusal or incisal edge,
using vertical or oblique pulling strokes. Rinse the
working area with water from the three-way syringe as
needed and have the patient use the saliva ejector to
remove the debris from the mouth.
You may not be able to reach all of the
interproximal areas with the polishing cup. To polish
these areas, place the polishing paste in the facial and