tooth stains and polishing

Question 1

modes of stain attatchment

Answer 1

• Can adhere directly to the tooth surface
• Can be contained within plaque and calculus
• Can be incorporated into tooth structures

Question 2

types of stains

Answer 2

Question 3

sources of stains

Answer 3

Exogenous: caused by factors external to the tooth (extrinsic OR
intrinsic stains)

Endogenous: caused by factors within the tooth (always intrinsic)

Question 4

Do tooth stains cause disease?

Answer 4

No, they are not an etiological factor for diseases within the oral cavity and
therefore, removal of stains is for esthetic purposes only

Question 5

yellow stains
* ages?
* Associated with?
* Typically related to?
* Source is typically?

Answer 5

• Common in all ages
• Associated with plaque accumulation
• Typically related to poor oral hygiene
• Source is typically food pigments

Question 6

Green Stains
* color?
* Found where?
* Typically noted on what surfaces?
* Sometimes covered by?
* Dark green stain may become incorporated into?
* Caused by?

Answer 6

• Light to dark in color
• Found within plaque
• Typically noted on facial cervical third of maxillary anteriors
• Sometimes covered by materia alba or grayish debris
• Dark green stain may become incorporated into tooth structure
• Caused by chromo-genic bacteria (color-producing bacteria), tobacco use, dark food/drinks (blueberries, red wine, coffee) and poor oral hygiene

Question 7

Black-line Stains
* Found along?
* Can appear as?
* Attached via?
* Made up of?
* Common in?
* Reforms?

Answer 7

• Found along cervical third near gingival margin
• Fine line that can be continuous or interrupted
• Can appear black at pits/fissures
• Attached via pellicle structure
• Made up of microorganisms (gram + rods)
• Common in women and children
• Reforms after removal

Question 8

tobacco stains
* color?
* Diffuse staining of? sometime incorporates into?
* Heavier deposits (especially chewing
tobacco) can become?
* Frequently noticed on what surfaces?
* Composed of?

Answer 8

• Light brown to dark black in color
• Diffuse staining of plaque; sometimes
  incorporated into calculus
• Heavier deposits (especially chewing
  tobacco) can become intrinsic staining
• Frequently noticed on lingual aspects of teeth
• Composed of tar products

Question 9

Other Brown Stain causes?
Tx’s? leaf?

Answer 9

• Stannous fluoride
• Anti-plaque agents
• Betel leaf

Question 10

Orange or Red Stain
* Often appears at what surface?
* occurrence rate?
* Etiology

Answer 10

• Often appears at cervical third portion of tooth/anterior region
• Rare occurrence
• Etiology: chromogenic bacteria

Question 11

Intrinsic Stains causes

Answer 11

• Drug-induced (tetracycline)
• Tooth-trauma stain (necrotic pulp/pulpless tooth)
• Restorative materials
• Tooth development (fluorosis, hypoplasia, genetics)

Question 12

What does polishing do?
* Removes?
* Smooths?
* Improves?
* Aids in?

Answer 12

• Removes extrinsic stain and plaque
• Smooth out the tooth surface
• Improves esthetic appearance
• Aids in prepping the tooth prior to
  bonding

Question 13

What effect does polishing
have on teeth?
* Removes?
* Abrades?

Answer 13

• Removes fluoride-rich enamel layer
• Abrades dentin/cementum

Question 14

Negatives of Polishing

Answer 14

Question 15

Contraindications of Polishing
no stains?
sensitivity?
caries/decalcified?
cementum/dentin?
crowns?
new teeth?
inflam?

Answer 15

No extrinsic stain

Hypersensitivity

Decalcified/carious lesion

Cementum/dentin exposure

Fixed crowns (zirconia, gold, etc. require a specialty paste)

Newly erupted teeth

Gingival or periodontal inflammation (do not polish after scaling/root planing!)

Question 16

factors of rate of abrasion for polishing

Answer 16

• Quantity (more particles applied = faster rate of abrasion)
• Speed of application (higher speed of handpiece=faster rate of abrasion)
• Pressure applied (greater the pressure=faster rate of abrasion)
• Quality of abrasives (dry abrasives are contraindicated)

Question 17

Polishing Agents
(used intra-orally for stain removal)

Answer 17

• Pumice (flour of pumice, FFF)
• Silicon dioxide
• Tin oxide (good for gold)

Question 18

Composition of Prophy Paste

Answer 18

Question 19

grits of prophy paste

Answer 19

Fine, medium, coarse grit are available

Question 20

prophy cups

Answer 20

soft, rubber and latex free

Question 21

are prophy angles reusable

Answer 21

no, disposable

Question 22

What do you need to polish?

Answer 22

• Slow speed handpiece WITH torque converter (RDH handpiece)
• Disposable prophy angle
• Prophy paste
• Saliva ejector
• Air/water syringe
• 2x2 gauze

Question 23

How to Polish Teeth

Answer 23

Question 24

Polishing Stroke

Answer 24

Question 25

how should polishing handpiece sound

Answer 25

low hum

Question 26

Things to Remember when polishing speed? abrasive paste? what should be done after polishing? removal plaque from occlusal?

Answer 26

Use slowest handpiece speed Use least abrasive prophy paste Floss teeth after polishing to remove any remaining plaque/prophy paste debris Bristle brushes are available to polish/remove plaque from occlusal surfaces