The Impact From the Hygiene Operatory on Composite Restorations: Part II

In a previous post, the multi-factorial impact that a coarse or extra-coarse prophy paste can have on the surface of composite restorations was discussed.  How is it then that the hygienist can remove plaque, calculus, stain and biofilm while not harming the surface of restorative materials or tooth structure?

In discussing this with my hygienist, Jodi Demming, RDH, she informed me that the key is to use what she calls selective polishing.  Typically, one paste is not appropriate for the entire dentition of most patients given the variety of materials and clinical situations.  The use of a fine polishing paste or a cleaning paste with no abrasives is safe, however, it doesn’t remove stain.

Polishing Paste and Composite Restorations

In areas requiring stain removal, selective use of a more abrasive paste – medium or coarse – is recommended. These more abrasive pastes must be followed by the use of a fine paste to help improve the surface following the more coarse paste. Although this sounds like it would create a lot more work for the hygienist and increase the necessary appointment time, it actually can be done quite easily and efficiently. In our office, we use Proxyt polishing paste from Ivoclar. (Figure 1) It is conveniently supplied in tubes and can be dispensed as needed to minimize waste.

A medium or coarse paste is used when removal of stain on tooth structure and restorative materials is necessary. This is then followed by the use of a fine paste to re-polish the surface. To make this an efficient process, Jodi observes the dental condition of the patient and then places the different materials on the back of her non-working hand for easy accessibility. (Figure 2) It must be noted that in some situations, it may not always be possible to restore surface polish of the restoration with paste. In these situations, it may be necessary to use restorative composite polishers to re-activate the surface of the restoration.

By following this simple polishing protocol in our office, we have been able to prolong the surface shine, polish and overall esthetics of the composite restorations for our patients. (Figures 3 and 4)

(Click this link to read more dentistry articles by Dr. Gregg Kinzer.)

Gregg Kinzer, D.D.S., M.S., Spear Faculty and Contributing Author