The right time to polish

A common debate seems to be surfacing again. When should we polish our patient’s teeth?

Many clinicians have started polishing at the beginning of the appointment, suggesting that it saves time. I personally prefer to polish after scaling, but have a few patients that do better with polishing prior to scaling. These patients have extremely sensitive tissue and teeth due to particular chronic systemic disorders. One patient has MS (multiple sclerosis) and has a difficult time tolerating the polishing, so prefers to get it over with at the beginning of the appointment. Sjogren’s Disease and fibromyalgia patients also seem to appreciate polishing prior to scaling.

On difficult patients, I usually find that if I have polished prior to scaling, I end up selective polishing at the end of the appointment to remove any areas of stain that may still present. I also feel that polishing is the last chance to microscopically smooth the root surfaces and ‘burnish’ the teeth with the fluoride containing prophy paste. In my own mouth, I like to have my teeth polished after scaling and have a fluoride treatment. There are many different theories on this topic. Ultimately, the clinician must decide what is best for their patient. Make an evidence- and experienced-based decision and go for it.

Welcome to my life,
Lisa