From Trisha's Desk Trisha E. O'Hehir, RDH, BS Editorial Director, Hygienetown Magazine

Polish First

Trisha E. O'Hehir,
RDH, BS
Editorial Director,
Hygienetown Magazine
There are more than 35 message boards on Hygienetown.com directly addressing various polishing concepts. Some deal with polishing pastes, air polishers and the idea of selective polishing. The newest question to be raised is whether or not polishing first is acceptable. Responses vary from "skip polishing completely," to "only polish selectively," to "follow the old fashioned way and polish after scaling," to the newest approach – "polish first."

I was taught the old fashioned way, always polish after instrumentation, but I've been persuaded to see the value of polishing first. Hygienists have been polishing first for several decades and for just as many reasons. Some polish first to remove plaque biofilm and stain to make instrumentation easier. Dental assistants polish first when there is no hygienist in the office and the dentist follows up with the hygiene instrumentation. I prefer to polish first to avoid doing undercover perio treatment, which, I hate to admit, I did for years.
I heard about polishing first back in the early 1980s from Cindy Rink, RDH, here in Arizona. I learned that it's a great way to avoid doing undercover perio therapy. If you polish first, the patient is happy because to them, they have just had the cleaning. If you then do the periodontal exam, and find lots of subgingival calculus, you won't be as tempted to try to get it all off before the end of the appointment. You have time to discuss periodontal disease and treatment with the patient without rushing to get to the polish at the end.

Picking up a power scaler or curette somehow commits us to finishing the job, even if we soon discover there is more deposit lurking subgingivally than we anticipated. By polishing first and taking the time for a thorough periodontal examination, you won't get caught rushing through a bloody prophy.

Polishing first helps the schedule. If there isn't time to remove a full mouth of subgingival calculus after you polish, do the exam and present oral hygiene instructions, that's good! You won't be tempted to do undercover perio, and run late. The scaling part of a prophy should be minimal, not every interproximal surface.

Try polishing first, decide for yourself if it's for you and then tell us what you think in the message boards. Put the word "polishing" in the search box on Hygienetown.com and join the discussions.
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