Let’s Talk About Tooth Polishing

It is a common assumption that the terms ‘tooth polishing’ and ‘tooth cleaning’ are interchangeable. Despite being closely related, both terms have a clear distinction based on the definition given by the American Academy of Periodontology. Simply put, tooth polishing is a procedure that smoothens the surface of your teeth, making them lustrous and glossy. This helps to maintain gum health by reducing the deposition of dental plaque and stains on your teeth.

On the other hand, tooth cleaning (dental scaling) is a procedure that uses an ultrasonic device or a hand instrument to remove dental plaque (food debris) and calculus (hardened dental plaque) from your tooth surface. This procedure is typically done before tooth polishing [1]. (Find out more about dental scaling here.)

Polishing Rubber Cups vs. Air Polishers

A standard procedure of tooth polishing comprises of a small rubber cup or brush attached to a mechanical device and polishing paste that is available in various grades, ranging from fine to coarse.

However, over the years, air polishing has emerged as a valuable tooth polishing technique that is widely used in dental clinics today. Air polishing makes use of a mechanical device that propels a slurry of water and abrasive particles (sodium bicarbonate) under air and water pressure onto the tooth surface.

According to a study, air polishing was reported to be more effective at removing dental plaque and stains from natural grooves and pits on the biting surfaces of teeth [2]. However, other research studies concluded that both methods have equal effectiveness at removing dental plaque and stains on teeth surfaces [3].

Is Tooth Polishing Good for You?

‘The advantages of tooth polishing’ has been a controversial topic within dentistry. A recent clinical review of various studies has shown that tooth polishing alone does not prevent gum disease even if it is done regularly. However, regular tooth scaling and polishing that are done together have shown to play a role in preventing gum disease as there is a significantly lesser build-up of dental plaque on the patients’ teeth [4].

Nevertheless, studies have also reported that the overuse of tooth polishing could wear off the outermost layer of the tooth, causing the tooth to become more susceptible to the accumulation of dental plaque and stains, as well as tooth sensitivity. Furthermore, the surrounding fluoride layer which protects the tooth could be removed by excessive tooth polishing. Therefore, dentists today typically perform tooth polishing selectively on patients, depending on their needs [5].

Does Tooth Polishing Whiten Your Teeth?

Teeth polishing and teeth whitening are two different procedures that are often misunderstood to be one and the same. Teeth polishing only removes external tooth stains such as stains caused by coffee, tea and smoking. If you are wondering why your teeth still appears yellowish or darker in colour despite dental scaling and polishing being done, it is usually caused by natural colour of the inner layer of your teeth known as dentin.

To lighten the natural colour of your teeth, teeth whitening, also known as bleaching, is one of the options to do so. This procedure is done by applying a gel that contains a bleaching agent (peroxide) onto the surface of your teeth. The bleaching agent in the gel will then break down the yellowish or dark pigment in your teeth, making your teeth whiter than before.

Ultimately, your dentist will be able to advise you on the best treatment to go about your teeth stain problems.

Is ‘Polishing Paste’ Just Another Term For ‘Toothpaste’?

One might think they are the same, but they are not. In short, polishing pastes are a lot coarser than over-the-counter toothpastes and therefore, are only used professionally in a clinical setting. Polishing pastes typically contain abrasive agents of varying particle sizes. Those with a particle size of medium to coarse are used to remove stubborn tooth stains that cannot be removed by brushing with toothpaste alone. Conversely, those with fine particles are typically used to create smooth and lustrous teeth surfaces, thus, reducing the formation of dental plaque, calculus and stains on them.

However, excessive tooth polishing, especially with polishing pastes that contain medium to coarse abrasive particles, may wear down the outer surface of the tooth, leading to tooth sensitivity [5]. For that reason, the toothpaste that we use daily has minimal abrasiveness to avoid this problem.

Should You Polish Your Teeth at Home?

Many teeth polishing home kits and home remedies have been advertised in stores and online, insisting that they would produce the same ideal results you get from professional tooth polishing. Some examples are baking soda and activated charcoal to remove tooth stains. However, it is important to understand that the overuse of products with coarse particles can wear down the outermost layer of your tooth which cannot be reversed thereafter. The absence of the outermost layer can lead to teeth sensitivity and even a higher tendency for tooth decay to happen. Furthermore, the United States Food and Drug Administration has not approved activated charcoal products for teeth whitening. Children and pregnant or breastfeeding mothers are also advised against the product [6].

One way to ensure that the toothpaste you are using is not detrimentally abrasive to your teeth is to ensure that the toothpaste adheres to the acceptable relative dentin abrasivity (RDA) level of no higher than 250, as stated in the American Dental Association’s guideline [7]. Overall, it is recommended to err on the side of caution and consult a dentist about your stubborn tooth stains instead of taking matters into your own hands.  

…lifetime use of proper brushing technique with a toothbrush and toothpaste at an RDA of 250 or less produces limited wear to dentin and virtually no wear to enamel.

American Dental Association

Takeaway

Tooth polishing is a common standard procedure that is often done after tooth scaling. Polishing paste contains abrasive particles of varying sizes that function to smoothen the surface of your teeth or aid in removing dental plaque and stains. Both methods – using a rubber cup or brush and air polishing – are effective in polishing your teeth.

The procedure does not whiten your teeth like teeth whitening does, and polishing pastes differ from commercialized toothpastes sold in stores. As excessive tooth polishing can lead to detrimental effects on the tooth surface, dentists perform the procedure based on their discretion on each patient’s needs. Therefore, it is recommended to seek professional advice on any tooth concern of yours instead of resorting to home remedies and kits.

Reference

1. American Academy of Periodontology. Glossary of Periodontal Terms. 4th ed. Chicago: American Academy of Periodontology; 2001. p. 42. 
2. Garcia-Godoy F, Medlock JW. An SEM study of the effects of air-polishing on fissure surfaces. Quintessence Int 1988;19(7):465-7.
3. Braun A, Krause F, Frentzen M, Jepsen S. Removal of root substance with the Vector-system compared with conventional debridement in vitro. J Clin Periodontal 2005;32:153-7.
4. Lamont  T, Worthington  HV, Clarkson  JE, Beirne  PV. Routine scale and polish for periodontal health in adults. Cochrane Database of Systematic Reviews 2018;12.
5. Sawai MA, Bhardwaj A, Jafri Z, Sultan N, Daing A. Tooth Polishing: The current status. Journal of Indian Society of Periodontology 2015;19(4):375-80.
6. Whelan C, Frank C. Does Activated Charcoal Teeth Whitening Work? [Internet]. Healthline; 2018 Dec 4 [citied 2021 20 April]. Available from here.
7. Toothpastes [Internet]. American Dental Association. 2019 [cited 20 April 2021]. Available from here.