Coronal Polishing: What It Is and When You Might Need It

An oral prophylaxis is a routine cleaning done in the dental office, consisting of two parts. First, your dentist or dental hygienist removes all plaque, calculus and soft deposits above and below your gumline, as the textbook Essentials of Dental Assisting explains. Next, they will use an abrasive paste and a motorized handpiece with an attached rubber cup to polish your crowns — which are the visible portions of your teeth. This creates a smooth, clean surface that helps repel plaque, notes Essentials of Dental Assisting.

While coronal polishing is sometimes part of a routine dental cleaning, it is not a replacement for regular oral prophylaxis, which removes all plaque and calculus. In fact, polishing only the crown portion of your teeth is sometimes called cosmetic polishing, according to an article published in the Journal of Indian Society of Periodontology (JISP). This is because, other than removing stains and plaque to smooth and shine the tooth, polishing offers no other therapeutic benefit.

Dentists and licensed dental hygienists are the only professionals legally allowed to perform a complete oral prophylaxis. However, some states do permit dental assistants to perform coronal polishing, as long as they have met state requirements. For example, the UT Health San Antonio School of Dentistry offers a training course that is required for any dental assistants who want to perform coronal polishing in Texas. After completing the course and meeting state requirements, they can perform the polishing procedure with the supervision of a dentist.

The following scenarios, outlined by an article published in DentistryIQ, are usually the only times a dentist would recommend an extra polishing:

• You have extrinsic stains and light plaque on the crown portion of the tooth.
• You are planning to get a crown, bridge, sealants or orthodontic bands and brackets.
• You need to remove residue from temporary cements.
• Your dentist wants to clean the tooth surface in order to determine your correct tooth shade.

If tooth stains reach inside the enamel, otherwise known as intrinsic stains, polishing is not recommended since it won't be effective for this type of staining. Plus, polishing tooth enamel removes a bit of the tooth's fluoride-rich layer, which then takes about three months to rebuild, according to the JISP article. This is why, if extra polishing is necessary, it should be done with the least abrasive paste, using the proper technique, pressure and speed.

If you meet any of the following criteria outlined by the DentistryIQ article, your dentist will likely not recommend polishing:

• Your teeth have demineralized spots on the enamel or root decay.
• You have acrylic veneers or restorations that are gold or porcelain.
• You have a respiratory or infectious condition that may be irritated by the aerosol spray involved in polishing.
• Your teeth are sensitive or you have recessed gums.
• Your teeth are newly erupted and the enamel hasn't fully mineralized.
• Your teeth have exposed cementum or dentin.

In addition to maintaining a good oral care regimen at home, keeping up with routine dental visits and cleanings will keep your teeth healthy and stain-free most of the time. However, if your dentist feels that you would benefit from an extra polishing, you should feel comfortable going ahead with the procedure. Afterward, you can enjoy that wonderful feeling of smooth, polished enamel, as well as a sparkling white smile.

Oral Care Center articles are reviewed by an oral health medical professional. This information is for educational purposes only. This content is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your dentist, physician or other qualified healthcare provider.