The Many Opinions of Dental Polishing: Where Do You Stand

-

Dental polishing has always been one of those satisfying moments in a dental hygiene visit. From the patient perspective it's that finishing touch that leaves patients running their tongue across that "just saw my dental hygienist" feeling. As our profession continues to evolve, so does our understanding of what polishing truly brings to patient care.

It’s no longer about whether we polish or not, it’s about how, why, and when we polish. As dental hygienists, we’ve learned that polishing is both an art and a science, and that every patient deserves an approach tailored to their unique needs.

The Shifting View of Polishing

There was a time when every patient received a full-mouth polish, every visit. Then came the movement toward selective polishing, the idea that only teeth with visible stain should be polished to prevent unnecessary enamel wear. That was decades ago, based on early research that has since been questioned.

Today, the focus is less about limiting polishing and more about performing it thoughtfully. Dental polishing can play a meaningful role in maintaining smooth tooth surfaces, and support with biofilm management. It can also enhance the patient experience and when done properly,  it isn’t just cosmetic, it’s part of the preventive process.

A Twist in the Sequence: Polishing Before Scaling?

Every so often, you hear it come up in a professional discussions — “Have you tried polishing before scaling?” This includes air polishing, and/or use of a traditional or cordless handpiece. 

The idea is simple: polishing first removes soft debris and surface stain that might otherwise obscure deposits, making it easier to see and feel what remains. Some dental hygienists find this improves visibility and makes instrumentation more efficient and precise. Pairing this approach with a disclosing agent can take it one step further, helping clinicians identify remaining biofilm while also turning it into a valuable patient education moment. Seeing that pink or purple tint on their own teeth gives patients a clear visual of where plaque tends to linger, often sparking more engagement and better homecare habits.

Others, however, prefer the traditional approach of scaling and then polish, like many aspects of the dental hygiene profession, there isn’t one right answer. It’s about clinical judgment, based on patient specific needs. 

The Evolution of Products and Technique

Today’s polishing pastes do more than remove stain, many are developed to support enamel health and enhance patient comfort. Common beneficial ingredients include fluoride, calcium phosphate, potassium nitrate, and xylitol.

Polishing pastes that contain calcium phosphate salts such as Amorphous Calcium Phosphate (ACP) are compounds that help with tooth remineralization by providing calcium and phosphate ions to the tooth surface, increasing mineral deposition as part of the natural remineralization process. Ingredients like potassium nitrate may also help reduce dentin hypersensitivity, supporting patients with tooth sensitivity.

For those cases where a coarse or medium paste is needed to tackle heavy stain, you may want to consider following with a fine paste. This step helps leave the tooth surface smooth, reducing plaque retention. One of the first dentists I worked with shared this strategy with me early in my career, really a simple but thoughtful habit that stuck. Over the years, I’ve heard many colleagues echo the same approach: using a fine paste as a final step after coarse, medium, and most definitely after pumice. It’s a small extra step that makes a noticeable difference, helping maintain the integrity of the enamel. 

Low-splatter prophy angles and paste delivery systems also make the process cleaner and more comfortable for both patient and clinician. Add to that new air-polishing options with ultra-fine powders, and hygienists now have more control and versatility than ever before.

That said, I’ve heard from many hygienists that their paste options are limited,  sometimes only course or extra-course grit and pumice. This can make it challenging to polish conservatively, especially on sensitive surfaces or when aiming for a finer, smoother finish. It’s a reminder that technique, as much as product, plays a key role in protecting enamel and enhancing patient comfort.

Polishing with Purpose

As with most things in dentistry, it comes down to balance. The goal isn’t to over-polish or skip it altogether,  it’s to polish with intention. Here are a few key takeaways for a thoughtful approach:

  • Assess each patient individually: tissue health, stain level, and restorative surfaces all matter.

  • Choose the gentlest effective paste: fine or cleaning paste whenever possible. If only coarser options are available, follow with the least abrasive approach and light pressure. Plan a team discussion for preferences that are requested for patient care. 

  • Mind your technique: low speed, light pressure, and short duration help protect enamel and increase patient comfort.

  • Consider the sequence: polish before or after scaling based on tissue health and visibility, but always with intention.

  • Keep the patient experience front and center: the smooth finish isn’t just cosmetic; it’s part of the patient experience, that patients commonly value, and a procedure that can help with achieving optimal oral health. 

Final Thoughts

Dental polishing has stood the test of time because it matters, not just for stain removal, but for the many advantages it can offer when tailored to each patient. Patients love the feeling, and when we approach polishing with intention, it's a win for everyone. 

So, the next time you are considering dental polishing take a moment, and think about how it can best serve the patient in your chair.  Is polishing simply about stain removal, or is it a moment of care that reflects our evolving understanding of prevention and patient care ?

Comments

Post a Comment

Popular posts from this blog

Cultivating Leadership Within Your Dental Hygiene Team

-
Strong leadership has never been more important to the success of a dental practice. This includes leadership within the dental hygiene department.  In today’s fast-paced, ever-evolving dental practices having key team members who can support effective, efficient workflows and foster positive team dynamics is essential. Dental hygienists are uniquely positioned to lead by example, influence patient care, and contribute to the overall success of the dental practice. When leadership is missing within the dental hygiene team or across the practice it creates disconnects, and leads to a lack of shared purpose around patient care. This breakdown affects team culture, patient experience, and ultimately the success of the entire practice.  That’s why identifying and addressing leadership gaps must be a top priority for every dental practice committed to long-term success. It’s important to recognize that effective leadership doesn’t happen overnight. Nor is it the responsibility of a...
Read more

Leadership in Action: How Dental Hygienists Are Elevating Patient Care with Technology

-
As dental practices strive for growth, strong leadership is essential and it starts with a new way of thinking and connecting with your team. While leadership plays a role in every area of the dental practice, one aspect that deserves special focus is the commitment to integrating and leveraging technology. This isn’t just about facilitating growth, it’s about fostering a team that is dedicated to creating patient experiences that have a direct impact on oral health outcomes.  One of the most exciting advancements in dentistry is the ability to engage patients through visual technology, particularly with the introduction of 3D scanning. Beyond streamlining clinical processes, this technology creates powerful new opportunities for education, engagement, and truly patient-centered care. Who at your practice is championing the team's commitment to technology? Leadership doesn't stop with the decision to bring new technology into the practice, or ensure the team is trained, it’s ab...
Read more