To prophy or not to prophy? That is the question

Prophylaxis paste (polish) is used to remove plaque biofilm, remove stain and remnants of calculus that may remain after scaling to produce a high lustre that the patient feels happy with. It is an abrasive paste that may contain medicaments such as fluoride to assist the clinician in helping prevent disease. As the patient expects this to be carried out, it may prove very difficult to change the mindset of patients that there is no need to polish teeth and perhaps this can be applied to clinicians too who are under pressure to deliver the patients’ expectations?

There are various sources of extrinsic stain to the teeth that the patient may want removed: cigarettes, cigars, paan, paan masala, coffee, tea or foods that contain a lot of spices (Figure 1). Historically, the dental professional may have experienced more staining than we do in surgery today. Industrial stain was prevalent in the past and was commonly seen in those involved with metal working of various forms. This produced deep, dark stains of various hues yet they are rarely seen these days probably due to improved health and safety but also because of the decline of industrial manufacturing in the UK. Other stain may be attributed to poor oral hygiene, smoking, teas and coffee, food staining, mouthwashes and other sources. The patient’s request to remove the stain has to be met regardless of the source. However, this has to be balanced by the need to preserve tooth tissue.