Is Tooth Polishing Necessary?

When a dental hygienist cleans your teeth, s/he usually finishes with polishing using a mildly gritty paste and a rotating polisher. It seems like sandpapering with an electric sander. Is it necessary or beneficial to polish teeth this way?


Polishing teeth may make them feel smooth and gleaming, but the procedure isn’t necessary. “There is no health benefit to polishing,” said Julie Frantsve-Hawley, editor of The International Journal of Evidence-Based Practice for the Dental Hygienist. “It’s not going to impact tooth decay, gum disease or oral cancer.”

In its latest position paper, the American Dental Hygienists’ Association advises that polishing should not be considered a routine part of dental cleaning. Polishing with a gritty paste can remove stains on a tooth’s surface. But to get rid of stains, hygienists should also be scaling, said Marcia Lorentzen, the dean of the Fones School of Dental Hygiene at theUniversity of Bridgeport in Connecticut. Most of us are familiar with scaling, which typically involves removing tartar and plaque off the teeth with a metal hook-like instrument.

It used to be standard for all teeth to be polished until research showed that doing so removed enamel. Then in the 1970s, an influential textbook, “Clinical Practice of the Dental Hygienist”, by Dr. Esther Wilkins, recommended “selective polishing” – meaning the hygienist should only shine stained parts of the teeth and not the whole set.

As to whether enamel will be worn down, Dr. Frantsve-Hawley, a registered dental hygienist who has a Ph. D in biological and biomedical sciences, said twice-a-year polishing at the dentist’s office, even with the coarsest paste, is “not frequent enough to cause significant damage to the enamel”.

Dr. Lorentzen agreed, saying, “Polishing is not a significant risk.” By contrast, not using a soft toothbrush or brushing too hard daily can damage the softer structures of the teeth, including the cementum, the surface layer of the tooth root.

Patients who remained concerned about enamel damage but want polishing can request the dental hygienist to use a finer-grained paste. – Catherine Saint Louis