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Dentist insists I polish all tooth areas on every visit

I have been working at this dentist for 18 months, she has never had a hygienist before. Recently she realised that I do not polish after an initial gross scale removal prior to RSD appointments. She insists that every part of the tooth on every visit should be heavily polished.I tried to explain that there are contraindications to polishing, which included root polishing and polishing with pocketing and heavy bleeding but she says it is rubbish and insists I must polish.I have done what she has asked but over the course of the last 18 months, she has seen the odd patient after 3 or 4 weeks with some build up returned. When I look at the patients notes, it is clear that they do not brush. Yesterday, she made me redo a patient, saying that this is due to me never polishing. I do polish after a routine appointment as this is what her patients are use too. When I looked in the patients mouth, they had large plaque deposits lingual on the posteriors and palletally on the anterior. Her notes showed that she never use to brush but the dentist told the patient that it has built up because I don’t polish but I did polish. Am I doing something wrong? How do I build the trust up?



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Author Note:
Sorry, I have realised my question should have been short until I got to description, i don't know how to edit it now.

1 Answer

Coronal polishing, which is cosmetic not therapeutic, is contraindicated after non-surgical periodontal therapy or in a patient with active periodontal infection. Here’s a link to research that states this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4555792/
In short, this is because the abrasive particles (grit) can be trapped subgingivally during healing and reattachment and impede healing.
 
Meaning, you are correct and unfortunately your doctor is misinformed and needs to be educated. A patient’s lack of homecare and subsequent plaque and calculus formation has nothing to do with whether you polished or not. With that said, polishing does help create a smooth surface which makes less surface area for plaque and stain to accumulate, however, if a patient isn’t brushing, whether you polished or not isn’t going to make a difference in how they present at their next appointment, calculus-wise. I’m a little shocked your doctor would think that polishing over proper homecare is how patients build plaque and calculus, to be honest.
 
To take things a step further, if this doctor is going to micromanage and dictate how you treat hygiene patients when it comes to something like coronal polishing, which you are highly educated on, is this office really the best fit? You need to work in an office that shares the same patient care standard and protocols as you. Otherwise, you are working in an less than ideal environment which can really wear you down and even cause burnout.

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