The scale and polish is one of the most fundamental treatments in dentistry. Short of toothbrushing, it is possibly the most effective way at maintaining oral hygiene. In much the same way that small portions of regular exercise are the best way to avoid heart issues, regular dental maintenance is the best way to avoid major procedures. But just like heart conditions, open-heart bypass surgery will always get more attention than a casual daily jog. And, unfortunately, scales and polishing will always be seen as insignificant compared to major restorations or implantation.
Plaque and tartar formation
Plaque starts as a thin biofilm across the surface of the tooth enamel. Biofilms are communities of bacteria that communicate with each other and share different products of metabolism. By working as a team, they can digest a wide range of materials and make sure to protect each other from the competition of rival bacteria. Biofilms rapidly form, and as they increase in thickness and complexity, they eventually become macroscopically noticeable; we call this build-up plaque.
Plaque is not the final stage of these biofilms; as they increase in maturity, they begin to more permanently adhere themselves to the surface of the enamel. They start laying down calcified compounds, building on the deceased layer of bacteria, much like the formation of a coral reef.
This darker hardened plaque is referred to as tartar; there is no practical way to remove tartar at home although it can sometimes be lightened with bleaching agents.
How is a scale and polish carried out?
As a very well established procedure, a scale and polish is a common protocol carried out in almost all surgeries across the UK by hygienist Richmond. The primary focus of a scale and polish is to remove firmly attached tartar and leave the teeth in a cleaned state that makes them less vulnerable to biofilms and the build-up of plaque.
During the descaling part of the treatment, plaque will be scraped off of your teeth. This is often done using an electric descaler, which is a small spatula-like tool that vibrates ultrasonically, breaking up plaque and allowing it to be chiselled from the teeth. Alternatively, an airflow system could be used; this pushes a jet of water, sodium percarbonate and abrasive powder at high speed, acting as a tiny sandblaster to remove the tartar.
After descaling, polishing is done using a buffing head on the dental drill and a set of mild abrasive pastes similar to toothpaste. The final surface of the patient’s teeth will be glossy, smooth and glass-like. The reason for trying to achieve the smoothest surface is to prevent microscopic crevices or ridges for bacteria to cling to as the first pioneers of a new bio-film. If these bacteria can be disrupted, the entire process of new tartar build-up can be delayed.
Beyond these practical reasons, the smooth finish does feel extremely pleasant, and after plaque and tartar are removed from the enamel, the patient’s teeth are likely to look lighter and healthier with an appealing shine.