Instructor for DH Methods of
Education, Inc., an educational
program for dental and dental
1. Akesson I, Johnsson B, Rylander
L, Moritz U, Skerfving S. Musculoskeletal disorders among female dental
personnel - clinical examination and
a 5-year follow-up study of symptoms. Int Arch Occup Environ Health.
2. Christensen RP, Bangerter VW. Determination of rpm time and load used
in oral prophylaxis polishing in vivo. J
Dent Res 1984 Dec; 63( 12): 1376-82.
3. Christensen RP, Bangerter VW. Immediate and long-term in vivo effects
of polishing on enamel and dentin. J
Prosthet Dent. 1987;57:150–160.
4. Dondiego L. Factors in Coronal
Polishing Evidence-based research
prompts new approaches to a
standard procedure. May/Jun 2012
Volume 8, Issue 3.
5. Marshall ED, Duncombe LM, Robinson RQ, Kilbreath SL. Musculoskeletal
symptoms in New South Wales dentists. Aust Dent J. 1996; 42( 4):240-246.
6. Murphy DC. Ergonomics and the
Dental Care Worker. Washington DC:
American Public Health Association;
7. Pence et al. Repetitive coronal
polishing yields minimal enamel loss. J
Dent Hyg Fall 2011; 85( 4): 348-357.
8. Waring MB, Horn ML, Ames LL,
Williams NJ, Lyne SM. Plaque reaccumulation following engine polishing or
toothbrushing: a 90-day clinical trial.
Dent Hyg (Chic). 1988 Jun; 62( 6):282-5.
1. 2003 CDC Guidelines: Handpiece
and single use device sterilization–
2. 2016 CDC Summary of Infection
Prevention Practices in the Dental
3. American Dental Hygienists’
Association Position on Polishing
Procedures, 1998— adha.org
Coronal polishing is part of the
dental hygiene process of care for
many of our patients. The need
for clinicians to be well informed
of the evidence regarding clinical
outcomes, therapeutic polishing
agents and newer technologies in
handpiece choices is paramount.
The experience should be a posi-
tive, beneficial one for the patient,
as well as for the clinician. Choose
wisely when considering your next
hygiene handpiece. Consider the
potential freedom from cords, foot
pedals and CDC compliance with
We are evolving in our profes-
sion to meet the needs of our
communities. Conversely, we must
advocate to meet our own clinical
needs and adopt technologies and
equipment that will deliver more
effortless, stress free performance.
Career longevity can frequently be
interpreted by musculoskeletal
conditions. Be mindful to care for
your body and implement changes
that will reduce stress in the fast
paced world of dentistry and allow
you to focus on what is most im-
portant, your patient! RDH
Marianne Dryer, RDH, MEd, is a
Global Clinical Education
Curriculum Developer for Dentsply
Sirona. Her focus is on ultrasonic
instrumentation, local anesthesia,
and radiology technique. Her
experience in dentistry spans over
30 years as a clinician and an
educator. She is a graduate of
Forsyth School for Dental
Hygienists, Old Dominion
University and received her
master’s in education from St
Joseph’s College of Maine.
Marianne was the first-year
coordinator at Collin College in
Dallas, Texas, for six years where
she was selected for the
Outstanding Faculty Award and
was nominated for the Advisor of
the Year. She has been a faculty
member at Cape Cod Community
College since 2007. Marianne is
also a periodontal instrumentation
and provide each patient with a
sterilized handpiece each
time. Complying with the CDC
guidelines for reprocessing dental
handpieces is a major part of infection prevention in the office.
The Nupro Freedom Prophy System allows you to do that at a
fraction of the cost.
Patients often consider polishing
as the hallmark of the prophylaxis
appointment, often critical to patient satisfaction. Polishing provides some patients with an improved esthetic appearance, and
they are convinced that their teeth
have been thoroughly cleaned.
Coronal polishing choices should
be individual to the patient while
meeting their needs and
Clinicians must be aware of
current evidence-based research
regarding biofilm and stain removal. For example, polishing over
demineralized areas will result in
three times more surface enamel
being removed than intact enamel. Polishing agents must be carefully considered so that no harm
is done to the enamel or cementum by aggressive technique or
materials. If the enamel surface is
scratched as an example, it then
becomes a reservoir for harboring
Factors that will affect abrading the tooth surface during polishing include pressure, speed,
quality of paste, and shape, size,
and hardness of the abrasive particles. Cleaning and polishing
abrasive agents incorporated into
the prophylaxis paste contain different shapes and edges that
scratch the surface of the enamel.
The grit or size is the main factor.
(Dondiego, 2012). There are a variety of prophy paste products that
provide therapeutic benefits such
as potential for remineralization
and relief of hypersensitivity.
claim a three-hour constant run
charge, which equates to a full day
of patients providing an approximate three-minute polish for 10
patients. The Nupro Freedom may
be quick charged in 15 minutes,
allowing for extended use prior to
performing a complete charge.
The ability to move through
the polishing procedure more flu-
idly is an obvious benefit, partic-
ularly to the pediatric patient. The
frequent removal for adjustments
for the pedal function and seating
accommodation can be disruptive
and add unnecessary time to the
SmartMode Technology pro-
vides further fluidity by its intui-
tive process of speed adaptation
according to the clinician’s need
for increased rotation and power.
With increased use, the technique
adaptation is accomplished, and
true freedom is the end result.
Some cordless handpieces may
also provide additional benefits
with compliance to infection prevention protocols. In 2016, the
Centers for Disease Control and
Prevention (CDC), released its
Summary of Infection Prevention
Practices in the Dental Setting,
reinforcing that dental handpieces
should always be heat sterilized
between patients, and not high
level or surface disinfected.
The acceptable methods of
sterilization include chemical vapor sterilizers, dry heat, and autoclaves. Ethylene oxide gas is not
recommended for dental handpieces ( CDC.gov). The issue of
heat sterilization of handpieces
for every patient every time
equates to high cost, heavy usage
on the handpiece and turbines,
and increased staff time.
The Nupro Freedom cordless
handpiece allows clinicians to
autoclave the removable sheath