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A Review of the Evidence for the Provision of the Routine Scale and Polish for the Prevention of Periodontal Disease Rachel Birt Claire M Healy Denise MacCarthy Lewis Winning Dental Update 2024 48:3, 707-709.
The routine scale and polish is the most commonly performed treatment procedure in general dental practice. With a large proportion of state dental health expenditure in the UK and Ireland being used to provide ‘routine scale and polish’ treatments, it is necessary to establish the true value of this treatment for patients. In this narrative review, we discuss the available evidence regarding provision of the routine scale and polish. Based on the available studies, there is little evidence to support the use of the routine scale and polish alone for the prevention of periodontal disease.
CPD/Clinical Relevance: This paper evaluates the evidence surrounding the routine provision of scaling and polishing for the prevention of gingivitis and periodontitis.
Article
Dental plaque has been shown to play a central role in the development of periodontal diseases (PDs) including gingivitis and periodontitis.1,2,3 Oral hygiene instruction (OHI) should play a primary role in the prevention and management of periodontal disease.4 Scaling and polishing (S&P) by dental professionals is a treatment intended to complement the patient's own plaque control and is not intended to act as a replacement.5 Studies suggest that calculus deposits are not significant in the development of periodontal diseases; however, it has been suggested that calculus does serve as a reservoir for bacteria and potentially minimizes the effectiveness of personal oral hygiene measures (Figure 1).6
Presently there is no standard definition for the term ‘scale and polish’, which is also referred to as oral prophylaxis, professional mechanical plaque removal or periodontal instrumentation. The American Academy of Periodontology defines scaling as the ‘instrumentation of the crown and root surfaces of the teeth to remove plaque, calculus and stains from these surfaces’.7
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