Effects of Fluoride and Prophy Paste on Restorations

Fluoride application is beneficial for preventing recurrent decay near dental restorations. According to Artopoulou et al., 1.1% sodium fluoride (NaF) is the preferable choice for esthetic restorations. Sodium fluoride has been shown to cause less stain and deterioration of porcelain surfaces than 0.4% stannous fluoride (SnF2).⁵ Dental hygienists should also avoid the use of acidulated phosphate fluoride, which may cause alteration of the filler particles and discoloration of the resin. If fluoride mouthrinses are recommended for home care, avoid suggesting rinses that contain alcohol, which acts as a solvent for the BIS-GMA resin. This results in softening the material, which can increase roughness and stain.^1,39

The use of CAD/CAM (computer-aided design/computer-aided manufacturing) restorations within dental practices has increased and dental clinicians will need to be familiar with their characteristics in order to properly maintain them.⁶ Some materials, such as e.max CAD lithium disilicate ceramic (Figure 9), have good abrasion resistance, but prophylactic pastes produced a reduction in translucency.⁷ In a study comparing the effects of prophylaxis on surface gloss and roughness of CAD/CAM composite resin and ceramic blocks (intended for indirect restorations), it was found that surface changes from using course paste were not improved by subsequent polishing with fine paste.³⁴ This suggests the importance of using the finest paste possible to perform the procedure. In order to keep the restoration looking new and as natural as possible, it is important to follow manufacturers’ recommendations regarding the appropriate product to use for maintaining the restoration.¹

Figure 9. These radiographs show crowns made of lithium disilicate (often called e.max). They appear slightly radiopaque radiographically.

Images courtesy of Dr. Brian Goodacre, Loma Linda, CA.

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