Daily Mail says ‘costly’ scale and polish 'may be unnecessary’

Daily Mail says ?costly? scale and polish ’may be unnecessary?

The Daily Mail article quotes a Cochrane Review that found little or no difference between regular planned scale and polish treatments compared with no scheduled scale and polish for the early signs of gum disease. But the article says that ‘the often costly service’ may be unnecessary for those with good teeth and makes ‘no difference’ to dental health.

The article quotes Thomas Lamont, Clinical Research Fellow at the University of Dundee’s Dental School and Hospital, who conducted the research, who said: “There was a small reduction in calculus or tartar levels, but it was uncertain if this is important for patients or their dentists. Participants receiving six-monthly and 12-monthly scale and polish treatments reported feeling that their teeth were cleaner than those who did not receive treatment. However, there did not seem to be a difference between groups in terms of quality of life.”

But Professor Damien Walmsley, the BDA’s scientific adviser, has urged caution over the study. He said: “Patients were found to value the procedure as part of their routine dental care. Calculus can’t be effectively removed by tooth brushing. Gum disease is often caused by a build-up of plaque bacteria, and the best way to remove this is by twice daily tooth brushing.

“In some hard-to-reach areas, plaque bacteria can accumulate and may eventually mineralise to form a tough, crusty deposit called calculus or tartar. You can’t remove this just by brushing your teeth, but a dentist, dental therapist or hygienist can remove it. If calculus isn’t removed, more plaque can build around the tooth and under the gum line, leading to the progression of gum disease. Further research would be required to establish the cost-effectiveness of scale and polish, as a separate consideration from reducing gum disease.’

The review can be found at: Cochrane Database of Systematic Reviews, Routine scale and polish for periodontal health in adults (Review), Lamont T, Worthington HV, Clarkson JE, Beirne PV. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004625.pub5/epdf/abstract

Routine scale and polish for periodontal health in adults

The review was carried out by authors working with Cochrane Oral Health to assess the effects of routine scale and polish treatments for healthy adults; to establish whether different time intervals between treatments influence these effects; and to compare the effectiveness of the treatment when given by a dentist compared to a dental therapist or hygienist.

The review studied a total of 1711 participants and involved adults without severe periodontitis who were regular attenders at dental appointments in the UK. The studies were conducted in general dental practices. One study measured outcomes at 24 months and one study at 36 months.

Key results

The studies found little or no difference between regular planned scale and polish treatments compared with no scheduled scale and polish for the early signs of gum disease. There was a small reduction in calculus (tartar) levels, but it was uncertain if this is important for patients or their dentists. Participants receiving six-monthly and 12-monthly scale and polish treatments reported feeling that their teeth were cleaner than those who were scheduled to receive no treatment. However, there did not seem to be a difference between groups in terms of quality of life.

Neither of the studies measured side effects (such as damage to tooth surfaces and tooth sensitivity), changes in attachment level, tooth loss or halitosis (bad breath). Neither study compared scale and polish treatments provided by different professionals, e.g. dentists, dental therapists and hygienists.

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