So today I attempted an extrinsic stain competency, and failed. I have now experienced first-hand how heavy generalized staining is very difficult to remove. I think I’d have a better chance at having this patient quit smoking before I could get every piece of stain removed at this point in my level of clinical experience. He is a very heavy smoker and has not been seen in our clinic for debridement in about a year. My faculty for this session also made me aware that some areas of staining would be removing tooth structure had I tried to remove it completely from these areas.
I am anxious to see how this patient presents to clinic for his 4-month recall. I have thoroughly instructed him on what he can due to prevent future stain. For starters, I have taught him how it is important to brush the lingual surfaces of his teeth. Before we went over OHI, I’m not really sure that he was focusing much attention to this area of his mouth. I also taught him how stain could be lessened by drinking water after dark-staining beverages or after smoking. Ultimately, if I could work on getting him to quit smoking or reduce it, he would not present to clinic as such a challenging patient for me now. Despite the amount of effort needed to debride his mouth, he is an amazing patient who helps to make me feel more comfortable in clinic by his patience and understanding.
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I chose an over-qualified patient for my extrinsic stain comp. I worked for over an hour trying to remove the stain on the anterior linguals. I used the cavitron, the RCP, the brush head for the polisher, a sickel, and this abrasive floss thing a faculty recommended. In the end, I still did not remove all the stains. I recommended using a more abrasive prophy paste and a newly-sharpened sickel. That patient and all there staining influenced me to cut back on drinking iced tea and coffee.
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