What’s Trending with Hygiene Instruments
By : Sue Ellen Umali
Many people just close their eyes and bear and grin it all especially if they've waited a year or two before seeing you for their appointment. This isn't what any dental hygienist wants to be known for and definitely not how we want to be perceived as when patients see us.
So how can we change this? Well, you could be the best guitar player in the world but without a guitar that has the proper strings and is not properly tuned and maintained, it may seem as if you aren't. The same goes for a hygienist. Having the tools that are necessary for treating a variety of people is important especially when it comes to customized care.
In our office, we understand the necessity for a variety of instruments and have tried and tested many of them to see what would provide our patients with the most comfort while helping our hygienists continue to be efficient at what they do.
Based on what we have tried, both the Piezoelectric and Ultrasonic have their benefits. We have tried both yet are still in favor of the Ultrasonic, namely the Cavitron because of its versatility. Unfortunately, because of the lateral tip movement of the Piezo, a major downfall is that the clinician must re-position herself often to adapt the tip whereas with the Cavitron, having elliptical tip movement allows for more adaptability and less operator strain.
Tip On Tips
For universal use, we like the the Triple Bend Focused Spray Slimline 1000. It allows you to fit in those tight interproximal spaces and allows you to adapt with minimal discomfort to the patient. Because of its slender tip, you can access subgingivally quite easily again with minimal discomfort.
One tip that we have come across which is great for those tough lingual surfaces is the Beavertail Insert. How many hygienists can say that they have worked a full day without having that patient with moderate mandibular lingual anterior calculus? The beavertail is great for this and other heavy lingual calculus or smooth surface calculus.
We're lucky enough to have quite a number of inserts in our armamentarium and have been able to get great use out of our lefts and rights as well. They're intended to be used interproximally but are fantastic for using underneath lingual retainers which sometimes pose difficulty to access without operator strain. We keep these in our perio-kits but will pull them out for those difficult to clean fixed lingual retainers.
Having a closed bottle system vs. a city line allows for use of an anti-microbial agent during debridement when necessary and because it is a closed system, there is more control over the water quality in the bottle. One advantage that you can purchase with some ultrasonic systems is the ability to convert to prophy-jet mode which is very effective at removal of stain. So if you're looking into a new unit for your office, these are definitely items to consider.
Maintenance of your Power Driven Instrument
Like with everything, maintenance is key to ensure that your power driven instruments are working properly. Almost all of the city line and even bottled system units that have the option of a city line, contain a filter on the water hose itself that needs to be changed for every so many uses so make sure you have this on your maintenance schedule. When your unit is not outputting any water, this may be the cause as it could be clogged.
Where we have found there to be significant differences are in the varying brands of hand scalers that are available today. After testing a number of scalers and currettes from different companies, we still stand behind Hu-Friedy because of the variety of scalers and currettes that they offer and the fact that you can easily change their coded rings. We typically order the Ever Edges as we like that they don't require as much sharpening as the regular BUT the only downside is that because it is made with a stronger metal which allows it to maintain its sharpness, they are a little tougher to sharpen. For a course on Maintaining Your Edge, click here. So why are the coded rings important? Well, it makes things easier when keeping track of kits and also keeping track of instruments that require sharpening, etc. The rings are made specifically for the design of the instrument so you don't have issues with them falling off or issues with a tacky residue left over like tape leaves. We have tried other brands and have had issues with resin handles cracking and instrument tips discoloring. Some issues were a decrease in tactile sensitivity and not being as ergonomic.
The two instruments that we like and have included in our armamentarium are the Nevi 2 SCNEVI29E2 which is made by Hu-Friedy and other instrument companies or the Montana Jack by P.D.T.. We like that both are very thin at the tip which allows for access in those tight interproximal spaces where light difficult-to-access calculus may be lurking. They can easily access what their wider counterparts cannot. They are both similar so you'd only need one or the other in your kit.
After taking a course and receiving a Sharp Diamond Coated instrument from LM Dental and trying it out for about 7 months now, we can honestly say that they have held up to their claim of maintaining their sharpness without being sharpened - as if we purchased them yesterday. We've had no issues with sterilizing them either which was a concern because of their silicone handle (you can select from 3 different handle types). Ergonomically, they are comfortable to use and allow for good tactile sensitivity. We were very excited to learn about their newest instrument the Syntette which is a combination of a mini 11/12 currette and 13/14 currette all-in-one allowing removal of deposits from both mesial and distal surfaces. We ordered this again in the Sharp Diamond Coat to enjoy the benefits of sharpen free. After 4 months of using it, we love it!!! It is definitely an instrument that can make you more efficient while providing continued comfort to your patients. We do not use LM Dental's instruments exclusively because their Sharp Diamond Coated instruments are still limited to being available in minis but we are hoping that this will change soon.
For implant instruments, we are not fond of plastic instruments or those where you have to screw on the tips. When you're trying to beat the clock, who has time to screw these in? We do like the titanium instruments and have only a universal sickle (H6-H7) and posterior universal (204S) by A. Titan Instruments in our kits. I haven't really encountered sub on an implant that required more than these two instruments to remove. We are also a big fan of the blue implant ultrasonic tips which require a special implant insert (yellow handle). We debride the bulk of calculus with this and remove the rest that is near the thread with the hand scalers.
We hope that we've been able to offer some insight on what we think are great instruments to use in the dental hygiene industry and also what to consider. As an office, we're always looking for ways to improve what we do everyday and understand the importance of having the tools to provide customized care.
After being a hygienist for 14 years and CDA 7 years before that, I've learned that the most important key to doing what you love and doing it well is having the tools to do it with and of course having a workplace you love!
Thank you for taking the time to read this post!
Disclaimer: We have no affiliation with any of these instrument companies or their distributors. We just wanted to offer a review on what we believe are exceptional instruments to have as hygienists.