When your patient’s gums attach at 4mm below the gum line, scaling helps prevent plaque from fallings inside the pockets. This technique is crucial to combating gum disease and improving the long-term oral health of your patient.
While the power scaler has typically been a go-to in treating patients with plaque problems, COVID-19 has changed the current landscape. More specifically, many regulators and employers have insisted that dental professionals stop using power scalers.
However, COVID-19 limitations and safety practices don’t eliminate scaling altogether — which brings us to hand scaling.
The shift to hand scaling is necessary, but it doesn’t make it easier for dentists who have strictly been power scaling. It’s a significant adjustment for many throughout the field.
Fortunately, as a passionate practitioner, you have the skills to adapt! We’re here to help you do it with these helpful hand scaling tips.
Would you ever play basketball in dress shoes? We’ll assume the answer is ‘no.’
The same mentality applies to hand-held instruments for scaling!
While universal tools exist, they generally don’t hold a candle to mastering specific instruments for all manners of periodontal work. For instance, longer shank scaling devices (After Fives) with smaller working ends (Minis) give you better access to pocketing. Furcation areas also make a massive difference with accessing pockets.
Alternatively, rigid shanks are necessary for heavier calculus. These won’t flex against deposits and don’t put as much pressure on your hand.
We’ll point out that universal instruments do work for some dentists. But provided you can efficiently adapt a universal manual device to all types of patients, be mindful of good ergonomics.
Moreover, you’ll require the correct mix of curettes and sickles to help you access different areas without adding too much trauma to surrounding tissues.
When it comes to hand scaling, each of your fingers has a specific job. How you place each finger dictates how precisely you control the instrument’s working end.
The better your grasp, the more power and less repetitive stress in your hands, keeping you protected from long-term injuries.
Want to ensure your grasp is firm and powerful? Here are the basics of finger placement:
Pinching too hard on your instrument can contribute to long-term repetitive stress injuries.
Follow these suggestions to reduce your pinch force:
Apply the leading third edge of your hand scaling instrument to the tooth. Don’t apply the full working end because it’ll cause discomfort (or even trauma) for the patient.
You can be effective with the instrument by directing pressure to the leading third without applying as much overall pressure.
Properly locking your cutting edge into the tooth also lessens pressure while maintaining effectiveness. Try to use a Gracey curette. It has a sloped cutting edge, offering the ideal angulation where the terminal shank remains parallel with the tooth surface.
Do you not have a Gracey curette to work with?
Then note that sickles, universal curettes, and other instruments without sloped working ends require a 60-70 degree angle between the tooth and instrument face.
Power scaling instruments help you be more efficient with deep teeth cleaning. Unfortunately, COVID-19 has made it a non-option for many dentists.
So, by following the above tips and mastering hand scaling, dentists can continue to provide high-level care without putting themselves, their patients, and their staff at risk to COVID-19.