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Tips & Techniques to Adapt Dental Hand Scaling to a Post-COVID World

 

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.


Hand Scaling Tip 1: Diversify Your Instruments


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.
 

Hand Scaling Tip 2: Know the Value of Finger Placement


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:

 

  • Lightly rest your index finger and thumb opposite each other on the handle.
  • Ensure there’s a space between your thumb and index finger so you can easily roll the instrument and not split your fingers. This helps you maintain control.
  • Alongside the nail of your middle finger is the side of the finger pad. It should rest on the functional shank. The other side of the pad of your middle finger can overlap with your ring finger.
  • Stabilize your ring finger, giving you a firmly planted fulcrum point. You’ll steady your hand, preventing any slipping and giving you more control.
  • Your pinky should remain close to your ring finger, staying neutral.

Hand Scaling Tip 3: Prevent Too Much Pinch Force


Pinching too hard on your instrument can contribute to long-term repetitive stress injuries.


Follow these suggestions to reduce your pinch force:

 

  • Keep your fingers relaxed between each stroke.
  • Use as little pressure as possible.
  • Switch between tougher and easier-to-reach areas, giving you continual breaks during the scaling process.
  • Put pressure on your fulcrum when you need to add power. This will give you more force without increasing the firmness of your pinching.
  • Well-maintained, correctly sharpened instruments preserve their original design while reducing the pressure and the number of strokes needed for removal.
  • Look for round handles instead of octagonal ones. The handle should be at least 10mm thick in diameter and no more than 15 grams in weight.
  • Prominent knurls on the handle help with texturing and offer more friction, so you won’t need to pinch as hard.

Hand Scaling Tip 4: Hone Your Edge Technique to Reduce Pressure on Your Grip


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.

 

Use These Techniques to Keep Your Patients Safe While Still Providing a High Level of Care


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.

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