Pre-clinic Exam 2
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| what are the parts of the instrument? | handle, shank, working end
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| what is on the instrument handle? | design name, design number, manufacturer
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| what is unpaired working ends? | instruments with two dissimilar working ends
both ends don't match (explorer)
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| what is paired working ends? | instruments with working ends that are mirror images of each other
look the same, but can't use the instrument on all teeth
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| what is design name? Design number | school or person who designed instrument
identifies the working end
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| what is recommended for the handle of instrument? | large diameter, light weight handle, bumpy texturing (knurling)
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| what should you avoid for the handle of instruments? | small diameter, heavy and small solid metal handle, smooth or flat texturing
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| what are the three characteristics that must be considered for the handle of instruments? | weight, diameter, texture (knurling)
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| what is the working end of an instrument? | last bend all the way to the end of the instrument
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| knurling helps the hygienist... | hold on to the instrument in the wet field and increases control and decreases muscle fatigue
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| what is the functional shank? | below working end and extends to last bend in shank near handle
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| what does the functional shank allow the hygienist to do? | allows working end to be adapted to the tooth
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| where is the short functional shank used? | supragingival scaling only
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| where is the long functional shank used? | supragingival and subgingival scaling
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| lower shank or terminal shank is what? | sectional of functional shank nearest working end
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| what is the lower shank used for? | provides visual cue for correct working end
right end of the instrument
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| what is a simple shank design | curved in 1 plane (front to back)
straight shank
instrumentation of anterior teeth
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| what is a complex shank design? | bent (front to back and side to side)
angulated or curved shank (get around teeth with big shapes)
instrumentation of posterior teeth
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| what is flexible shank design? | thinner diameter
greater tactile sensitivity
for small and medium deposits
more pressure needed for medium deposit
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| what is rigid shank design? | larger diameter
withstands heavy pressure for large deposits
les pressure needed
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| what is tactile sensitivity? | the ability to feel vibrations that are transmitted through the tip into your middle finger
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| what kind of working end does the curet have? | semi-circular shape
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| what kind of working end does the scaler have? | triangular
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| what is a balanced instrument? | working end of a balanced instrument is centered in line with the long axis of the handle
the distance from the working end to the shank should not be less than 35-40 mm
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| where do we use curets? | subgingival
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| where do we use scalers? | supragingival
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| what are assessment instruments? | help us gather information on the patient
probe (attachment) , explorer 11/12 (find deposit supragingivaly and subgingivaly), shepord's hook (carious lesions)
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| what do all the assessment instruments have in common | skinny, flexible shanks used supragingivaly
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| what are debridment instruments? | scalers for heavy deposit
sickle scaler, file, hoe, chisel
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| what are area specific curets? | complex shanks that are not universal
use them for certain specific areas of the teeth
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| what are the problems using an incorrect instrument? | difficulty accessing area
inadequate deposit removal
muscle fatigue
gouged root surfaces
breakage of instruments
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| what are the parts of the mouth mirror? | handle, shank and working end
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| how do you hold the mirror when it is not in use? | palm grasp because you waste energy when you reach over and grab it from cassette every time
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| how do you use the mirror | put in non dominant hand, palm grasp or modified pen grasp, fulcrum for retraction
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| where is the thumb and index finger held in modified pen grasp? | thumb and finger opposite each other at or near the junction of the handle and the shank and do not overlap
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| where is the middle finger in the modified pen grasp? | rests lightly on the shank
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| where is the ring finger in the modified pen grasp? | it is your fulcrum finger, stabilizes the hand and supports the hand
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| where is the little finger in the modified pen grasp? | near ring finger, has no function in the grasp
held in a relaxed manner
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| what is indirect vision? | viewing teeth through the mirror when direct vision is not an option
viewing linguals of maxillary anteriors
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| what is indirect illumination? | using mirror to reflect light into an area that is hard to see
working on linguals of the lingual surfaces of maxillary posteriors
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| what is transillumination? | shining light through the teeth in order to view calculus
using mirror on facial surfaces of mandibular anterior teeth
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| what is retraction? | using mirror to hold back the tongue or cheeks out of the way when working on teeth
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| what can you do if your mirror gets foggy? | warm on buccal mucosa
warm in palm of hand
ask patient to breathe through nose
dip in a cup of listerine or rinse with air water syringe
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| what should you avoid with mirror | hitting teeth, injuring alveolar bone, scratched mirrors, foggy mirros
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| which buttons do what on the air water syringe | left is water
right is air
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| what is the air water syringe used for in examination? | through examination
dry supragingival calculus
visibility
deflect free gingival margin to see calculus
recognize restorations
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| what is the air water syringe used for in treatment? | dry area for finger rest
evaluate complete deposit removal
applications of caries prevention agents
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| how is the air water syringe used | palm grasp, test air flow prior to patient insertion
apply short controlled bursts of air
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| what should you avoid with the air water syringe? | assembling incorrectly, spraying air forcefully, creating aerosol, causing splatter, startling patient, hypersensitive teeth, carous lesions
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| throughly dried supragingival calculus appears... | chalk-like
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| if your patient has hypersensitive teeth or carious lesions, you should use.. | gauze
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| air is used to deflect the free gingival margin in order to detect... | subgingival calculus
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| the air syringe is held with a... | palm grasp
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| dried calculus is easier to detect than wet calculus with the explorer because it is... | less slippery
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| what are the different types of grasps? | pen, modified pen, palm grasp
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| what type of pressure do you need when doing the instrument grasp? | light, firm, rigid
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| what do overlapping fingers make it difficult to do? | roll the instrument
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| what holds the instrument secure? | index finger and thumb
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| what is the finger that stabilizes, leads and supports the hand in modified pen grasp? | ring finger
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| what does wrist/forearm motion entail? | keeping our wrist inline with our forearm
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| what is rolling arm motion? | pivoting process
initiates movement of an instrument from the fulcrum finger
writs rolls left to right
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| what does the intraoral fulcrum do? | stabilization of the dominant hand in the mouth
pad of ring finger on tooth near the tooth to be worked on
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| where should the intraoral fulcrum be placed inside the mouth ideally? | 1-4 teeth away from being instrument
never rests directly on tooth surface being scaled
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| where can the intraoral fulcrum be placed on the teeth? | incisal edge or occlusal surface
occlusobuccal line angle
occlusolingual line angle
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| what are the benefits of the fulcrum | stable support, unit, stroke pressure, decrease injury
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| what are the limitations of the fulcrum | missing teeth, mobile teeth, sensitive teeth, facial musculature
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| what end should be adapted to the tooth of the curet? | toe 1/3
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| what end should be adapted to the tooth of the sickle? | tip 1/3
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| how can we make a fulcrum if patient is missing teeth? | cotton roll, gauze
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| what is the ideal angulation? | 60-80
40-90
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| what is the leading third of a curet working end? | semi circular toe third
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| what is the leading third of a sickle working end? | triangular tip third
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| what is the inserting angulation? | 0-40
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| what is angulation? | relation between the face of the working end and the tooth surface
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| what is the working angulation for the instrument? | 60-80
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| why do you use angulation when you are inserting the blade onto the tooth | two cutting edges, close the cutting edge up against the tooth and slide it down, cutting edge doesn't cut the gingiva
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| what is the place of insertion or "get ready zone" for anterior teeth? | midline
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| what is the place of insertion or "get ready zone" for posterior teeth? | distal line angle
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| what is the assessment/exploratory stroke? | long, feathery-light stroke
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| what does the explorer use to detect? | irregularities, smooth surfaces
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| what does the probe detect? | locate attachment
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| what is the calculus removal/scaling/working strokes? | biting, well controlled stroke
moderate to heavy pressure, removal of deposits , reshape overhanging margins
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| what is the root debridement stroke? | multidirectional, shaving stroke
moderate stroke becoming lighter and longer
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| what is burnishing calculus? | remove outer spicles and round the deposit so it feels like tooth surface
it is harder to remove after it has been burnished
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| how do you flip your instrument | never near the patient's face, flip over chest or over bracket tray
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| do not take scaler where? | subgingival
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| what are the factors that affect stroke selection? | gingiva, tooth surface, instrument, deposit
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| what are horizontal strokes? | around line angles, infurcation areas, in deep pockets too narrow for other strokes
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| where will we use horizontal strokes mostly? | buccal and lingual of molars
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| what are oblique strokes? | insert base of pocket
tip towards base of pocket
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| where do we use oblique strokes? | facial and lingual surfaces of posterior teeth
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| where do we use vertical strokes? | anterior teeth- facial, lingual and proximal surfaces
posterior teeth- mesial and distal surfaces
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| where do you start when removing deposit? | most apical piece of deposit and continue removing in sections until you remove the most coronal
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| what are the types of sickle scalers? | curved sickle scalers
straight sickle scalers
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| what does the face look like with the curved sickle scaler? | face is flat, curved lengthwise, perpendicular to lower shank
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| what is an example of simple shank design | sh 6/7
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| what is an example of complex shank design? | s204s9
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| what does the cross section look like in a curved sickle scaler? | triangular
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| what are the contradictions for using sickle scalers? | sharp cutting edge, bulky instrument, lacerates gingiva easily
cannot be used in root planning, cannot be adapted to the concavities to the root, can result to root gouging
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| is the fulcrum a stationary or moving point? | both, pivot on your fulcrum to get around the line angle
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| high fulcrum is what? | up on your ring finger
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| low fulcrum is what? | dropping your hand down
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| how do you check if you have the correct working end for posterior teeth? | place the instrument to the most distal surface of the tooth
the shank of the instrument is parallel to the long axis of the tooth is correct (up and over occlusal)
if it is down and around the tooth, incorrect
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| how do you use the sickle scaler on posterior teeth? | start at 90 to check working end
tilt the lower shank instrument slightly towards the tooth
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| what surfaces do you not use your posterior sickle scaler on? | buccal or lingual
only distal or mesial
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| what is the correct tooth blade angulation that is used with the 204S sickle scaler? | 70-80
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| where do you find supergingival calculus usually on posterior teeth? | buccals of maxillary molars because of salivary glands
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| which part of the working end should be adapted and remain in contact with the tooth surface during scaling with the SH6/79 sickle scaler? | tip third of the blade
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| which of the following best describes the correct scaling stroke used with sickle scalers? | overlapping, vertical, oblique
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| the cross section of the curved sickle scaler is triangular and has two cutting edges (T/F) | true
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| the triangular and two cutting edge of curved sickle scalers allows the clinician to place the instrument into the sulcus without trauma to the gingiva (T/F) | false
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| assessment stroke definition | instrument that will be used on every patient to evaluate the tooth or health of the periodontal ligaments
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| back of instrument definition | the portion of the instrument working end that is opposite the face. sickle scalers have pointed backs and curets have rounded backs
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| what is a balanced instrument definition | instrument in which the working end is aligned with the long axis of the handle when placed on lined paper the line will run down the middle of the handle and the middle of the working end
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| calculus removal stroke definition | an instrument stroke used to remove calculus deposits
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| chisel instrument definition | an instrument modeled after a carpenter's chisel intended for cutting or cleaving hard tissue. the cutting edge is beveled on 1 side only the shank may be straight or angled
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