Instrument Sharpening, Diabetes, HIV/AIDS
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| which type of instrument will reflect light? | dull instrument
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| why do we sharpen? | reduce fatigue
improve instrument control
improves tactile sensitivity
improves deposit removal
decreased burnished calculus
less root gauging
saves time
minimizes pt discomfort
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| when do you sharpen? | ability to feel sharp edge grabbing onto a surface is lost
after each use
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| when do you replace an instrument? | original shape significantly altered
strength and integrity has been compromised
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| what are the types of stones used for sharpening? | Arkansas, Ceramic, India, Mandrel mounted stone
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| what lubrication do you use for Arkansas stone? | oil
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| what lubrication do you use for India stone? | oil
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| what lubrication do you use for ceramic stone? | water or dry
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| what materials do you need for sharpening | safety glasses, gloves, 2X2 gauze, magnifying glass, plastic test stick, light source, stable work surface
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| what is the terminal shank? | area of the instrument between the blade and the first angle
proper alignment of the terminal shank will automatically place the blade in the correct position
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| what is the working end? | consists of a blade that has one or two cutting edges that run from the terminal shank to the tip or toe
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| what is the functional shank? | extends from the handle to the blade and includes the terminal shank
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| how does instrument labeling work? | each working end is identified by the number closest to it
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| how do you grasp your instrument for sharpening? | nondominant hand with a secure palm grasp
brace your thumb against the upper shank to counter balance the pressure caused by grinding
blade to be sharpened at the bottom with tip towards you
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| how do you grasp your stone for sharpening? | grasp the lower half of the stone in your dominant hand
hold stone upright at 12:00 by placing your thumb on the edge towards you and fingers on the edge away from you
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| what is the anatomy of the sickle scaler? | two cutting edges
triangular cross section with tip
facial surface of the blade is positioned at 90 degrees to terminal shank
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| what is the instrument position for sickle scalers for right handers? | terminal shank at 12 o'clock
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| what is the stone position for sickle scalers for right handers? | lubricated side of the stone against right lateral surface of blade
initially direct top of stone upwards towards 12 o'clock
tilt the too if the stone away from the instrument to 3 minutes AFTER 12 o'clock
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| how do you move the stone when sharpening? | heel third--> middle third--> toe/tip third
fluid up and down motions
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| how do you sharpen the opposite blade for the sickle scalers for right handers? | rotate the instrument so that the tip is pointed away from you
terminal shank at 12 o'clock
top of stone away from handle to 3 minutes AFTER 12 o'clock
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| what is the instrument position for sickle scalers for left handers? | terminal shank of the blade being sharpened at 12 o'clock
tip pointed towards you
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| what is the stone position for sickle scalers for left handers? | lubricated side of the stone against the left lateral surface of blade
initially direct top of the stone towards 12 o'clock
tilt the stone away from instrument to 3 minutes BEFORE 12 o'clock
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| how do you sharpen the other end of a sickle scaler for left handers? | rotate the instrument so that the tip is pointed away from you
position terminal shank of blade at 12 o'clock
tilt the stone away from the handle to 3 minutes BEFORE 12 o'clock
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| what is the test stick position? | grasp the bottom third of the test stick in your non dominant hand between your thumb and index finger
hold test stick upright at 12 o'clock
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| how do right handers test the sickle scaler sharpness? | hold instrument in dominant hand with modified pen grasp
position handle behind the test stick with tip pointed towards you
place cutting edge on left side of test stick and fulcrum on right side
tilt terminal shank to 3 minutes AFTER 12 o'clock
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| how do left handers test the sickle scaler sharpness? | dominant hand, modified pen grasp
position instrument handle behind test stick with blade pointed towards you
cutting edge to right side of the test stuck and fulcrum on the left side
tilt terminal shank slight towards 3 minutes BEFORE 12 o'clock
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| what is the anatomy of the universal curette? | two parallel cutting edges
rounded toe
facial surface of the blade is positioned to form 90 degree angle with the terminal shank
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| how do right handers place their instrument for sharpening the universal curette? | hold instrument vertically in non dominant hand
blade to be sharpened will be at bottom with toe pointed towards you
position terminal shank at 12 o'clock
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| what is the stone position for the universal curette for right handers? | lubricated side of the stone against the right lateral surface of the blade
initially direct the top of the stone upwards towards 12 o'clock
tilt the stone away from the instrument to 3 minutes AFTER 12 o'clock
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| how do right handers sharpen the opposite cutting edge of the universal curette? | rotate the instrument so that the tow is pointed away from you
terminal shank at 12 o'clock
stone position at 3 minutes AFTER 12 o'clock
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| how does a right hander round the toe for the universal curette? | rotate the instrument so that the toe of the blade is directed towards 3 o'clock
position stone horizontally under the blade and tilt towards 2 o'clock
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| how does a left hander hold their instrument for sharpening a universal curette? | vertically in non dominant hand
blade to be sharpened at the bottom with tow pointed towards you
position the terminal shank at 12 o'clock
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| where does a left hander place the stone for universal curette sharpening? | lubricated side of the stone against the left lateral surface of the blade
initially direct the top of the stone upward towards 12 o'clock
tilt the top of the stone away from the instrument to 3 minutes BEFORE 12 o'clock
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| how does a left hander sharpen the opposite side the blade for a universal curette? | rotate the instrument so toe is pointed away from you
terminal shank at 12 o'clock
stone at 3 minutes BEFORE 12 o'clock
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| how does a left hander round the tow of the universal curette? | rotate the instrument so that the toe of the blade is pointing at 9 o'clock
position the stone horizontally under the blade directed at 9 o'clock and title upwards towards the 10 o'clock position
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| how does a right hander test the sharpness of the blade of the universal curette | place instrument handle behind test stick with toe of blade pointed towards you
cutting edge against left side of the test stick and fulcrum on the right side
tilt the terminal shank towards 3 minutes PAST 12 o'clock
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| how does a left hander test the sharpness of the universal curette blade? | place instrument handle behind test stick, toe pointed towards you
cutting edge against the right side and fulcrum on the left side
tilt terminal shank to 3 minutes BEFORE 12 o'clock
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| what is the anatomy of the Gracey curette? | facial surface of blade is titled downward at a 70 degree angle to terminal shank
only one functional edge to sharpen
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| Right handers for Gracey curette ODD/EVEN | ODD point toe of blade TOWARD you
EVEN point toe of blade AWAY from you
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| Left handers for Gracey curette ODD/EVEN | ODD point toe of blade AWAY from you
EVEN point toe of blade TOWARDS you
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| how does a right hander hold the instrument for sharpening a gracey curette? | terminal shank of instrument tilted towards 3 minutes BEFORE 12 o'clock
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| what is the stone position for the right hander in sharpening a Gracey curette? | position against the right lateral surface of the blade at 12 o'clock
tilt the top of the stone slight towards 3 minutes AFTER 12 o'clock
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| how does a right hander round the toe for a Gracey curette? | terminal shank at 3 minutes BEFORE 12 o'clock
Rotate instrument so tie of the blade is directed at 3 o'clock
face of blade parallel to working surface
stone tilted upward towards 2 o'clock
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| how does a left hander position their instrument for sharping a Gracey curette? | terminal shank 3 minutes AFTER 12 o'clock
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| how does a left hander hold the stone for sharping a Gracey curette? | stone against the left lateral surface at 12 o'clock
tilt the top of the stone slightly to 3 minutes BEFORE 12 o'clock
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| how does a left hander round the toe on a Gracey curette? | terminal shank at 3 minutes past 12 o'clock
rotate instrument so toe of blade is at 9 o'clock
face of the instrument should be parallel to the table surface
tilt the stone upwards to the 10 o'clock position
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| how does a right hander test the sharpness of a ODD Gracey Curette blade? | toe will be pointed towards you
instrument handle behind the test stick, cutting edge to left side of stick and fulcrum on the right side
12 position for terminal shank, do not place ring finger onto of test stick: fulcrum opposite of cutting edge
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| how does a right hander test the sharpness of an EVEN Gracey Curette blade? | toe directed away from you
instrument handle in front of the test stick
12 position for terminal shank, do not place ring finger on top of test stick: fulcrum opposite of cutting edge
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| how does a left hander test the sharpness of an EVEN Gracey Curette? | toe is directed towards you
handle behind the test stick, cutting edge against right side, fulcrum on left side
terminal shank 12 o'clock, do not place ring finger on top of test stick
fulcrum against opposite side of cutting edge
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| how does a left hander test the sharpness of an ODD Gracey Curette? | toe is directed away from you
instrument handle in front of the test stick
terminal shank and test stick at 12 o'clock
do not place ring finger on top, opposite cutting edge
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| what is diabetes? | group of metabolic disorder characterized by hyperglycemia (abnormally high blood glucose) resulting from defective insulin secretion or defective insulin action or combination of both
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| what is insulin | anabolic hormone used to build up the body
stimulates the entry of glucose into the cell and enhances fat storage
w/o glucose remains in bloodstream rather than being stored by cells
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| what is type I diabetes? | impaired insulin production, childhood or adolescence
results from the destruction of beta cells of the pancreas
AKA ABSOLUTE insulin deficiency
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| what is type II diabetes | inability to use the insulin produced by the body
predominantly genetically inherited
AKA Peripheral insulin resistance
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| what are the symptoms of type I diabetes? | sudden appearance of constant urination, excessive thirst, extreme hunger, dramatic weight loss, irritability, weakness and fatigue, nausea, vomiting
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| what are the symptoms of type II diabetes? | slow onset of recurring or hard to heal skin, gums or bladder infection, fatigue, blurred vision, cataracts, tingling or numbness in hands or feet, itching, drying of mucus membranes
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| how do you manage type I diabetes? | have to have insulin (shot, pills, pump), food control for counting carbs, checking blood sugar levels, cholesterol control, high blood pressure control
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| how do you manage type II diabetes? | diet control, oral medications, physical activity, weight management, checking blood sugar, cholesterol control, might have to add insulin later
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| chronic symptoms associated with diabetes? | vascular: macro/microangiopathy
eyes: cataracts, glaucoma, blurred vision
kidney, reproductive system, skin, mouth (perio and caries), peripheral nerves
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| what are some oral manifestation of diabetes? | parotid swelling, viscous saliva, xerostomia, caries, fungal infections, cheilosis, glossodynia, fruit breath, abnormal wound healing
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| clinical serves of the diabetic patient? | brief appointments, morning appointments, maximize stress reduction, consult physician
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| what are some signs of hypoglycemia? | decreased conversation, confusion, change in mood, nausea, sweating, goodsebumps, tachycardia, anxiety
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| if the patient is conscious how do you treat a patient with diabetes who has a hypoglycemic event? | treat with 15 grams if simple carbohydrate
repeat finger stuck glucose test in 15 minutes
document event
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| how do you treat a uncooperative patient with diabetes who has a hypoglycemic event? | 24 grams instant glucose, call for help at 2299,
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| how do you put the glucometer together? | lay out on paper towel push clear plastic end into the pen until click, push the needle end cap into the pen so it covers, twist and pull blue lancet cover until removed, insert strip into glucometer (metal end first)
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| how do you use the glucometer on your patient? | ask patient which finger they prefer, wipe off tip with alcohol
patient palm up, hold finger that will be stuck with non-dominant hand
place pen in dominant hand and put needle cap firmly onto pad of finger
with thumb, click end of pen
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| how do you take a reading on the glucometer | set the pen down and pick up glucometer, do NOT milk the finger
gently touch top of glucometer strip to drop of blood
give patient gauze to hold on their finger
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| how do you disinfect the glucometer? | remove strip from glucometer and dispose in red biohazard bag
twist and pull needle end cap from pen and dispose in sharps
clean glucometer and pen with alcohol gauze
put glucometer and pen into a sterilization bag but do not seal
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| what is a normal blood pressure? | less than 120 systolic
less than 8- diastolic
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| what is prehypertension blood pressure? | 120-139 systolic
80-89 diastolic
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| what is stage 1 hypertension blood pressure? | 140-159 systolic
90-99 diastolic
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| what is stage 2 hypertension blood pressure? | greater than 160 systolic
greater than 100 diastolic
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| what is emergent blood pressure | greater than 180 systolic
greater than 110 diastolic
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| if the patient is unable to take oral medications for pre med, what can they take? | ampicillin, cefazolin, ceftrizaone
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| if the patin is allergic to penicillins or ampicillin orally, what pre-med can they take? | cephalexin, clindamycin, azithromycin, clarithromycin
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