Be sharp! Is your hygienist on the cutting edge?

Janet Hagerman, RDH, BS, presents the challenge of keeping hygiene instruments sharp in the dental practice, but not without offering a solution that can help solve the immediate problem of maintaining and protecting instrument inventory, as well as unite doctors and hygienists as partners in the practice.

By Janet Hagerman, RDH, BS

A study conducted by RDH eVillage newsletter found that 25% of hygienists sharpen their instruments less frequently than once per month, and half of those quarterly or less. Yet, being sharp is critical! Imagine trying to cut a crown prep with a dull burr or steak with a butter knife. Imagine trying to remove hard, crusty debris with scaling and root planing (SRP) from a tooth root beneath ulcerated, infected soft tissue using dull curettes.

When you consider that much of this debris remains hidden from view beneath gingiva, entirely dependent upon a very sensitive tactile touch for removal, the quality of instrument maintenance becomes of critical importance. And, just like our steak example, using a dull instrument can result in torn, abraded tissue. However, unlike our steak example, performing SRP procedures with dull instruments will also result in ...

  • Burnished residual calculus that provides a safe, resistant haven for infection-causing bacteria
  • Excessive instrumentation strokes
  • Probable discomfort for the patient enduring that SRP

With approximately 70% to 80% of our population suffering from periodontal disease, and our registered dental hygienists being charged with providing the nontherapeutic periodontal treatment, how can we not address the critical state of the instruments our hygienists use to provide this service?

When the RDH eVillage study queried hygienists as to the challenges of maintaining sharp instruments and replacing worn instruments, the vast majority of responses clearly cited cost as the reason. Interestingly, while many hygienists blamed their doctor for not providing the necessary funds, they also blamed themselves. The study cited direct quotes from many hygienists complaining that “other” hygienists in their offices ruined instruments with improper sharpening techniques. Dentists who regularly air their frustrations on blog posts and in chat rooms share these concerns. Apparently, many hygienists are ineffective at the skill of instrument sharpening, and hygienists themselves acknowledge this.

The challenge

It is apparent that we have a major disconnect here, and yet the dilemma is understandable. While hygienists learn how to sharpen instruments in school, this skill does not always carry over to private practice. While many hygienists are passionate about their skill level and are indeed very skilled, just as many, if not more, struggle with sharpening from both a time and skill perspective. Here are two of the results of improper instrument sharpening:

  • Improperly sharpened instruments can cause patient injury (torn tissue, residual calculus, and bacteria) and hygiene injury (unnecessary repetitive wrist movement). No wonder hygienists are frustrated!
  • Improperly sharpened instruments can also cause excessive and unnecessary expense from prematurely ruined instruments. No wonder doctors are frustrated!

The solution

Fortunately, there is a solution that not only helps solve the immediate problem of maintaining and protecting instrument inventory, but it also helps to unite doctors and hygienists as partners in the practice.

Here is what you can do to improve and correct the situation in your office:

  • Ask your hygienist to read this article, as well as this article’s companion article in the May issue of RDH magazine, Be Sharp! Are you on the cutting edge?
  • Discuss the situation in your office with your hygienist. Chances are your hygienist will really appreciate your interest in this problem.
  • Approach the situation from a business perspective and ask your hygienist to do the same. Ask your hygienist to research the office hygiene instrument inventory (see the RDH Instrument Inventory Plan at the end of this article) to prepare for your next meeting.
  • At the second meeting, review your hygienist’s instrument findings and proposal. Identify needs. Make a plan. If someone in your office is responsible for supply ordering, that person can be included in this meeting as well.

Once you’ve identified your need, determine a plan for correction. Like a good treatment plan, prioritize your needs for instrument maintenance and replacement. Assign a dollar amount on a regular (monthly) basis and charge your hygienist with staying within (or below) that budget. You may not get all instruments “fixed” immediately, but once you have a plan, your hygienist can implement — and should be responsible for — continual upgrades at regular intervals. Share your new plan with appropriate team members so everyone is on the same page.

Another great solution is Nordent’s revolutionary new sharpening service. The Nordent company manufactures hygiene instruments and sharpeners and has, for years, been committed to helping hygienists and dentists maintain effective, quality sharpness. Their new Relyant line includes a sharpening system that is a real problem-solver. While Nordent’s sharpening service will sharpen any brand of instrument, they will sharpen any Relyant instrument for free for the life of the instrument. Then, when the instrument is no longer safe to sharpen, the company will discount your replacement. Their service includes an auto-ship program, making the process easy for you to incorporate within your practice.

According to Nordent’s VP of sales, Tim Irwin, who has worked with thousands of practices all over the country, “The RDH survey really opened our eyes. It became apparent that for many offices, regular sharpening in the office just isn’t realistic. We hope that with our Relyant System, we can help clinicians work with instruments in better condition and realize all of the benefits of working with sharp instruments.”

This system is a win-win for all, freeing the hygienist to concentrate on patient care and periodontal therapy. Whatever system you choose — whether sharpening yourself or using a professional service, or a combination of both — commit yourself and your practice to using and maintaining only sharp instruments.

Implementing these strategies will enable you to achieve these common goals:

  • Protect valuable office inventory; i.e., instruments and the doctor’s budget!
  • Protect hygienists from repetitive wrist overuse
  • Protect and support the doctor-hygiene professional relationship
  • Protect your most valuable asset — your patients

Be sharp!

RDH Instrument Inventory Plan

  • Take instrument inventory.
  • Band (color-code) all hygiene instruments appropriately.
  • Document acceptable level of sharpness and/or need for replacement.
  • Bag and label appropriately.
  • Research costs and services for maintenance and/or replacement.
  • Prepare your proposal.

Author bio
Janet Hagerman, RDH, BS, is an international speaker, author, and consultant. A graduate of the Medical College of Georgia, she has practiced clinical dental hygiene for more than 30 years, and helped hundreds of dental practices in her roles as speaker, coach, and clinical director. Contact Janet at Visit her website at

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