by Maria Perno Goldie, RDH, MS
Power-driven instrumentation is a fundamental aspect of periodontal therapy.(1) The focus of this method is disruption of bacterial plaque biofilm, the etiology of periodontal disease. Ultrasonic scaling has been shown to be comparable to manual scaling; however, you have the added benefit of less chairside time, and less operator fatigue.(2) This article will review some key aspects of power-driven instrumentation and introduce a new insert that is user friendly and easy on the operator.
You may want to consider an antimicrobial mouth rinse by patients before ultrasonic or other power-driven oral procedures, intended to reduce the number of microorganisms the patient might release in the form of aerosols or spatter that subsequently can contaminate dental health-care personnel (DHCP) and equipment operatory surfaces. In addition, preprocedural rinsing can decrease the number of microorganisms introduced in the patient's bloodstream during invasive dental procedures.(5)
Ultrasonic tip design is a very important aspect in the success of power-driven instrumentation. A standard tip insert design can be used in most cases remove the calculus easily. However, different situations require unique tips. Inserts are available in universal, triple-bend, beaver-tail, chisel, and periodontal probe-like tip designs. Swivel features increase ease of use and decrease drag from the handpiece cord, thus improving comfort from an ergonomic perspective. Not only do they allow you to go from mandibular to maxillary without removing the insert, but even more importantly, you can follow the line angle of the tooth without twisting the cord. This will decrease the need to lift the insert and simultaneously relieve stress on the wrist.
Most inserts are interchangeable with most units. For instance, a 25KHz Parkell, HuFriedy, or Discus Dental insert will work in any 25KHz Cavitron scaler ... and vice versa. The number of times the scaler tip vibrates each second is called its "frequency." Most magnetostrictive scalers are either 25 KHz (25,000 cycles per second), or 30 KHz (30,000 cycles per second).
Ultrasonic scaling has improved ergonomically in recent years due to the advent of ultrasonic inserts with lights. Discus Dental's new LED ultrasonic inserts, Insight, offer a unique solution that addresses the specific needs of the user and maximizes patient comfort. Dual-LED illumination allows you to work without moving the overhead light, improving workflow, and allowing a more neutral body position. It is currently the only ultrasonic insert with a light feature. The easy, smooth swivel moves with you, and the ergonomic design helps maintain a comfortable, neutral wrist and shoulder position. In a field test of 300 testers, over 75% said Insight is better than their current primary insert; over 90% rated favorably on smoothness of swivel, and 99% felt the grip was comfortable and well balanced.
Ergonomics is the science of designing the job, equipment, and workplace to fit the worker — in this case, the dental hygienist or dentist. Proper ergonomic design of ultrasonic units and inserts is necessary to prevent repetitive strain injuries, which can develop over time and can lead to long-term disability. Illumination in the posterior areas help to create a neutral body position, the size and comfort of the handle, and swivel feature all make the new Insight™ LED inserts a great choice for a more ergonomic scaling experience. The ergonomics of lighting — the relationship between the light source and the individual — clearly has a significant effect on productivity.
The Insight LED INSERTS work in all autotune magnetostrictive units, such as Cavitron, Parkell Manual/Auto-Tune Ultrasonic Scaler, and the Coltène Whaledent BioSonic Ultrasonic Scaler System. No additional power is required. Insight ultrasonic Inserts are available in an array of tip designs. See Figures 1 and 2 for photographs of the Insight designs.
See the light for yourself! One definition of "see the light" is to change for the better. Do yourself a favor and try the new insight™ LED INSERTS by Discus Dental. See if you agree with the 75% - 99% of those who tested the insert, and preferred its ergonomic design. As the saying goes…. "Try it, you'll like it!"
Director's Note: At RDH Under One Roof, Maria Perno Goldie is presenting a course titled, "Oral Health and Whole Body Wellness." This presentation highlights current information on the links between oral health and systemic health conditions, as well as about how the links affect dental practices. For more information, visit www.rdhunderoneroof.com.
Maria Perno Goldie, RDH, BA, MS, Maria graduated from the University of Pennsylvania, School of Dental Hygiene and is the recipient of the 1999 University of Pennsylvania Dental Hygiene Alumni Achievement Award. She is also a 2003 winner of the Pfizer/ADHA Award for Excellence in Dental Hygiene. She is a member of the American Academy of Dental Hygiene (AADH) and an Honorary Member of Sigma Phi Alpha, the National Dental Hygiene Honor Society. As a noted researcher, author, and speaker, Maria has presented seminars nationally and internationally on topics such as Women's Health and Wellness, Oral Care for the Cancer Patient, Oral Cancer, and Immunology and Periodontal Disease. Maria is a member of the International Association for Dental Research (IADR), Oral Health Research Group, and the American Dental Education Association (ADEA). Maria is a life member of the ADHA and the California Dental Hygienists' Association (CDHA). She serves on the Editorial Review Board of the International Journal of Dental Hygiene. In addition, she is a quoted expert in Women Doctors' Guide to Health and Healing published by the editors of Prevention Magazine, and is a co-author of Conversations in Health & Wellness, along with John Gray and others. Maria served as the 1997-98 president of the American Dental Hygienists' Association (ADHA), served on an advisory panel to develop "The Future of Dental Hygiene Report.", and is the President-Elect of the International Federation of Dental Hygienists (IFDH). She can be reached at [email protected].
References
1. Drisko CL, Cochran DL, Blieden T, et al. Position paper: sonic and ultrasonic scalers in periodontics. Research, Science and Therapy Committee of the American Academy of Periodontology. J Periodontol. 2000;71:1792-1801.
2. Position paper: sonic and ultrasonic scalers in periodontics. Research, Science and Therapy Committee of the American Academy of Periodontology. J Periodontol. 2000 Nov;71(11):1792-801.Review.
3. Dental Economics. Scaler facts. October 15, 2003.
4. Centers for Disease Control and Prevention. Guidelines for Infection Control in Dental Health-Care Settings — 2003. MMWR 2003;52(No. RR-17):28-34.
5. Pallasch TJ, Slots J. Antibiotic prophylaxis and the medically compromised patient. Periodontology 2000 1996;10:107–38.
