Dentaltown November 2017 - 47

Michael, thanks for posting for it is a very appropriate question for today's hygienist managing patients. And you should be knowledgeable to at least advise.
The systematic consensus of peer reviewed clinical studies demonstrates clearly that
ultrasonic instrumentation is at least equivalent if not superior to manual instrumentation in
periodontal management. Today's perio direction/focus is the disruption of biofilms and this
technology hits the mark via photo acoustics. As for ergonomics, it is "hands down" decreasing
carpal tunnel etc. in favor of power driven instrumentation including time efficiency.
Many dental hygiene programs are now introducing ultrasonic debridement first followed by
manual instrumentation. While traditional hygiene has focused on manual instrumentation for
the past 75 years, it is now time to listen to science and ergonomics and move into the next era.
Change is not easy, but this direction benefits both the patient and the clinician. ■

sperio
Member Since: 07/17/05
Post: 35 of 43

8/13/2017

I prefer my hygienists use the ultrasonic scaler initially to disrupt biofilm (for patients that
can tolerate.) Hand scale next with properly sharpened and maintained scalers and curettes.
Blow air and check quadrants with EXD 11/12 scaler. Polish with prophy paste. All hygienists in
my office use loupes and lights. Saves a lot of time and improves quality of care. I provide them
if they don't own their own. ■

dds262
Member Since: 09/04/14
Post: 36 of 43

8/13/2017

I think OP is doing a fine job. As for those who think she is overstepping the mark, she
is obviously the go-between for the owner and RDH. Ultrasonic is so much faster, so I use it
wherever I can. When RDH's are trained, they are often not allowed to use ultrasonic, only
hand scale, basically for practice. Unfortunately, when a lot graduate, they think that what they
are doing is better, but they are yet to learn efficient time management techniques. ■

aussiedentist
Member Since: 09/01/10
Post: 39 of 43

8/22/2017

Turning up the ultrasonic scaler to higher than medium is the equivalent of scraping teeth
with dull hand instruments when it comes to efficiency and comfort. Have enough tips to make
them part of every tray setup. If they are standard in every kit, and it is understood that the
hygienist will use the ultrasonic with every patient, even if it's just for a minute. Remember,
patient comfort is more important than efficacy. Expert technique will be acquired with practice! And it can only be acquired with practice. ■

Trish Walraven
Member Since: 08/14/04
Post: 41 of 43

8/23/2017

I don't know about Australia, but in my state, the hygienists work under my license. If there
is something that needs to be corrected, whoever her boss is needs to have the talk with her. If
you don't sign her paycheck, she is not going to listen to you. The dentist or dentists that have to
check after her need to have the talk with her. Too bad if they come across poorly. ■

kharris3724
Member Since: 01/08/09
Post: 42 of 43

8/23/2017

To scale or not to scale?
Search: "Does Not Use Scaler"
What's your policy on ultrasonic scaling? Has a hygienist ever refused an ultrasonic
scaler? Share your experiences with fellow Townies online. Go to dentaltown.com and
search the message boards for "does not use scaler"-this conversation will be one of
the top results.

dentaltown.com \\ NOVEMBER 2017

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Table of Contents for the Digital Edition of Dentaltown November 2017