Figure 3-12. - Periodontal probe ultrasonic tip.
Before starting ultrasonic scaling, take time to explain the procedure to your patient. The noise, water spray, and vibratory sensation produced by the ultrasonic scaler may frighten the patient if no warning is given. Place a plastic drape on your patient in addition to the patient towel to prevent clothing from becoming wet. If possible, have the patient rinse for 30 seconds with an antimicrobial mouthwash before treatment to reduce aerosol pathogens. The amount of water that will accumulate in the patient's mouth will necessitate the use of a saliva ejector. Ask your patient to hold the evacuation tip if necessary.
Hold the ultrasonic handpiece in a modified pen grasp (discussed later in this chapter) with the end of the hose tucked in the palm of your hand. This prevents the hose from weighing down the handpiece. Establish a fulcrum (discussed later) on a tooth in the same arch as close as possible to the tooth you are treating. The working end of the instrument tip should be adapted to a 10° to 15° angle to the long axis of the tooth. Use the lateral surfaces, face, and back of the instrument tip for scaling. The toe or tip of the working end should never be used to scale.
If the patient reports tooth sensitivity during ultrasonic scaling, several possibilities exist. First, be certain the insert tip is at a 10° to 15° angle to the tooth surface. You can increase the speed of tip movement over hypersensitive areas to alleviate discomfort. A change in the motion of the insert tip from vertical to horizontal, or vice versa, sometimes helps diminish sensitivity. It may be necessary to lighten your finger pressure on the handpiece, especially on exposed dentin. If sensitivity persists, decrease the power setting.
Incorrect adaptation of the instrument to the tooth will cause pain to the patient and damage to the tooth.
It is very important to understand that the instrument tip must be in direct contact with the calculus deposit to be effective. Use light, rapid strokes, keeping the tip moving at all times to avoid heat build up or tooth damage.
No special maintenance is required; however, several precautionary measures should be followed:
Do not place the unit on or next to a heat source since it could damage the electronic components.
Do not keep the unit in a tightly confined space or corner. Keep it where a normal amount of air will circulate freely on all sides of the unit.
The unit should not be used when the patient or operator of the unit is wearing a cardiac pacemaker.
You may experience some difficulties with the unit that requires minor adjustments. For example, the handpiece may heat up if there is insufficient water flow or air is trapped in the handpiece. Water flow requires adjustment if the spray from the insert does not properly cover the area of the activated insert tip. Water leaks from the handpiece during operation generally indicate that the O-ring on the insert is worn and requires replacement. Always consult the manufacturer's instructions for the causes and corrective measures for other problems.
The air polishing unit (fig. 3-13) uses air and water to project a controlled stream of specially processed sodium bicarbonate. It removes gross extrinsic stain, plaque, and soft debris from all exposed surfaces of the tooth enamel. It polishes and cleans tooth surfaces, pits, and fissures. Some patients prefer this method of polishing, which reduces the sense of pressure and heat associated with use of a rubber cup and pumice. Air polishing is ideal for polishing teeth to whichContinue Reading