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Elevators, dental charts
Nearly all practitioners have an ultrasonic dental scaler. Unfortunately, few have an adequate dental polisher. No
matter which method is used to remove supragingival calculus (ultrasonics, rotopro, hand scaling), grooves are left
in the enamel surface. Unless the enamel surface is polished smooth, it will attract more plaque. There are many
types of polishing units available. A prophy polishing cup attaches to the low speed handpiece in most delivery systems.
The periodontal probe is as important in a dental examination as a a stethoscope is in a general physical exam.
A perioprobe is marked off in millimeters. As a general rule, gum pocket depths greater than three millimeters in
dogs and two millimeters in cats need closer attentio- radiography, root planing, curettage, and/or periodontal
surgery.
Proper use of a curette requires a gentle touch. When used properly, the rounded toe and back cause little
damage subgingivally. The curette is angled acutely against the root surface, to remove gingival calculus, which is
dark brown to black in color. The strokes are overlapped 10 to 20 times to plane the root surface until it feels
glassy smooth, when checked with the explorer tip. For subgingival curettage, the opposite end of the curette is
angledagainst the lining of the gingival sulcus. While the operator presses on the gingiva with the index finger of
the opposite hand, the curette is used to scrape the lining of the gingival sulcus.Two other hand instruments, the
sickle scaler and the curette, can be used effectively during dental prophylaxis. Sickle scalers are designed for
supragingival use (above the gum line), whereas curettes are used subgingival (below the gum line). Sickle scalers
that are double ended (mirror image ends) are ideal. The scaler is triangular in cross-section.
The most effective working angle is 45-90 degrees to the tooth surface. A pull stroke is always used.
Perhaps the most overlooked and important aspect of basic dentistry is charting what is abnormal and proposed
treatment plans. There is no better way of learning, than sitting down with a dental chart and a sedated patient,
evaluating each tooth's appearance, position in the arch, mobility and periodontal pocket depth.
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