1 – Use your ultrasonic scaler!

– At least 80% of your scaling on average should be done with an ultrasonic scaler (magnetostrictive or piezo).

– It is more efficient and more effective (irrigation, cavitation, etc.) than hand scaling in most areas.

– It is easier on your hands.  Stop killing yourself!

– Less hand scaling means a decreased need to sharpen and purchase instruments since they will last longer.

– Use at least 1 universal and 1 perio tip.  Start with the universal and finish with the perio tip as needed.  Debriding with only a perio tip is inefficient (I’ve made this mistake too many times), unless there is very little calculus present of course.

2 – Polish first.

– Polishing is by far the most efficient way to remove plaque, stain and very soft calculus.  Do not scale plaque!

– Once the soft stuff is gone, it will be easier to see (especially with loupes) and tackle the hard calculus.

– Use coarse or extra-coarse prophy paste.  Stop wasting your time with fine grit.

– Polishing before scaling teeth is like sweeping before mopping your kitchen floor.  The sequence just makes sense.

3 – Perio patients do not receive prophies.

– If a patient is maintaining the proper recall interval and completing recommended homecare, then the prophy should not take any longer than 20 minutes on the vast majority of patients.

– If a patient is not a perio patient and is not maintaining the proper recall interval and/or has poor homecare, then have them return for a second prophy in 1-2 weeks and then recommend a shorter recall interval if needed.  Put the responsibility on them.  It’s not fair to you or your employer to routinely complete 40 minute prophies in one appointment.

– Active perio patients should get scaling and root planing (D4341 or D4342).

– “Healthy” perio patients with reduced periodontium should get perio maintainence (D4910).

Questions?  Comments?

Mark Frias, RDH
kona26@hotmail.com