When you consider the fact that the dental hygienist spends more time on average with patients than any other team member, devoting your time to choosing the right equipment and learning best practice techniques, can positively transform both yours and their hygiene experience.
Ultrasonic scalers are fundamental to the day-to-day role of the dental hygienist, and the key to technique efficacy is to understand and experience their full potential by incorporating a range of inserts (tips) for use across a variety of clinical procedures. The primary reasons for understanding how to fully utilise your ultrasonic scaler and knowing which
inserts to use for which procedure, are to lessen the chances of wear and maintain a better patient outcome.
Scaling with worn ultrasonic inserts lessens the effectiveness of treatment, and those with as little as 2mm of wear can lose around 50 per cent of their scaling efficiency. With inserts not working to their full potential it takes much longer to remove calculus, resulting in not only unnecessary strain in the hands and shoulders for the dental hygienist but consequently longer treatment times and increased sensitivity and discomfort for the patient.
Insert selection
Many hygienists and dentists are under the misconception that one insert is enough to achieve success with ultrasonic scaling, but the reality is that a variety of inserts should be utilised according to the individual needs of the case.
Using the wrong insert for a particular procedure means that your ultrasonic scaler and inserts aren’t working to their full potential, and could do more damage than good. Whether it’s for light calculus removal or to remove heavy stains and subgingival calculus, dental hygienists need to change their inserts accordingly, as each is individually designed to handle different levels of deposits.
For general maintenance and scaling, standard size inserts, like those in Dentsply’s Powerline range, efficiently remove heavier deposits and calculus whilst the Slimline series is ideal for root surface debridement (RSD). When faced with more compacted teeth for instance around lower anteriors, turning to a slimmer tip such as the Thinsert, enables better access to difficult-to-reach areas and is particularly good for treating patients suffering from generalised inflammation but shallow pocket depths. Additionally, using an insert that has an adequately functioning water delivery system will flush away debris and improve your visibility of the working area, making treatment far more comfortable for the patient.
Insert compatibility
You wouldn’t put unleaded petrol in a diesel car simply because it’s not going to deliver the best results, so why would you risk debridement with inserts that aren’t a harmonious fit with the power unit? Whilst all inserts look very similar on the surface, on closer inspection there are key differences in terms of operation. Many dental professionals continue to interchange units and inserts at will regardless of the manufacturer, despite it being proven that such working practices could lead to unpredictable results or in the worst-case scenario, failure.
Reputable manufacturers have components that are intricately designed to work together as part of a family. Using ultrasonic inserts and power units from the same manufacturer will optimise system performance. Inserts produced by different manufacturers vary in output and by not being properly matched to a specific manufacturer’s generator
system could compromise performance during treatment. It can also cause heightened sensitivity and discomfort to
the patient as the components are not working to their full potential and can ultimately do more harm than good.
Risks of cost cutting
Often the reason for not using compatible inserts is the cost consideration, with the belief that buying cheaper inserts that can be found by a quick search on the internet will still give effective results. However, not only is there a risk that items bought unseen, often from abroad, can be of poor quality, they could also be counterfeit.
Using cheaper inserts does not save practices money; in fact it can work out to be far more costly in the long run. Cheap and incompatible inserts wear more quickly, need purchasing and replacing more often and have a detrimental effect on the unit over time – not least forgetting your overall delivery of first-class patient care.
It’s inconceivable as to why one would risk damaging either of these. The cost of same manufacturer inserts purchased through reputable providers are a small expense when compared to the initial outlay of your valuable ultrasonic unit.
Tip-top maintenance
In order to maintain optimal efficiency and avoid any risk of breakage, ultrasonic inserts should be discarded and replaced as soon as they show signs of wear. Any insert that appears bent or damaged should be disposed of
immediately.
To remove any guesswork in insert wear, refer to an insert efficiency indicator, a visual wear guide. Simply lining up used inserts against a diagram of the insert at its full potential when new, indicates just how worn the insert has become during use and gives an indication to the approximate remaining working use.
The key to successful ultrasonic scaling is in not cutting corners. Cheap and worn inserts used on incompatible equipment will be less cost-effective and result in longer treatment times. Remember – high-quality equipment leads to high-quality treatment, which ultimately means high-quality patient care.
References available on request.