Nordent Manufacturing, Inc.
1
Why should I sharpen my instruments?
2
A Sharp Instrument Will...
allow you to work more effectively and improve
tactile sensitivity.
afford you better control.
reduce procedure time.
reduce strain and fatigue on your patient.
greatly reduce strain and fatigue on YOU!
3
In dental hygiene...
One of the main contributing factors to Cumulative
Trauma Disorder
is
dull or improperly sharpened instruments.
4
In a recent survey by RDH Magazine...
41% of hygienists report suffering
from carpal tunnel syndrome or
having symptoms indicating future
CTS problems.
5
Symptoms of CTS include...
Nocturnal pain or numbness.
Paresthesia (numbness, tingling, increased
sensitivity)
Hypesthesia (decreased sensitivity to touch)
Hand clumsiness
Hand weakness
Pain or burning
6
Factors Known to Contribute to CTS
Predisposing factors (diabetes, hypothyroidism, medications, injury,
arthritis, etc.)
Wrist ratio (the proportion between wrist depth and height).
Length of time practiced.
Number of days worked per week.
Number of patients per day.
Number of “heavy calculus” patients per day.
Scaling technique (finger and wrist positioning).
Instrument maintenance regimen.
Instrument handle selection.
7
Light Weight – Large Diameter
“Ergonomic instrument design can help reduce CTS in
two basic ways. Lighter weight instruments require
less muscle tension to place, angulate, adapt, and
simply hold….Varying diameters allow the application
of force through different joints of the same
finger…This allows muscles to trade off and rest a little
throughout the instrumentation session.”
Nunn PJ, Hart CT, Gaulden GF, Perfect Instrumentation Can be Hazardous to Your Health.
Access 1995; 9 (1)
8
Sharp Instruments Mean Less Force
“It has been found for dental hygienists that the amount
of force exerted is more likely to cause carpal tunnel
syndrome than the number of repetitions. Therefore,
any tool with a cutting edge should be kept as sharp as
possible during the entirety of the procedure.”
Fredekind, Richard and Cuny, Eve, Ergonomics and the Dental Care Worker, Murphy,
Denise C., Washington D.C., American Public Health Association, 1998
9
If I sharpen my instruments
frequently, they won’t last as long.
10
Frequent and proper sharpening will
make your instruments last longer and
reduce replacement costs.
11
If you sharpen your instruments
frequently...
Sharpening will be quicker and easier.
You will sharpen more accurately.
You will need to remove less material to achieve a sharp cutting edge.
12
Many People Assume…
High quality instruments are expensive.
They really are not!
Quality instrument manufacturers use the finest grade
stainless steel available, and subject instrument tips to
more extensive tempering and hardening processes.
13
High quality instruments require less
maintenance and stay sharper longer!
Example:
High quality scalers can be used 450 and 1000 times!
The average cost for a quality scaler is $24.00.
$24.00 divided by 450 uses =
5¢ per use
5 scalers per kit cost…
25¢ per patient
14
Factors Known to Contribute to CTS
Predisposing factors (diabetes, hypothyroidism, medications, injury,
arthritis, etc.)
Wrist ratio (the proportion between wrist depth and height).
Length of time practiced.
Number of days worked per week.
Number of patients per day.
Number of “heavy calculus” patients per day.
Scaling technique (finger and wrist positioning).
Instrument maintenance regimen.
Instrument handle selection.
15
A Quality Instrument Manufacturer...
Uses the best materials available
(440A grade stainless steel).
Tempers and hardens instrument tips to exacting
standards.
Employs qualified instrument craftsmen and engineers.
Employs rigorous quality control procedures.
Designs instruments that are balanced and ergonomic.
Produces innovative instrument designs.
Will not retip instruments.
16
Disadvantages of Retipping
Real liability risk.
Inferior materials and workmanship.
Lower hygienist satisfaction.
Higher maintenance costs.
Long term costs are much greater.
In comparison, new, high quality instruments
are more economical than retipping.
17
Professional Sharpening Services
Do not retip instruments.
Restore the original blade surfaces
and sharp edge.
Should be used in conjunction with
an in-office maintenance program.
Are very effective and relatively
inexpensive.
18
Sickle Scaler
19
Jacquette Scaler
20
Universal Curette
21
Gracey Curette
22
Instrument Tip Anatomy
Terminal
Shank
Blade Face
Blade Heel
Blade Tip
Lateral Surface
23
To Sharpen Your Instruments You Need...
A Sharpening Stone
Arkansas
India
Ceramic
Lubricating Fluid
A Firm Working Surface
Good Lighting
A Relaxed Attitude!
24
Three Types of Sharpening Stones
Arkansas is a natural stone, white to black in color.
They
are available in soft, medium, hard and ultra hard and must
be lubricated with honing oil.
India is a man made stone, brown in color.
They are
available in coarse, medium and fine grits and must be
lubricated with honing oil.
Ceramic is a man made stone in various colors.
They are
available in coarse, medium and fine grits and may be
lubricated with water.
25
Stationary Instrument, Movable Stone
1 Inside blade face is held parallel to the
floor.
2 Approach the instrument blade with the
stone at the 12:00 position.
3 Angle the stone back to the 1:00 position.
26
Utilize a Table Edge for Stability
Hand and forearm rest on the table top.
Instrument hand is braced against the table edge.
Angle the instrument toward you for easier access
and better visibility.
Grasp the stone from along the bottom to utilize
both the front and back surfaces of the sharpening
stone.
Position yourself near a corner for additional
27
access.
Free-hand Sharpening Position
Move Back from the Table
Position the Instrument in
your Lap
Forearms Parallel to the
Floor
Look Directly Down on the
Instrument Blade Face
28
Proper Sharpening Grasp
29
Align Sharpening Stone at the 12:00 Position
30
Anterior Scaler
Blade Face Parallel to the Floor
31
Anterior Sickle Scaler
Position the
Instrument
Blade Face
Parallel to the
Floor
Align the
Sharpening
Stone at 12:00
32
Begin at the 1:00 Position
33
Anterior Sickle Scaler
Position the
Sharpening
Stone at 1:00
Begin at the
Heel of the
Blade
Medium
Pressure, Long
Even Strokes
34
Begin at the Heel
35
Move Through the Middle of the Blade
to the Tip or Toe
36
Posterior Sickle Scaler
37
Universal Curette
38
Sharpen the Toe of Your Curettes Separately
39
Gracey 11-12 Curette
Blade Face Parallel
Sharpening Stone
Sharpening Stone at 12:00
at 1:00
40
Test for Sharpness with a Test Stick
41
A Dull Edge Reflects Light…A Sharp Edge
Will Not
42
Sharpen Your Explorers
Stationary stone, moveable instrument
Sharpening stone parallel to the floor
Terminal shank parallel to the long axis of the
sharpening stone
Engage only the tip
Drag explorer tip LIGHTLY toward you
Utilize the clock method
43
Every Brand, Every Pattern, Every Time!
44
Every Scaler & Curette has 1 Thing in Common…
45
2 Unique Features Guarantee the Correct Angle
Blade Positioner
Sharpening Cone
46
Turn Knob to Raise or Lower Positioner Bar
47
Fit Jaws around Shank and
Tighten Using Back Knob
48
Move to Cone & Sharpen
49
50