Even the most skilled dental hygienists can regularly leave calculus after periodontal therapy. Research shows that approximately 17% to 64% of calculus is left after traditional nonsurgical scaling and root planing, and 7% to 24% remains after surgical intervention.1 Even with the best ultrasonic inserts and radiographs, hygienists know we are really working “blind” when we instrument tiny surfaces and remove calculus and biofilm that’s under the gingiva. When you think about it, it’s pretty amazing what we do every day!
Since we’re working subgingivally in tissue and blood, it’s critical to feel comfortable with the 11/12 explorer for thorough calculus removal. After watching hundreds of students learn, practice, pass off, and try to perfect this skill while in dental hygiene school, there are patterns I’ve seen as people learn and feel more comfortable with this instrument.
4 things to remember as you practice this skill in private practice
- Go slow. It’s easy to rush through exploring since it feels like it takes a lot of time. However, going a bit slower will be the biggest time saver. It will help you feel exactly what is happening subgingivally, will prevent over-instrumenting, and will prevent wasting time with removal of areas that are not calculus.
- Use the correct end. As you hurry, it’s easy to push through and use whatever end is in your hand. However, these instruments are specifically designed to hug different areas of the teeth, fall into contours, and have the side of the instrument touching the tooth instead of the tip. Using the correct end will ensure you’re using the lateral sides to feel.
- Have an 11/12 close to you to use! It’s easy to skip this exploring step, especially in private practice when no one is checking up on your calculus removal. But it is such an important step to make sure you remove as much calculus and biofilm as you can.
- Use a light grasp. As you adapt, it’s easy to tense your fingers and knuckles. But with exploring, you want as light as grasp as possible to feel calculus, anatomy, overhangs, or decay. Keep your hand light as you explore.
Next time you’re using an 11/12 explorer, stop and do a little self-check to see if you’re doing the best method for both you and your patients.
To learn more about exploring and using this important instrument, check out the Hygiene Edge video.
Reference
- Drisko CL, Killoy WJ. Scaling and root planing: removal of calculus and subgingival organisms. Curr Opin Dent. 1991;1(1):74-80.
