by Eileen Morrissey, RDH, MS
One of the gremlins in my clinical work world manifests when I attempt to scale teeth with dull instruments. Gremlins are irritating annoyances that increase my stress level as they hover around. I could tell you that I'm Ms. Perfect RDH, with perpetually sharp curettes and scalers in my setups. The truth is that my instruments are not nearly as sharp as they should be. My excuses are probably similar to yours. (If you have a small violin, now would be a good time to play it.) When my schedule is fully booked, I have little downtime. If I do have a cancellation, there is plenty to catch up on -- sharpening is just one.
I've always been reluctant to sharpen instruments in front of patients because I think it makes them anxious. It doesn't matter that I smile and reassure Mrs. Patient that a finely honed instrument makes me more efficient, and that it allows me to use less pressure during maintenance visits. I read her body language, and she's not putting off a good vibe. Instead, I quickly try to accomplish some sharpening before I bring her back to the treatment room. I know I don't do the task justice. The better solution to achieve this important ritual would be to come in early, sharpen instruments at lunch, or stay a bit later. More often than not, I just don't get around to doing it.
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Other articles by Morrissey:
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This is why I sometimes have dull instruments, which brings me back to the gremlins. I'm not doing my patients any favors if I burnish their calculus, which is a real possibility if I use dull instruments. Ask Anna Pattison, queen of the dental hygiene instrumentation world. I listened to her speak last May, and she presented slide after slide that illustrated just how much burnished calculus is left on patients' teeth. Surprisingly, the majority of it is on or near the CEJ!
Many of these problems were solved for me in June of this year when I was introduced to American Eagle's XP (sharpen-free) instrument technology. To that end, my mantra has become, XP, XP, will you marry me? Forever more, I'll be at your door.
Using XP instruments has rejuvenated my instrumentation world. The difference between scaling with dull instruments and scaling with XP instruments, which are exquisitely sharp and stay that way (I am not kidding), is the difference between night and day. Can we say nirvana?
When you have the right tools for a task, as Mary Poppins would say, "Snap, the job becomes a game!" I have tried other instruments that supposedly stay sharp longer, but I never really saw it. The XP instruments, though, are the real deal, and you will not appreciate this until you're holding them in your hands. When you do, you can lighten your death grip. I had to adjust mine, because I was accustomed to having to use more pressure when I scaled with dull instruments. That is not necessary here; in fact, it's counterproductive. (You don't want to break off the tip of an XP scaler.)
Lighten up, and shave the calculus deposit. Release the gremlins from your scaling world when you do so, because you'll feel less fatigue at the close of the day. So celebrate! My favorite technique is to remove the bulk of a deposit with ultrasonic; then I fine tune with hand instrumentation using XPs. (A combination of ultrasonic followed by hand scaling is the protocol we teach in the dental hygiene curriculum at my community college.)
I could not be more excited about sharing this discovery with my colleagues. By the time this column is published, I will have taught a "hands-on" XP instrumentation seminar at Burlington County College in N.J., and several other venues in Pennsylvania. It's fun for attendees to earn CE credits while actually trying the instrumentation on other RDHs or typodonts. It enables participants to get a true feel for the technology, and it's a welcome change from lecture-only presentations.
To quote Dr. Anthony M. Di Cesare, a periodontist and one of my beloved former employers, "In the hands of a skilled clinician, any instrument will work its magic." I know that Dr. Di Cesare means any sharp instrument will work magic! Since being introduced to the XP technology, I'm working at slowly building up my inventory to favor XP. There is no turning back for me! Onward we go; it is in our hearts' core.
EILEEN MORRISSEY, RDH, MS, is a practicing clinician, speaker, and writer. She is an adjunct dental hygiene faculty member at Burlington County College. Eileen offers CE forums to doctors, hygienists, and their teams. Reach her at [email protected] or 609-259-8008. Visit her website at www.eileenmorrissey.com.
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