Instrument Sharpening

Who developed the instrument sharpening technique we will be discussing?

Sherry Burns RDH

Objectives of instrument sharpening

-restore a sharp cutting edge to the blade
-preserve the original shape of the blade

Sharp instruments are effective for

deposit removal with less lateral pressure and fewer strokes

Results of using dull instruments

-inefficient deposit removal
-lower quality work
-increased need for lateral pressure
-reduced tactile sensitivity
-tighter instrument grasp
-more strokes required for deposit removal

RESULT: burnished calculus

Benefits of sharp instruments

-improved calculus removal
-reduced fatigue
-improved tactile sensitivity
-minimized patient discomfort
-improved instrument function

Sharpening stones

-used to restore cutting edges on dull instruments
-available in different types and grits
-classified into 3 categories: 1. Arkansas stones 2. India Stones 3. Ceramic stones
-should be cleaned after use to remove debris

Arkansas stone

-natural stone

-fine grit

-flat, wedge, cylindrical, conical shapes

-frequently used to sharpen scalers and curettes

-coat stone with mineral grade oil to float away metal shavings

-light recontouring or regular maintenance sharpening

What is sludge?

the buildup of oil and metal shavings that results from instrument sharpening

India stones

-synthetic stones

-fine, med, or coarse grit

-recondition worn/dull instruments

-water or oil can be used to lubricate stone

-does NOT build up sludge

Ceramic stones

-newest type

-synthetic

-fine or medium grit

-single or dual grit

-oil is not need for lubrication, can be used dry

-reconditioning dull blade edges

What must be properly aligned during instrument sharpening?

the terminal shank of the instrument (the area between the blade and the first bend of the shank)
**13/14 Gracey rounded terminal shank

How to determine sharpness?

-Plastic stick
-Visual inspection

When should you replace an instrument?

-original shape of instrument altered
-strength and integrity of the instrument compromised
-mark with red tape

Which hand will you hold the instrument with while sharpening?

non dominant

Which hand will you hold the stone while sharpening?

dominant hand

always hold the lower 1/2 of the stone, thumb on edge toward you to avoid cutting yourself

Sharpening work area

-flat counter/surface
-good lighting
-loupes
-stone
-lubricant (water or dry)
-cotton rolls
-plastic test stick

T/F: Light will reflect is the instrument is dull

True

During a plastic stick test a dull instrument will...

slide over the stick

During a plastic stick test a sharp instrument will...

grab/bite the stick, hear a ping

Steps to sharpening a scaler (right handed clinician)

1. Identify cutting edge
2. Lubricate stone if needed
3. Position terminal shank at 12:00, stone at 1:00 and have toe pointing towards you

When a stone is correctly placed against the blade,

the internal angle of is approximately 70 degrees

Technique for sharpening a scaler

Heel > Middle > Toe
ONLY the stone moves, NOT the instrument

Instrument sharpening devices

not recommended, can ruin instrument if proper angulation is not used

How to retrieve a broken instrument tip?

-Remain calm
-Maintain patient and operator position
-Immediately isolate area using cotton rolls or gauze
-DO NOT allow the patient to close, use air, use suction, leave the patient
-Request faculty intervention
-Visually inspect for fragment
-Use gauze to retrieve

If you can't see the broken instrument fragment

-examine sulci or pockets

If you cannot locate a broken instrument fragment

-take a periapical radiograph
-refer patient for chest x-ray