DEN 101: EXAM 2 Instrumentation & Clinical Fundamentals

Instrument design & function

• A complex shank has multiple bends for posterior adaptation 

• An instrument is balanced when the working end is centered over the long axis of the handle 

• For tactile sensitivity, choose light, hollow, ribbed, or textured (knurled) handle

• The working end determines the instruments purpose (explorer, curet, scaler) 

• Angled shanks are generally used on posterior teeth

Fulcrum, adaptation, and activation

• Fulcrum provides control, prevents injury & improves precision

• Lower shank of a universal curet should be parallel to the tooth surface

• Exploratory strokes are light, controlled, and used to detect deposits

• Fulcrum finger acts as the pivot for adaptation & activation

Mirror & examination techniques

• Use a mouth mirror for indirect vision, illumination, and retraction 

• *A front surface mirror prevents double images (Ghosting) 

• *Cone shaped socket mirror allow replacement of mirror heads

• Palpation types:

  • Bilateral (opposite sides)- TMJ

  • Bimanual (same structure, two hands)- Tongue & glands 

  • Digital (One finger)- Tongue

  • Bidigital (Fingers & tumb)- Lips  

Explorers and scalers

• The 11/12 explorer is double-ended, paired, for posterior teeth

• Explorers’ fine shank & working end make it highly sensitive for detecting calculus

• 204 & Nevi scalers remove supragingival calculus on posterior teeth (triangular cross section, 2 cutting edges)

• Scaler cutting edge is formed where the face and lateral surfaces meet

• Maintain scaling angulation of 70-80 degrees for effective calculus removal

Curets, adaptation, and strokes

• Universal curets (EX: barnhart) used throughout the mouth, *Graceys are area specific*

• Adaptation: keep 1/3 tip of working end in contact with tooth surface

• Apply firm lateral pressure during scaling and light pressure during exploration

• Stroke detection: Vertical, oblique, and horizontal as needed

• Exploratory strokes are long & tight

• Working strokes are short & controlled

Probes & palpations

• The novatech probe design improves access to posterior teeth (right angle) 

• Probing measures from the gingival margin to the junctional epithelium 

• Follow a systematic exam sequence to avoid skipping areas 

Stroke & technique summary

• Exploratory stroke: light grasp & pressure

• Working stroke: firm grasp & lateral pressure

• Pull stroke: for scaling and calculus removal

• Push stroke: for probe insertion only

• Maintain adaptation by rolling/rotating the handle between the thumb & index finger