Inspect instruments before using:
Clean
Sterile
Good condition
Scalers need to be sharp to be effective
Stored correctly
Instrument Wear Over Time
Cutting edge can become narrow
Shape may become altered
Working end reduces in size
Instrument becomes weak
Discard instruments that are worn due to risk of fracturing whilst working in the oral cavity
Sharp Instruments
Enhance tactile sensitivity
Allow clinicians to work more precisely and effectively
Are safer - less risk of trauma to the tooth and soft tissues
Improves comfort for the patient
Sharp instruments improve technique
Easier to remove calculus - difficult to remove deposits with blunt instruments, takes longer, strokes less effective
Improved stroke control
Reduced number of strokes
Therefore:
Reduced clinician fatigue and an increase in work-related musculoskeletal disorders
Risk of fracture of instrument tip with blunt or over-sharpened instruments
Cutting Edge
Need to understand cross-sectional design of scalers
The cutting edge is formed by the junction of the face and the lateral surface
Overtime the metal cutting edge is worn and becomes rounded
Instrument with tungsten carbide tips can only be sharpened by the manufacturer
Checking the Cutting Edge:
Vision (has length but no width)
A sharp cutting edge is a line
A dull cutting edge will reflect the light
Cutting Edges
Sickle = triangle
Curette = Semi-circle
Tactile:
Feel by testing the instrument on a sharpening test stick
Sharpening Systems - Natural Stone
Arkansas - hard, quarried from mineral deposits and is used because of its fine abrasive particle size
Man-made synthetic- swallow Gleason and Dentsply
Hand held stones:
Flat
Cylindrical shaped
Electronic
Different systems are used in conjunction with oil, water or kept dry
Dynamics of Sharpening
Some suppliers provide a more abrasive stone to reshape instruments
Sharpening is accomplished by grinding the surfaces that form the cutting edge (lateral surface, face)
Know the shape of the instrument you are sharpening
Identify the cutting edges
Technique
Stationary stone, moving instrument
One hand hold a the stone, the other holds the instrument and it is this hand that moves
Pen or palm grip
Hold stone with one hand and the instrument with the other
Maintain correct angle of the instrument with the stone
No more than 3 strokes at a time
Check for sharpness and repeat if necessary
After Sharpening
Reshaping/recontouring
May need to reshape the back of a curette to maintain a smooth rounded back
Removal of metal bits/wire edge
Wire edge (metal particles) attach to the edge after sharpening and may gouge cementum if left
Remove with a light stroke using the cylindrical sharpening stone
Burs can be prevented by finishing with a down stroke if the sharpening stone towards the cutting edge
Common Sharpening Errors
Altering working edge design
Removing unnecessary metal
Sharpening only the tip and mid third of the working edge
Flattening a rounded cutting edge
Health and Safety
Instruments should be sterile prior to sharpening to prevent disease transmission
Stones and testing sticks should be decontaminated according to manufacturer’s guidelines
Once sharpened, instruments should be rasterised and package according to decontamination
Chair side Guide:
Stone always 110° position
Face of blade parallel to the floor
Toe pouting towards you
Graceys = 110°
Sickle/curette = 90°
Ash Sharpening Kit:
2x test sticks should - angle handle 45° to the stone to test the sharpness
Sharpening oil - lubricate the stone and carry debris
Sharpening rod - gives final edge to curved blades
Flat sharpening stone
Magnifying glass or x10 loupe
Getting started
Understand instrument shale and cutting edges
View/assess cutting edge in good light
Pen Grip or Palm Grip
Instructions
To begin sharpening, place the stone about 15cm in front of you and hold it with one hand to steady it. Sharpen with a flat stone on a level surface, to reduce the risk of cutting your hand should the instrument or stone slip, and make no more than 3 strokes at any one time; check and repeat if more sharpening is necessary
Dentsply recommend replacement when the blade js reduced by 50%
Sickle Scaler (H6)
Pen grip and place the blade flat to the stone
Angle the handle 45° to the stone
Push the instrument forward and back over the stone but apply pressure when pushing the instrument away
Test the tip for sharpness and remove any wire edge
Universal Columbia Curette (13)
Blades are 90° to shank
Pen grip and then the blade so that the hook faces the left. If viewed from the side, the curved portion toward the toe will face down
Angle the blade 30° to the stone
Move forwards and back over the stone, putting pressure on the pull direction and moving around the curve of the blade
Turn the blade over and change to the palm grip
Move stone to edge of the table and lower the handle angle to 10°
Move forwards and back, applying pressure to the pull
Test the tip for sharpness and remove any wire edge
Ensure toe has not become pointed (rework if necessary)
Gracey Dedicated Curette (9)
Blades 70° to shank
Pen grip, turn blade so hook faces the left. If viewed from the side, the curved portion towards the toe will face down
Angle the blade to 30° to the stone
Move forward and back, putting pressure on the pull and moving around the curve of the blade
Test tip for sharpness and remove any wire edge
Ensure toe has not become pointed (rework if necessary)