Setting the Table for a Dental Hygienist

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Closeup of a butler or waiter in a tuxedo setting a formal dinner table

Sure, this waiter knows what he’s doing as he’s setting that table for dinner, but I can admit that I have a borderline panic attack when I show up to a wedding reception and see that it’s a formal sit-down dinner with half the kitchen drawer at my place setting. That’s why I’m a big fan of chopsticks. And cereal.

Emily Post would have had a field day with all of the instruments in a dental hygiene cassette.

Angie holding a tray of dental tools in the sterilization room

A dental cassette is just what we call the tray of torture tools readied for use by your hygienist – just like the tray Angie is holding here in this photo.

So, in just the same way that etiquette dictates the need for a separate knife for bread, fish, salad, and steak, a dental hygiene cassette contains everything they’ll need to ensure your cleaning appointment goes well (and goes as quickly as possible).

No Sporks Allowed

closeup of a dental cassette

Just like you won’t find a spork at a formal place setting, there is no equivalent of a spork in the teeth cleaning world, either. If you’ve ever been camping, you may have tried to hack your way through a crusty loaf of bread with a butter knife, or spread said butter on a piece of it with a stick, one that would actually be really good for roasting marshmallows. It’s all do-able, but there is something to be said for having the right tool for the job.

Mindy, Karey and Angie use different tools when they are cleaning your front teeth (anteriors), your back teeth (posteriors) as well as cleaning the various surfaces; mesial (the in-between, front facing surface), distal (the in-between, back facing surface), lingual (tongue side), or buccal (cheek side) of your teeth.

Furthermore, it takes a variety of “silverware” to finish the job, depending on what’s being scraped off, i.e. simple staining and fuzzy plaque versus the super hard stuff (tartar) that feels a bit like trying to chip off cement.

And what about the occlusal surface (that’s the top/crown part of your tooth responsible for mashing up food and making it digestible)? Let me just say this; if we have to use instruments to scrape stuff off of the top of your teeth, then I submit that you don’t actually own a toothbrush.

Dental Hygiene Tools

There is a broad variation on the “working” end of dental hygiene instruments, based entirely on their usage. This includes differences in:

  • toe and tip length – how far it has to reach
  • angulation – the ability to go around teeth
  • cutting edges – largely depends on how “caked on” things are
  • working strength – see previous “caked on” comment
closeup of dental hygienist tools

Many instruments that are used to go below the gum line are designed with shorter, thinner working tips which enable access to the deep and narrow crannies of your gums, otherwise known as the ‘popcorn kernel black hole.’

Hygienists have several dental tools in their arsenal so that they’re sure to have the right tool for whatever job needs to be done. All of the dental hygiene hand instruments can be divided into two main categories; tools for assessment and tools for treatment.

Assessment Tools

Assessment tools include a mirror – to see what’s going on (and it also doubles as a tongue wrangler), as well as the periodontal probe/explorer, which is used to measure how deep your pockets (gums not bank accounts) are. We don’t actually do anything in a dental office without a probe and explorer twirling in our fingers (or in your mouth).

Probes are marked in millimeter configurations so that we can get an easy measure on your gums. They are most commonly made from stainless or carbon steel metal, although some companies are now offering plastic probes that are specifically for implants.

If you flip a probe around, the other end looks a little like a sheep herder’s crook (this is the analogy that my right-brained wife uses). The ‘crook’ is the “explorer” part, and it has a flexible wire-like working end thats job is to feel out rough edges, tiny particles or tacky areas that are the start of decay by transmitting vibrations. It’s the equivalent of having me stick a finger in your mouth and feel your teeth for bumps and irregularities – without actually doing that, because that would be gross, and it might make you gag.

Treatment Tools

Treatment instruments are made up of ‘sickles’ and ‘curets’ and they all look pretty similar at first glance. What differentiates an instrument immediately is it’s “shank,” or the ‘arm’ of the tool that the scraper is attached to.

Business in the Front, Party in the Back
Shanks can be either ‘simple’ (straight) or ‘complex’ (angled). For the most part, a simple shank is designed to be used on areas that are easy to access, like your front teeth, which have 4 simple, relatively straight planes while more complex shanks are designed to be used on areas that aren’t easy to access, like your back teeth.

A hand instrument with a complex shank (or angled shank) is designed for the nooks and crannies around your teeth that are harder to access, which generally tend to be in the back. Obviously, this is where the length and strength of a shank arm becomes important.

An extended shank is designed to access deep pockets around the gum line.

Flexible and thinner shanks give more tactile feedback to the hygienist and can remove the finer deposits as well as slip between your tooth and gum tissue to get at the roots.

A rigid and thicker shank is used to remove the heavier deposits of tartar.

Area specific curets have a tilted end in relation to the shank which enables the the whole instrument to remain parallel to the tooth’s surface. Each area specific is designed so that it easily adapts to the difference in curvature between your front and back teeth, as well as the four surfaces of your tooth. These instruments are used with a gentle push or pull stroke – in whatever direction that gets the job done.

A universal curet is the ‘steak knife’ of a hygiene cassette; it’s versatility means that it can be used on both posterior and anterior teeth. It has a rounded back and toe, and two cutting edges (like a sword) which means less finger gymnastics. We also like to make sure those cutting edges are nice and sharp because this means less time in the chair for you because there’s less time and effort needed to remove build up.

closup of our ultrasonic scaler

Finally, the last nifty piece of technology we have in our hygiene toolbox is the ultrasonic scaler. Do you ever come in for your 6 month check up and feel like you’ve had a facial thrown in? That means you’ve had a ‘dental power wash.’

This is the most effective way of blasting off stubborn tartar and calculus (‘calcified bacterial products’- ewww!) with water, and also one of the best ways of preventing gingivitis. Try it next time you come in!
You can also learn more about the dental equipment we use here at Drews Dental.

Hopefully you enjoyed my theories on silverware and my explanation of the basic tools in our hygienists’ arsenal (aka the dental cleaning cassette). You might not be able to set a table worthy of a dinner at Downton Abbey, but you might be a tad less afraid of your next dental cleaning appointment. And, let me assure you that Mindy, Karey, and Angie all know their salad fork from their dinner fork and their dessert fork and getting an appointment with one of them is as simple as giving us a call at (207) 782-5308 or contacting us online.

Dental school taught me all about dental ‘silver ware’, however, to this day, I still have bad flashbacks when it comes to setting the table. At least that’s what I tell my wife.

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