I have another dental quandary. Do you scale each tooth? Here is my routine....Health history check, blood pressure, ask if any teeth hurt, xrays, then I lay my patient back. I do an intra oral check then probe. After that I decide it I am using the Cavitron (ultrasonic) or hand scale. If Cavitron, I start in the buccal UR area and then go to palatal UL then, lingual LL then, buccal LR. Then I switch suction to the right side and to palatal LR to linguals of anteriors then buccal of UL to facial of anteriors. Then I do the buccal of LL then lingual of LR. Then I do the lower anterior teeth last.
If I hand scale I do the lower anterior teeth surfaces toward my non dominant hand then the upper anterior teeth. Then I move to 9 o'clock and do the surfaces toward my non dominant hand. Then I do the same sequence as above for the posterior teeth maximizing patient position and my clock position. It works for me. I go around each tooth and only activate a stroke if there is calculus there. But I do scale each tooth to some extent.
So my question is....if there is not a pocket and there is cementum exposure do you scale? I feel that if I do not touch and fake scale each tooth the patient would not think I did a good job and they would feel robbed. Especially when they are perio maintenance and it is $199 every 3 months. There is a retired dentist who used to be a hygienist that frequents my office. She used to own it but has not for 2 years. She is bored. Anyway I cleaned her teeth and she did not want me to scale everywhere. She also did not want polishing except on her coffee stain on the lower anterior teeth. She is a brilliant dentist. She knows her crap but she is a bit out there. So I am wondering if she is valid in her thinking or if she is just weird.
I have seen roots of teeth that are hour glass shaped because of all the scaling through the years. I try not to be that aggressive on that cementum but I feel I need to clean every where for the value of my service. Any insight?
5 comments:
So, yea I have no clue what you are talking about. I put the picture of grandpa on my visor in the van and look at it and now I am just smiling and not crying about it any more. I hope that Dan is kissing you now.
loves
As long as you don't have the death-grip on your scaler and you're not causing attrition(?) then I would scale every tooth. I always do. It's suprising how much junk I'll pull out interproximally when it looks clean. And still more comes out when I floss.
Patients who are spotless though are really hard, because it's like, they don't even need anything! I'll do a light scale and be done in five minutes and then it's like, what now? I temped for a dentist once in Phoenix who told me I had to take the full hour scaling every patient because that's what they were paying for. I gave him the death stare because I think that's ridiculous. He said patients feel like they're not getting their money's worth when you only scale for 20 minutes.
"Easy" patients were often the most difficult patients I had. They didn't need any lecturing and hardly any scaling. I have told a few patients that they can switch to one-year recall because they are so good with their homecare.
This probably doesn't answer your question, but it felt good to unload all that!
I hand scaled every tooth on every patient, but only used the cavitron if I think they needed it. If I used the cavitron I still handscaled every tooth. I know, I'm a freak but I couldn't take the chance that they were gonna tell me that it was a crappy cleaning!
Every bloody damn too, Mair!! Though I really use the ultrasonic a lot, A LOT!
tooth! My hand goes faster than my mind
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