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Doing away with hand scaling?!

I have been practicing for 5 years and my DDS told me he wants to do away with all hand scaling because he says it’s quicker to use the Cavitron. I told him I don’t think that’s a good idea and that I will not be a “Cavitron only hygienist.” I explained to him that is not what I was taught, or the way I practiced at my previous job. I am not sure if he will end up going through with this, but what are the thoughts of others on this? Hand scaling is always needed following the use of a Cavitron/Piezo, right?



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11 Answers

Absolutely handscale after using the ultrasonic. Evidence-based techniques are what we must abide to! You must remember, dentists have under 300 hours of periodontic training whereas hygienist have almost 3,000 hours. If you know something to be correct, and have evidence to support it, don’t let someone “trying to save time” make you do something you feel uncomfortable with! Thorough patient care is number one!

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YES! I always handscale after using the ultrasonic. You need the tactile sensitivity that hand instruments provide in order to be sure all surfaces are smooth. Sure cavitron only is “faster” but what good is faster if there is still calc left behind? Some drs just don’t understand…

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You absolutely must fine scale by hand after cavitron…I would not be happy with him micromanaging my operatory patient time…I would definitely express that that is not the standard of care and not adequate alone…I would also not eliminate hand scaling nor risk losing skills by doing sub par work…both are important…maybe drop some literature on his desk…he needs it šŸ™‚

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I will always follow up with hand scaling, although the US has great benefits, so does hand scaling.

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Unless you are adept at scaling with the advanced ultrasonics and have taken those courses I would suggest that you always perform hand scalings especially after using an ultrasonic. Personally I need to really feel and use my tactile senses. With the curets I can do this much better than with an ultrasonic. Also one MUST hand scale compromised patients.

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I totally agree with DebbieG. He doesn’t need to be telling you how to do your job, you already know what to do! As long as you are completing the patient within his timeframe, he doesn’t need to worry about what you’re doing. Keep on hand scaling, it’s totally necessary. And I do like Debbie’s idea of dropping some literature on his desk! šŸ™‚

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Agree with all the above…in addition: What would he want you to tell pts when they ask why you didn’t hand scale? Pts notice these things and will not appreciate not having their teeth fully clean. There’s no way all calc can be removed from crowded lower ant without hand instruments. With all that “time saved” by skipping the hand scaling, does he plan on cramming an extra pt into your schedule? I feel so fortunate with a Dr. who leaves me alone and knows I have more expertise on the subject than he does!

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I can’t imagine not hand scaling after using the ultra sonic. How would the doctor like his prophy without hand scaling?

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I use ultrasonic and then use my hand instrument as an explorer and go around once more and if I find calculus etc….. I scale it off. Kara makes a great point if evidence based dentistry. Are you running way behind? Or is he just try to control you?

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Listen to everyone here! Hand scaling is a must after cavitroning!

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I also could not imagine not hand scaling after ultra sonic. I also do not use ultra sonic on everyone. Is your dentist anticipating shortening you time with patient/

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