There is an instrument for removal of broken instrument tips. Schwartz Periotrievers.
Best way to prevent is to replace or retip when they become too thin. When it happens you’ll have to just explain to the patient and retrieve the broken piece.
Personally, I have never had an instrument break while scaling. Instruments tend to break when they are past due for replacement. So the key is to keep a close eye on your instruments and replace when necessary. Here is a good article regarding this: http://www.rdhmag.com/articles/print/volume-28/issue-4/feature/instrument-replacement-how-when-amp-why.html
If an instrument does break, obviously check the oral cavity to locate it. If you can’t find the broken piece, check the suction trap for it. If you still can’t find it, a radiograph may be needed to locate it. Always inform the patient of what has happened and document it. If you feel the patient has aspirated it, it may be necessary for the patient to be sent for a chest X-ray.
And an x-ray could help you find the piece right? Even if its pretty small?
Because I’ve had it happen and couldn’t find the small tip and took an x-ray and it was clear. Just a scary situation.
An X-ray should help find it, assuming it is in the tissue. If the radiograph is clear, I would think its not lodged in the tissue. Biggest thing is to stay calm and rational if it were to ever happen again. Because yes, it is very scary!
This happened to me while I was in school – while I was cleaning a friend. He was a nice guy but he hadn’t had a cleaning in about 30 years and had super tenacious calculus.
I was trying to remove an extra stubborn piece of calc and the tip of my instrument just snapped off. I didn’t use the suction and then explored to try to find the tip – nothing. We took x-rays – nothing. We learned that we would have to go to the emergency room for a chest x-ray to make sure the patient hasn’t aspirated the tip, but my school’s dentist came over and told my patient that he probably swallowed it and to listen for it to hit the bottom of the toilet when he went to the bathroom the next morning. It was a funny end to a scary situation. Also, I wrote up my chart to show that the dentist had been notified and personally dismissed the patient. My patient still jokes about this situation!
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