I have met some pretty difficult calculus. My tricks are using the very tip of the US and “tapping” at the edge of the deposit. Another is files, they can usually break up the deposit. Make sure your instruments are as sharp as they can be.
Don’t be too hard on yourself, I think some people must eat glue with their cereal in the morning, with how tenacious their calculus can be.
I did have one patient, one of my favorites, that I saw for years and there was calculus on the distal of #19 that just refused to give up the battle. I would always take a BWX at the end of appointments to see that I had gotten what I could. I just kept a close eye on that area and the patient was terrific about being extra fastidious there with her home care. Her pocket never increased so we were doing something right.
Keep your chin up!
Oh yes I think we have all had this challenge. ..sometimes its just a matter of finding what instument tip is going to finally kill it… 🙂 Hang in there!
Parkell has a great insert that I break out for tenacious calculus. I’ve had three patients in the past twelve years that I felt defeated. It felt like the calculus was growing back as soon as I removed it there was more…….. Just know it’s gonna happen. We stay calm and hygiene on!
Link: http://www.parkell.com/Products/341/Burnett-Power-Tip-and-Burnett-Soft-Grip
As the other hygienists suggested, don’t be hard on yourself. We do the best we can and move on. It happens. It’s normal. Remember there is a patient attached to that calculus:)
I do the best I can and send them for osseous. The periodontist can take the remainder off when he flaps the tissue.
Thin ultrasonic tip constant back and forth up and down motion over the deposit. It will eventually break up! If that fails gently tap the edge until it pops off. Ive been in hygiene 13 years and I find I live and die by my ultrasonic for tenacious calc!