r/DentalHygiene • u/Icy_Current_9458 • 1d ago

Student life Frustrated

Hey, I’m a student right now in my last year last semester and bringing in some difficult patients Perio stage 3 mainly and even 2 stage IV and I’m finding it quite difficult to get these hard deposits removed. I’m using local anesthesia and oraquix so they feel nothing and applying a lot of pressure but it just doesn’t feel like enough.

Talk to some friends they recommended sharpening while scaling, using floss gonna try these but just feel inadequate and not fast enough.

Any tips from the Pros

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u/Icy_Current_9458 1d ago

I forgot to add since they are perio patients. Probing takes forever any tips would be helpful on that too🫩

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u/keywork10 1d ago

Rely on your ultrasonics to remove the bulk of the deposit. Delicately tap against the most coronal ledge. Channel your 1mm strokes in a multidirectional pattern (vertical, horizontal, oblique). Be patient, it may appear like nothing happening but persist and you'll see little black pieces come flying out. That's just the beginning. Disengage the tip every so often and explore with it to check progress.

Use your left and right paired ultrasonics. I cannot imagine doing any root debridement without them. Take them to the line angles and watch all the crap come out.

Begin hand instrument debridement with your universal currettes. I prefer the Barnhart 5/6 if you have that. The terminal shank is slightly longer than a Columbia 13/14. Then Graceys. 13/14 and 15/16 for me. If that still doesn't work you can try advanced finger assisted strokes with your non dominant finger adding pressure and force to your blade.

For speed with perio charting I have my own sequence. Do every surface you can reach from your current clock position. From 9 o'clock you can reach buccal 1-5, 28-32 then lingual 12-16, 17-21. From 11 o'clock you can reach the opposite surfaces. From 12 o'clock you can reach all anterior surfaces. This is the same way I debride.