Pre-clinical Periodontal Instrumentation: General Instructions/Dos and don'ts
TLDRProfessor Laura Mattingly from the University of Detroit Mercy School of Dentistry provides an in-depth overview of clinical criteria and techniques for dental instruments in the DPE 8111 periodontics course. She emphasizes the importance of correct chair positioning, with knee height alignment and nose-toes alignment for patient comfort. The professor demonstrates proper instrument handling, including modified pen grasp and positioning based on whether working on the maxillary or mandibular areas. She also stresses the significance of maintaining a neutral wrist position to avoid fatigue and potential injury. Mattingly covers general rules for instrument positioning relative to the tooth, such as handle parallelism and terminal shank alignment, and advises on light lateral pressure to prevent damage to the tooth. She concludes with do's and don'ts for maintaining the cutting edge at an optimal angle and ensuring patient comfort throughout the procedure.
Takeaways
- 📐 **Chair Positioning**: The chair should be at knee height and positioned so that when the dentist sits, their chair bumps into the patient's chair, ensuring proper access to the maxillary area.
- 👐 **Hand Position**: For maxillary instrumentation, the palm should be up, and for mandibular, the palm should be down, which helps in maintaining the correct instrument angle.
- 🔄 **Terminal Shank Alignment**: The terminal shank of the instrument should be parallel to the tooth for posterior areas, and the handle should be parallel to the terminal shank and tooth's long axis for anterior areas.
- 🧍 **Posture**: Maintain a neutral wrist position and sit straight up, bending forward from the pelvis to avoid fatigue and reduce the risk of carpal tunnel syndrome.
- 👀 **Visualization**: Look through the bottom of your glasses to see well and adjust the patient's position to improve visibility without straining your wrist.
- 📏 **Instrument Grasp**: Use a modified pen grasp to hold the instrument, which is a common technique for better control and precision.
- 🚫 **Avoid Overextension**: Do not overextend the wrist when trying to access hard-to-reach areas; instead, adjust the chair position to maintain a neutral wrist.
- ✋ **Wrist as a Guide**: Use your wrist position as a guide to determine the correct seating position, as a neutral wrist indicates proper ergonomics.
- 🦷 **Light Pressure**: Apply very light pressure when scaling, treating the tooth as delicately as an eggshell to prevent damage.
- 🔧 **Fulcrum Use**: When instrumenting, use a rocking motion on the fulcrum for better control and to prevent applying excessive force on the tooth.
- 📍 **Chair Position Codes**: Instead of memorizing chair positions by code, left-handed individuals can follow their wrist's natural position to find the correct chair position.
- ↕️ **Adjustable Headrest**: Adjust the headrest as needed for better access to different areas of the mouth, such as the mandibular lingual.
Q & A
Who is the speaker in the provided transcript?
-The speaker is Professor Laura Mattingly from the University of Detroit Mercy School of Dentistry.
What is the course being discussed in the transcript?
-The course being discussed is DPE 8111, which is the periodontics course.
What is the significance of the knee height in relation to the chair position?
-The knee height is used as a reference point to determine the correct height of the dentist's chair, ensuring it is at a comfortable level for the dentist to work without straining.
What is the rule for the position of the nose and toes when a patient is in a supine position?
-When a patient is in a supine position, their nose and toes should line up, which is an indication of the correct positioning.
What is the recommended grasp for handling dental instruments?
-The recommended grasp is the modified pen grasp, which is a technique used to hold dental instruments effectively.
What is the correct orientation of the palm when instrumenting the maxillary?
-When instrumenting the maxillary, the palm should be facing up.
What should be the orientation of the terminal shank when scaling the posterior teeth?
-The terminal shank should be parallel to the tooth being scaled for posterior teeth.
How should the dentist adjust their chair position if they are left-handed?
-If the dentist is left-handed, they should follow their wrist as a guide to find the correct chair position, ensuring that their wrist remains neutral.
What is the importance of maintaining a neutral wrist position while using dental instruments?
-Maintaining a neutral wrist position helps prevent fatigue and the risk of carpal tunnel syndrome, and it also ensures that the instrument is used accurately and effectively.
What is the recommended way to position the patient when instrumenting the mandibular lingual?
-The patient should be turned towards the dentist, and the dentist should use their wrist to guide the positioning and ensure they can see the area clearly.
What is the proper way to position the handle of the instrument in relation to the tooth?
-The handle of the instrument should be parallel to the long axis of the tooth to maintain the cutting edge at the correct angle and to apply light pressure on the tooth surface.
Why is it important to avoid bending the wrist excessively while performing dental procedures?
-Excessive bending of the wrist can lead to fatigue and increase the risk of carpal tunnel syndrome. It also may compromise the accuracy and effectiveness of the dental procedure.
Outlines
😀 Introduction to Dental Instrumentation Techniques
Professor Laura Mattingly introduces herself and outlines the general and specific criteria for using dental instruments in the DPE 8111 periodontics course at the University of Detroit Mercy School of Dentistry. She emphasizes the importance of correct chair positioning, which should be at knee height and adjusted so that the dentist's chair bumps into the patient's chair. The professor also discusses the correct hand positioning for maxillary and mandibular instrumentation, highlighting the modified pen grasp technique. She stresses the significance of keeping the terminal shank parallel to the tooth and maintaining a neutral wrist position to prevent fatigue and injury. Additionally, she provides tips on how to find the correct chair position by following the natural positioning of the wrist and ensuring the palm's orientation is correct based on the area being worked on (maxillary or mandibular).
📐 Proper Instrument Handling and Patient Positioning
The second paragraph focuses on the correct handling of dental instruments and patient positioning for effective dental procedures. Professor Mattingly explains the importance of keeping the instrument handle parallel to the long axis of the tooth to maintain the optimal cutting edge angle of 75 to 85 degrees. She cautions against applying too much pressure to prevent damage to the tooth, likening the delicacy required to handling an eggshell. The use of a mouth mirror and lip retraction for better visibility is also covered. The summary concludes with a reminder to keep the instrument handle parallel to the tooth and to use light pressure, reiterating the importance of these techniques for a successful clinical assessment.
Mindmap
Keywords
💡Preclinical faculty
💡Periodontics
💡Chair position
💡Modified pen grasp
💡Terminal shank
💡Supine position
💡Lateral pressure
💡Fulcrum
💡Carpal tunnel syndrome
💡PPE (Personal Protective Equipment)
💡Skills assessment
Highlights
Professor Laura Mattingly is discussing general and specific criteria for dental instruments in the DPE 8111 periodontics course at the University of Detroit Mercy School of Dentistry.
Chair position is crucial, with the bottom of the chair at knee height and the chair bumping into the patient's chair to ensure proper positioning.
When the patient is in a supine position, their nose and toes should line up for proper alignment.
Modified pen grasp is used for instrumentation, with palm orientation changing based on whether maxillary or mandibular work is being performed.
Terminal shank should be parallel to the tooth for posterior scaling, and handle should be parallel to the terminal shank and tooth's long axis for anterior work.
Using the wrist as a guide can help determine the correct chair position and maintain a neutral wrist position to prevent fatigue.
Proper seating position involves sitting straight up with ears over shoulders and bending forward from the pelvis.
Instrumenting at tooth number eight requires rocking on the fulcrum to apply the blade accurately and avoid fatigue.
Adjusting the headrest and watching the wrist position is important when switching between maxillary and mandibular instrumentation.
Maintaining a neutral wrist position is key to finding the correct chair position and maintaining proper posture.
Looking at the bottom of the glasses and bending forward can help with visibility during the procedure.
The handle of the instrument should always be parallel to the long axis of the tooth to maintain the cutting edge at an optimal angle.
Light lateral pressure is recommended, treating the tooth as delicately as an eggshell to prevent damage.
Retracting the lip with the mirror hand can improve visibility during the procedure.
Avoiding overextension or bending of the wrist is crucial to prevent fatigue and the risk of carpal tunnel syndrome.
Chair positions should be adjusted based on the needs of the procedure, rather than trying to do all work from a single position.
Following the natural guidance of the wrist can lead to the most effective and comfortable chair and instrument positioning.
The importance of maintaining proper personal protective equipment (PPE) is noted, although not demonstrated in the video for the sake of clarity.
Transcripts
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