The cutting edge of dental instruments
Instrument sharpening is a bit like marmite - you either love it or hate it - but as G. V. Black so famously said all those years ago: ‘Nothing in the technical procedures of dental practice is more important than the care of the cutting edges. No man has ever yet become a good and efficient dentist until after he had learned to keep his cutting edge sharp’.1Get more news about
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This statement made in 1908 still holds true and is as relevant to the dental profession today as it was then. I am sure we are all aware of the importance of maintaining our instruments – after all keeping them sharp is a problem we all face on a daily basis. But just why is it so important?
Well, although powered devices (sonic and ultrasonic) are widely used today (because they are quicker and brilliant at dispersing the biofilm), scalers and curettes still command a prominent role in periodontal therapy. Traditionally such treatment consists of two phases:
Indeed, efficient and thorough scaling, particularly on infected root surfaces, can only be optimally performed with sharp instruments – good scaling doesn't just depend on the operator's skill but also on the quality of the instrument in use.
The good news about instrument sharpness is that it is a variable the clinician can control. The bad news is that it can be an exacting, time consuming and often frustrating procedure. The strange thing is that basic sharpening principles and techniques are much better understood in other walks of life. I'm sure we all know how to sharpen a carving knife and I bet we'd be horrified to think our hairdressers didn't take the time to sharpen their scissors, but still the uncertainty surrounding our relatively simple dental application seems fairly incongruous.
Unfortunately, these objectives are not always met. This is partly because sharpening techniques are not easy to learn and require skill and practice to accomplish. However, once you get the hang of it you'll find that your instruments will reward you with a long trouble-free working life.
Instrument sharpening can be performed by hand using sharpening stones. It's well worth familiarising yourself with each instrument's individual characteristics for more instruments are worn out from incorrect sharpening than from overuse. Generally it's all about getting the correct angle of the instrument on the sharpening stone.2 During sharpening there must be a sufficient source of light in the working area and good stability of the stone and the instrument. Table 1 is a comprehensive guide to all the bits and bobs you'll need.