Why does my hygienist recommend hand scaling?

These days, even a regular visit to see the dental hygienist is not quite as straightforward as it used to be. This is because modern dental hygiene procedures use high speed tools with water to shift plaque. Your dentist may recommend hand scaling as an alternative. Although this method may take a little longer and seem more old-fashioned, it is effective.

What is scaling?

As part of our oral care and dental cleaning, visits to the hygienist are an important part of our routine. An appointment with a dental hygienist usually involves a procedure called scaling. Scaling removes plaque from around the gum margins and other places where bacteria gather and adhere.

Removing plaque, hard tartar or calculus, is important to prevent gum disease and guard against tooth loss. A regular dental care routine of brushing and flossing stops plaque from building up and hardening into tartar.

What does an ultrasonic scaler do?

Dental hygienists usually use an ultrasonic scaler because it is easier for the patient to tolerate. At its tip, the ultrasonic scaler vibrates to gently ease away plaque. The scaler also delivers a gentle stream of water to wash debris away. The hygiene assistant uses an aspirator to suck away the excess water.

The combination of water and tools means ultrasonic scaling is classed as an aerosol generating procedure (AGP). Current protocols to control viral transmission and protect patients and staff from covid-19 necessitate full personal protective equipment (PPE), restricted surgery use and enhanced cleaning.

What can I expect from hand scaling?

The hygienist may recommend hand scaling as an alternative because it doesn’t create an aersol effect.

Hand scaling is the traditional method of removing plaque. It is an effective technique, but takes a little longer and the some patients find the feeling of having their teeth scraped by metal a little uncomfortable. If you want to maintain your oral health, however, this is a good way to reduce plaque and keep gums healthy.

The technique is straightforward. Using a small mirror, the dental hygienist selects from a range of hand scaling tools. Working systematically around the quadrants of the patient’s mouth, the hygienist cleans along the gum line, as well as the spaces between the teeth.

What about polishing?

Usually, after either ultrasonic scaling or hand scaling procedures, the hygienist polishes the patient’s teeth. Once the tartar or plaque has been removed,  the hygienist uses a slow handpiece with a round brush and some paste to polish all the tooth surfaces. This gives the patient’s teeth a lovely smooth, clean feel afterwards.

At the moment, a regular hygiene appointment with hand-scaling does not include polishing. Polishing creates an aerosol splatter and so the treatment can only be delivered with protective protocols in place for an AGP.

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