Optimising non-surgical periodontal treatment


  Posted by: Dental Design      21st July 2020

As we look forward to dental practices re-opening, there are some new challenges to overcome. For example, many clinicians are aiming to avoid water jet instrumentation due to the issues surrounding aerosols and the potential risk of spreading infection. As such, we are tasked with minimising use of aerosols.

For non-surgical periodontal dental treatment, this means possibly putting down the powered instruments and going back to hand scalers.

Benefits of hand instruments

There are certain benefits afforded by periodontal hand instruments for both clinicians and patients. For example, treatment using these tools can be more comfortable for the patient – some people are sensitive to the water jet produced by power-assisted instruments. For some clinicians, hand instrumentation can offer better tactile sensation, and this may help contribute to the patient comfort.

Overcoming challenges

Like any dental treatment, there are some challenges to overcome when moving back to hand scalers, whether this is for the short- or long-term. For clinicians who prefer power-assisted solutions, it is important to familiarise yourself with the manual products in order to remember the technique and avoid the excessive pressure that can cause trauma to the tissues. These instruments require more attention and skill than power-assisted alternatives, but seeing as the vast majority of clinicians have been taught with both, it’s just a case of refreshing knowledge. In addition, many clinicians will use a combination of power and hand scalers in routine treatments, so the learning curve is pretty short if present at all.

Finally, the procedure can take a little longer with hand instruments, so it’s important to consider and offset the potential strain on the hands with regular breaks, effective scheduling and appropriate products.

Product selection

Selection of the right products is important if clinicians are to fully utilise the benefits and prevent the possible negatives of hand instruments. To compensate for the longer procedures, lighter and ergonomic products can have a significant impact on reducing hand strain and fatigue, so design is everything. A comprehensive range of hand instruments is available from LM including solutions for all angulations, positions and access points. Distributed by J&S Davis in the UK, the LM Gracey instruments are among my favourites with a curette for all tooth surfaces and areas of the mouth, as well as the LM ergonomic selection. With the LM instruments from J&S Davis, you get both the quality and support that you need. The products are long-lasting and comfortable – I am able to perform treatment for two hours at a time without any discomfort and I’m grateful to not have had any repetitive strain injuries in my hands over the last 20 years. In addition, the amazing support ensures we get prompt replies by email or even personal visits to the practice. To demonstrate my confidence in these solutions, J&S Davis has supported the training courses delivered through PerioAcademy for the past 7 seven years. The Academy offers an array of learning opportunities for clinicians to get up-to-date on the latest science and concepts in periodontology, including how to optimise non-surgical periodontal therapy – for more information, you can visit www.perioacademy.co.uk.

Top tips for hand scalers

Here are a few top tips to help clinicians optimise use of hand scalers in the weeks and months ahead:

  • Refresh your technique before going back to practice
  • Check your angulation depth to ensure the instrument goes deep enough and stays parallel to the tooth
  • Utilise the increased tactile sensation to develop your confidence in the procedure
  • Invest in high-quality, lightweight and ergonomic instruments that are flexible in terms of angulation
  • Access to a range of hand instruments is helpful to ensure you can effectively cater to different clinical indications


For more information on the industry-leading products available from J&S Davis, visit www.js-davis.co.uk, call 01438 747 344 or email jsdsales@js-davis.co.uk



Dr Hatem Algraffee BDS, MSc, M.Clin.Dent., MRD RCS, MFDS RCS

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