1. Use the lowest power setting needed to get the job done i.e. less is more! If you control your power setting you are more likely to be efficient and less likely to cause damage to the tooth tissue.
  2. Adjust the water so that it is a mist along with a drop every second. The aim is not to drown the patient.
  3. Pick the most appropriate tip for the tooth surface in question. Universal tips just aren’t that universal. You can use them just about anywhere in the mouth, but that doesn’t mean that they are the most effective tips. There are a number of different tip curvatures, thicknesses and lengths so do check out the range available.
  4. Scaling efficiency is significantly diminished with worn, damaged or bent tip inserts so audit your ultrasonic tips regularly. Ensuring your tips aren’t worn is as important as having sharp hand instruments. 2 mm of wear can result in 50% efficiency loss. Wear guides which are available from the manufacturer are helpful to determine how worn the tips are and if they need replacing.
  5. Tips should be activated prior to insertion into pockets i.e. press on that foot peddle before going into the pocket.
  6. Strokes should initiate at the gingival margin (rather than going to the depth of the pocket first as you do with hand instruments).
  7. Use a constant erasing type of motion or tapping stroke to remove tenacious deposits.
  8. Use a light grasp – this increases tactile sensation, allows the tip to move freely over the tooth surface, enhances patient comfort and reduces operator fatigue.
  9. In most cases, ultrasonics and hand instruments are considered to be equally as effective. However, ultrasonic scalers are considered superior to hand instruments in furcation areas largely due to the tip size (Drisko 1998).
  10. Don’t forget to check the surface on completion for smoothness and re-instrument if necessary.


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