Types of Instruments

Classification of Periodontal instruments

*For our purpose, this classification of periodontal instruments is good enough despite the fact that we can diversify the umbrella even more into root surface planning instruments and surgical instruments but for simplicity sake, I'm going to include universal curettes under scaling instruments and not under a category of their own because... classification into 3 groups makes it a little easier for you to remember. 

Dental Mirrors

Dental Mirrors are iconic instruments of a dentist or dental healthcare professionals for that matter. When we see a dental mirror, we would intuitively think of the dentist and for the more informed, dental hygienists/therapists as well just like when we see a dental chair/burrs/probes.

Their function is primarily to provide vision in indirect vision situations as well as to reflect light onto the tooth surface where direct light does not reach. They are also used for retraction of oral anatomy.

The basic dental mirror is part of most dental kits.The "working end" of the dental mirror is the head which can come in various standard sizes.

• Size 1 : 16mm
• Size 2 : 18mm
• Size 3 : 20mm
• Size 4 : 22mm
• Size 5 : 24mm

There are different types of mirrors for different situations

1) Flat surface - accurate sized images

2) Concave - magnified images produced

3) Double sided - for simultaneous retraction of lips/ cheeks and indirect vision

Probes

There are many different types of dental probes: Straight, william's WHO/BPE, Naber's, CPITN etc. And they can be classified into Explorer probes and Periodontal probes. 

• Explorer probes: These can be either straight or curved and they possess a sharp end which aids in tactile feedback in detecting carious surfaces and irregular restoration margins. In a periodontal setting, curved probes such as the Naber's probe are commonly used to diagnose furcations and detect the presence of calculus on root surfaces. Straight explorer probes are generally used for diagnosing dental caries and irregular restoration margins. 

Straight Explorer Probe

Naber's probe

• Periodontal Probes: There are many different types of periodontal probes but their main purpose is to measure to detect loss or gain of attachment of periodontal tissues.

The rationale behind measuring loss or gain of attachment is to assess the extent of periodontal disease and treatment effectiveness. To aid in this, Periodontal probes have different markings to indicate depth. 

So far in our Periodontology course, we have come across these 2 Periodontal Probes. 

• WHO/BPE Probe (Basic Periodontal Examination)
• Markings
• 0.5mm 
• 3.5-5.5mm
• 5.5-8.5mm
• 8.5-11.5mm
• Used for BPE - screening
• Assess calculus
• Walking steps
• align instrument parallel along the long axis of the tooth and go around the tooth

• Williams Probe (6-point pocket chart)
• Markings
• 1 to 10mm
• 4 & 6mm missing to aid reading
• Used for 6 point pocket charting and full periodontal charting+Diagnostics

Scaling Instruments
Scaling instruments can be classified into manual and powered scaling instruments. I would consider root surface debridement instruments under scaling instruments for there is overlap of the usage.
For example, curettes and powered sonic/ultrasonic scalers are utilised for both supra-gingival and sub-gingival scaling. Here, I will run through the general characteristics and common types of scaling instruments.

Sickle scalers

• Sickle scalers have working ends which contain tips. 
• They can have complex or simple shanks 
• Supra-gingival scaling only
• Face of working end is @ a 90 degree angle to the lower shank

So the types of sickle scalers we have in our Barts Kit would be 

1) SE H6

2) SE H7

The SE H6 has a complex shank, (used for posterior teeth) Bended to the right when tip facing you

The SE H7 also has a complex shank (used for posterior teeth) bended to the left when tip facing you

Curettes

• Curettes have working ends which contain toes 
• They can have complex or simple shanks 
• Supra-gingival + Sub-gingival scaling
• Face of working end is @ a 90 degree angle to the lower shank

The curettes we have in our kits are

1) 2R/2L Columbia

2) 4R/4L Columbia

3) 13/14 Columbia

The 2R/2L and 4R/4L both have straight and complex terminal shanks respectively and can be used for both supra and sub-gingival debridement. The former is used for anterior teeth whereas the latter, posterior. 2R/2L has a longer terminal shank compared to the 4R/4L.

2R/2L

4R/4L

The 13/14 Columbia has a shortened complex terminal shank which is used for both supra and sub-gingival debridement and can be used for both posterior and anterior teeth. 

Columbia 13/14