Steps to the Complete Prophy Flashcards
What are the steps to complete a prophy?
The oral cavity is evaluated Large pieces of calculus are removed The periodontal area is probed for pocket depth Subgingival calculus removal Detection of missed plaque & calculus Polishing Sulcus irrigation & fluoride treatment Application of a sealer Periodontal diagnostics Final charting Home care
Who makes the decision to administer antibiotics?
The veterinarian
Are antibiotics indicated for healthy patients with periodontal disease?
No
When are antibiotics indicated?
For patients with compromised health conditions
Why are mouth gags not used for more than a few minutes?
It causes overextension of the mandible. Which may lead to stretching and tearing of the ligaments & muscles of the jaw
What should be used instead of a mouth gag?
The mouth should be propped open with the nonworking hand
Why is the first step in a prophy a complete evaluation of the oral cavity?
Some patients may not allow this examination at all or only for a brief time
What are hand scalers used for?
Supragingival removal of calculus
Where should hand scalers not be inserted?
Below the gumline
What are scalers particularly effective in removing?
The calculus from the developmental groove of the fourth premolar
What stroke is used to remove calculus?
A pull stroke
A stroke pulling the calculus toward the coronal aspect
What is a fairly quick method for removing supragingival calculus?
Calculus removal forceps
What part of the calculus removal forceps is placed over the crown, and which part is placed under the calculus?
The longer tip is over the crown & the shorter under the calculus
When is the calculus is cleaved off the tooth?
When the tips are brought together
When using the calculus removal forceps, the operator should be extremely careful not to do what?
Damage the gingiva
Create an iatrogenic slab fracture
Ultrasonic or sonic scalers are used to quickly remove what?
The smaller deposits of the supragingival calculus
What do the ultrasonic scalers vibrate in the range of?
18,000 to 45,000 cycles per second
What should be used for supragingival scaling?
The side of a beavertail tip rather than the tip
How should the ultrasonic instrument be grasped?
Lightly, not tightly
Feel balanced with minimal pull from the handpiece cord
What must be allowed to do the work?
The handpiece, not the hands
Where is the handpiece is balanced?
On the index or middle finger
Where may the handpiece cord be looped to decrease stress on the hand from its pull?
Over the little finger
What is required to prevent overheating of the teeth and damage to the pulp?
Water flow
With what tip is an ample supply of water irrigation necessary for irrigation?
The board-based, beaver-type inserts
What helps provide a water supply and thereby ease the insertion of the tip in the sulcus?
Turning on the handpiece before insertion
How much pressure should the operator use when using ultrasonic or sonic instruments?
A light touch
Keep the tip moving while traveling around the circumference of the tooth
Not stopping in any area
Do ultrasonic and sonic instruments need cutting edges?
No, unlike hand instruments
What part of the tip should be held parallel to the tooth surface, what should not be pointed at the tooth surface?
The side should be held parallel, the tip should not be pointed at the tooth surface
What does a curved shank allow for?
Working around a crown or in a furcation
What steps does the ultrasonic technique include?
Sweeping cross strokes
Work in various directions
Use oblique or corkscrew tips to reach furcations
Avoid pressing the scaler tip on the tooth surface too hard
DENTAL
Digits Engage Neutral Technique Adaptation Light touch
What position is useful for maxillary posterior teeth?
An extraoral finger rest
Fingers should rest on the teeth for maxillary anterior & mandibular areas
A stable fulcrum is not always necessary
Engage
Activate the tip of the instrument & direct the tip subgingivally
Water lavage will facilitate a comfortable entry into the sulcus
Neutral
A balanced instrument grasp
The instrument should feel balanced in the hand with no pull from the cord
Use a light pen or modified pen grasp
Technique
Brush away the calculus
Using sweeping cross strokes
Adaptation
Ultrasonic & sonic instruments are active on at least two sides when in contact with the tooth surface
The side of the tip is held parallel to the tooth surface
The end of the tip should not be adapted to the tooth surface at a 90-degree angle
Light touch
Apply extremely light pressure
What settings should be used for the broad-based, beavertail-type tips?
Higher power settings
What should the power setting be decreased to when thin subgingival tips are used?
Lower settings
What does failure to decrease the power setting cause?
Fracturing of the tip or render it ineffective because the tips are manufactured to operate in optimal frequency ranges
Rather than scaling teeth, rotary scaler burs, end up doing what to calculus, and leading to a periodontal abscess?
Burnishing calculus
What should be used to measure the depth of the sulcus or pocket?
A periodontal probe
How should the periodontal probe be held for an accurate reading?
Parallel to the long axis
What does holding the probe at an angle result in?
An inaccurate measurement
If the marginal gingiva is at the normal cementoenamel junction, the probed depth will correspond with what?
Attachment loss
If a previous recession of the gingiva has occurred and the marginal gingiva has moved apically, the pocket depth will be less than what?
The actual loss of attached gingiva
What happens if gingival hyperplasia and a pseudopocket are present, the probed depth will be what?
Greater than the actual attachment loss
When charting, what is the recommended order?
Buccal of right posterior maxilla
Lingual of the left posterior maxilla
Lingual of left posterior mandible
Buccal of the right posterior mandible
What should be used to remove the calculus below the gumline?
A curette or select ultrasonic scaler
What should be used to scale and remove calculus below the gumline?
Ultrasonic scalers with subgingival tips
What is an extremely important part of the dental procedure?
The removal of subgingival calculus
What is the preferred method for holding hand instruments?
The modified pen grasp
Where are the thumb and forefinger placed on the instrument with a modified pen grasp?
At the junction of the handle and shank of the instrument
When using a modified pen grasp, where is the ring finger placed?
Held straight and placed on the surface closest to the tooth being worked on.
What is adapted to the tooth root surface?
The curette
What happens if the instrument does not fit the curvature of the tooth?
The opposite end of the instrument is adapted
What position is the closed position?
The face of the curette should face the root surface as it is inserted into the pocket
What position is the open position?
The instrument is moved over the calculus and then repositioned so that the cutting surface is under the calculus ledge
What is used to evaluate the tooth surface while checking for subgingival calculus?
An explorer
What are two techniques used to detect plaque and calculus?
Air-drying
Application of disclosing solution
Why should air-drying not be used if the integrity of the periodontium is in question?
Because air being blown into tissues can be trapped in the subcutaneous tissues or possibly enter the bloodstream
What are the use of a proxy angle and abrasive paste?
Mechanical polishing
What does polishing with an electric or air-powered polisher do?
Removes any plaque that may have been missed and smooths the tooth surface
What is the most economic means of making prophy paste?
To mix flour pumice with a slight amount of water
What speed are teeth polished with?
3000 to 8000 rpm
What does air polish use?
Air, water, powder projection
What are the advantages of air polishing when compared to a mechanical polisher?
Faster and less demanding Reducing the operator’s hand fatigue Less abrasive than abrasive pastes No production of heat Gives better access to the teeth No direct contact with the dental surface
What are the disadvantages of air polishing when compared to a mechanical polisher?
More expensive
Can be messier
What flushes out trapped debris and oxygenates the intrasulcular fluids?
Gentle irrigation
Should the full-strength disinfectant chlorhexidine that is commonly found in veterinary hospitals be used?
No
What are the two types of sealers available?
Sanos
OraVet
Why should radiographs be taken?
To evaluate the dental and bony structures for periodontal bone loss, root canal disease, other conditions
What is the last step to complete prophy?
Home-care instruction
