Dental InstrumentsMr. Caputo Unit #1 Lesson #3

Today’s Class• Driving Question: How can a dental assistant identify

instruments being used during a procedure?

• Learning Intentions: We will be able to state the names, features, and functions of various dental hand and rotary instruments.

• Anchor: During a dental visit what does the instrument set-up look like? Explain

Introduction to Unit #1• This unit the student is introduced to dental instruments, both

hand and rotary. Dental hand instruments may all appear different, but they all have the same basic components, whereas the working ends are designed to meet the various functions. Hand instruments are identified by instrument number formulas. Rotary instruments, including handpieces, burs, and attachments, are designed for different purposes. Burs, like hand instruments, have a basic design and are identified by numbers. Because there are so many different instruments, dental offices must practice a method of instrument organization. Preset trays, cassettes, and tubs are all used to increase efficiency in instrument care, storage, and use.

Introduction to Unit #1• The upcoming lessons focus on the form and function of

dental hand instruments. Hand instruments have three basic parts, the handle, shank, and working end. Each working end is different. To help identify the instruments, a three- or four-number formula created by G.V. Black is used. Hand instruments are also categorized by function, including examination, operative/restorative, and adjunctive. Every procedure tray setup begins with the “basic setup,” which includes the mouth mirror, explorer, and cotton pliers.

Dental Instruments• Include those used in the oral cavity:

• by manual hand implementation• through use of mechanical devices

• DA must know all instrument names and how they are utilized in order to effectively prepare for dental procedures

Functions of Hand Instruments• Explore• Cut• Carve• Place• Condense

Basic Components of Dental Hand Instruments

Courtesy Hu-Friedy

Handle• Designed to give stable grip and leverage• Round, hexagonal, serrated, smooth, or

padded• Ring finger of operator’s hand acts as a

fulcrum• Dentist signals dental assistant when an

instrument is to be passed• DA should grasp new instrument at non-

working end between thumb and forefinger in a pen grasp close to treatment area and parallel to current instrument being used

Shank • Tapered and may be straight, mono-angled (one angle),

bi-angled (two angles), or triple-angled (three angles)• Connects handle to working end of the instrument• Angle is designed so that a specific area in the mouth

can be reached with that particular instrument

Working End

Double-Ended Hand Instruments

Courtesy Hu-Friedy

G. V. Black’s Categories of Instruments

• Cutting (hand and rotary)• Condensing• Plastic• Finishing and polishing (hand and rotary)• Isolation• Miscellaneous

G. V. Black’s Instrument Formula

Major Categories of Dental Instruments

1. Examination2. Operative/restorative3. Adjunctive

• sterile dental instruments are always organized on the tray in their sequence of use from left to right, or from closest to patient to farthest from patient

• first instrument closest to patient is always the mouth mirror, which is the primary instrument in every dental setup

Dental Examination Instruments • Designed to be used specifically for

examining teeth and oral tissues• Used to examine the tooth or other

structures during initial oral diagnosis or after placing a restoration

• Basic examination setup:• mouth mirror• explorer• cotton pliers• periodontal probe• articulating paper• 2 x 2 gauze squares

Mouth Mirror

• May be plane glass mirrors, magnifying mirrors, or front-surface mirrors

• Available in metal, fiberglass, or disposable plastic

• Metal mouth mirrors are designed as cone and socket so mirror head can be replaced when necessary

• Most common sizes are numbers 4 and 5• Uses of mouth mirror

• allow for indirect vision, reflect light into dark areas of mouth, retract soft tissues of tongue, cheek, and lips

Explorers • Sharp, pointed metallic instruments designed so various

surfaces of the teeth may be conveniently reached with tip

• Double-ended explorers may be combination of shapes with different style at each end

• Varieties include: shepherd’s hook, pigtail, and right angle

Uses of Explorers• Locating caries and enamel defects on tooth surfaces• Locating supragingival and subgingival calculus• Locating faulty margins on dental restorations

What is the difference between supragingival and subgingival calculus?

The Shepherd’s Hook, Pigtail Explorer, and Right-Angle Explorer

Courtesy Hu-Friedy

Cotton Pliers

• Tweezer-like metallic instruments available as locking or nonlocking

• Working end consist of two tapered opposing portions

• Supplied with serrated or smooth beaks

Courtesy Hu-Friedy

Uses of Cotton Pliers• Handling small cotton pellets, cotton rolls, small

instruments• Handling small items placed into or withdrawn from

mouth• Carrying medications• Transporting items from drawers and containers in

treatment room to avoid cross-contamination

Periodontal Probes

• Determine depth and outline of soft tissue pockets

• Used with light pressure to probe root contours when exploring for calculus and root roughness

• Single-ended or double-ended• Slender, tapered, flat or cylindrical• Indentations or color markers spaced in

millimeters• Expro: periodontal probe on one end and #17-

right angle explorer on other end

Double-Ended Periodontal Probe and Single-Ended Periodontal Probe

Courtesy Hu-Friedy

Homework #1• Bring classroom contract back signed