Dental Gyaan - A vast Tour to dentistry and its application.: Dental Instruments

Wednesday, April 20, 2011

Dental Instruments - (Examining Instruments).

These tools allow the dental professional to manipulate tissues, to allow better visual access during treatment or during dental examination.
These are mainly of 2 types:-

1. Mirror.
2. Probes.
1. Mirror:

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Mouth Mirror - 1

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Mouth Mirror - 2

A mouth mirror or dentist's mirror is an instrument used in dentistry. The head of the mirror is usually round, and the most common sizes used are the No. 4 and No. 5. A No. 2 is sometimes used when a smaller mirror is needed, such as when working on back teeth with a dental dam in place. The mouth mirror has a wide range of uses. Three of its most important functions are allowing indirect vision by the dentist, reflecting light onto desired surfaces, and retraction of soft tissues.

Indirect vision is needed in certain locations of the mouth where visibility is difficult or impossible. The posterior (or lingual) surfaces of the anterior maxillary teeth is a notable area where mouth mirrors are often used. Other areas of the mouth can be viewed more readily with the mouth mirror, even though it would be possible to see them if the dentist or dental hygienist adjusted their body into a poor position. Without the mouth mirror, poor body positioning would occur daily and lead to chronic postural problems, especially of the back and neck.

There are other areas of the mouth where lighting is difficult, even with overhead dentists' lights. In these instances, the mouth mirror is used to reflect light onto those surfaces. This is especially useful if the mirror is simultaneously being used for indirect vision of an obscure area.

Additionally, the mouth mirror is used to retract tissues, such as the tongue or cheeks, to gain better visualization of the teeth.

Dentist's mirrors are also commonly used by engineers to allow vision in tight spaces and around corners in equipment. They are a common tool in optics and laser labs as well.
2. Probes:

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Dental Explorer - 1

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Dental Explorer - 2

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Dental Explorer - 3

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Dental Explorer - 4

Probes are basically of types:
* Dental Explorer (or Sickle Probe).
* Periodontal Probe.

1. Dental Explorer (or Sickle Probe):
A dental explorer or sickle probe is an instrument in dentistry commonly used in the dental armamentarium. A sharp point at the end of the explorer is used to enhance tactile sensation.

Until recently, it was advised that dentists use the explorer to determine the presence of tooth decay on tooth enamel. Some dental professionals have questioned this practice. Since enamel is demineralized in the early stages of tooth decay, the use of an explorer opens a cavity in the enamel where none existed previously. Instead, they argue that fluoride and oral hygiene should be used to remineralize the enamel and prevent it from decaying further. This debate still continues because sometimes decay can be difficult to diagnose without tactile verification. Additionally, radiographs and other products designed to identify decay (such as measuring fluorescence from a laser) help the dental professional make a final diagnosis of tooth decay.

There are various types of explorers, though the most common one is the No. 23 explorer, which is also known as a "shepherd's hook". Other types include the 3CH (also known as "cowhorn" or "pigtail") and No. 17 explorers, which are useful for the interproximal areas between teeth.

The Tufts 17/23 Explorer, also known as the Wilken's Explorer, contains both No. 17 and No. 23 on the same instrument; opposite sides of each other.

2. Periodontal Probe:
A periodontal probe is an instrument in dentistry commonly used in the dental armamentarium. It is usually long, thin, and blunted at the end. The primary purpose of a periodontal probe is to measure pocket depths around a tooth in order to establish the state of health of the periodontium. There are markings inscribed onto the head of the instrument for accuracy and readability.

Proper use of the periodontal probe is necessary to maintain accuracy. The tip of the instrument is placed with light pressure of 10-20 grams into the gingival sulcus, which is an area of potential space between a tooth and the surrounding tissue. It is important to keep the periodontal probe parallel to the contours of the root of the tooth and to insert the probe down to the base of the pocket. This results in obscuring a section of the periodontal probe's tip. The first marking visible above the pocket indicates the measurement of the pocket depth. It has been found that the average, healthy pocket depth is around 3 mm with no bleeding upon probing. Depths greater than 3 mm can be associated with "attachment loss" of the tooth to the surrounding alveolar bone, which is a characteristic found in periodontitis. Pocket depths greater than 3 mm can also be a sign of gingival hyperplasia.

There are many different types of periodontal probes, and each has its own manner of indicating measurements on the tip of the instrument. For example, the Michigan O probe has markings at 3 mm, 6 mm and 8 mm and the Williams probe has circumferential lines at 1 mm, 2 mm, 3 mm, 5 mm, 7 mm, 8 mm, 9 mm, and 10 mm . The PCP12 probe with Marquis markings has alternating shades every 3 mm. Unlike the previous two mentioned, the Naber's probe is curved and is used for measuring into the furcation area between the roots of a tooth.
PCP12 probe with shades alternating every 3 mm. The probe is on a modified Novatech shank, intended to make it easier to align the probe with the vertical axis of the teeth.

The periodontal probe can also be used to measure other dental instruments, tooth preparations during restorative procedures, gingival recession, attached gingiva, and oral lesions or pathologies.