That Water Machine at My Dental Cleaning...Does It Do As Good of a Job?
Ultrasonic scalers are used very often these days for routine dental cleanings. Some patients love them. Some patients hate them. Some hygienists love them. Some hygienists don’t prefer them. We’ll explain our preference for you here and then let you decide which you’d prefer.
We have to first start by explaining my school background for this one.
I attended the University of Southern California for my Bachelor’s degree in Dental Hygiene. The amazing woman who wrote the textbook for hand instrumentation, used in most dental hygiene programs, the great Anna Pattison, was my instructor.
With that, you could say that I was somewhat conditioned to be partial to the use of hand instruments. I can now confirm that it was for a good reason. What Anna Pattison taught us and believed, I have observed to be true during my two decades of experience in the real world of dental hygiene.
I don’t want to undermine my fellow hygienists out there who LOVE to use their ultrasonic scalers. Everyone has formed their own preferences and techniques over time. I also don’t want to discount the ultrasonic scalers at all because they are absolutely amazing for harder cases…BUT…
I have found that the thoroughness they provide for routine, regular dental cleanings does NOT compare to the thoroughness that the hand instruments provide.
I hope that all hygienists will stick with me on this one and stay open minded as I explain what I have seen.I have observed that large pieces of tartar are often left behind when ultrasonic scalers are used routinely. I see this regularly.
To be specific, this tartar is COMMONLY left behind on the “distals of canines,” “all upper anterior interproximals,” and of course the “distal of the second molars.” Many times the tartar is burnished (or flattened) onto the “buccals of the upper molars” as well. Often-times, the “facials of lower canines” are missed too.
The pieces of tartar left behind are often quite large, telling the story that they have been left to grow there for a good amount of time.
Cavities are often missed when ultrasonic scalers are used routinely for dental appointments.
This is a big one. If we don’t give enough time to feel around all aspects of each tooth diligently, hidden decay can go undetected.This is the predicament:
Our “tactile sensitivity” is just not as sensitive when using the ultrasonic scalers. In other words, we can’t FEEL the tartar as well, and we can’t FEEL the texture of your tooth surfaces.
We need this sensitivity to be able to FEEL for decay and diligently assess areas more likely to get cavities. We need this sensitivity to be able to FEEL the roughness and chunks of tartar on your teeth.
We won’t feel those small root decay areas starting until they are large. It’s also much harder to find decay “interproximally” (between your teeth) with an ultrasonic instrument.
The truth is, when we use the ultrasonic, we just can’t FEEL much of anything unless it’s large. We just kind of stick the instrument between the teeth, hoping it’s removing the tartar and flushing the gums out with the water.
When we use hand instruments, though, we have what we mentioned as “tactile sensitivity.”
This allows us to feel every teeny tiny last bit of everything, as we DILIGENTLY feel along the surfaces of all the teeth, searching and cleaning. We can fine-tune like no other. Even slight roughness can be smoothed.
Seeing these observations over the years, we personally feel that the ultrasonic is an unnecessary step in a ROUTINE cleaning, unless we need a little more help with the stubborn areas of tartar on the “lower anteriors” (bottom front teeth) or molar areas.
Why take the time to go around all of the teeth with the ultrasonic when we can use that time to feel more diligently with the hand instruments? If patients have been consistent with their regular cleanings, are mostly compliant with their home care, and the hygienists have been good and diligent with previous cleanings, it is rare that they will need help from an ultrasonic scaler.
We believe that more time should instead be given to DETAILED fine-tuning with the hand instruments if our goal is to maintain our patients’ mouths beautifully.
To clarify, ultrasonic scalers are more designed for times when extra muscles are needed to get the tartar off.
Sometimes the tartar becomes extra heavy or extra stubborn when it’s been many, many years since a patient has had a cleaning.
Some patients just build up quickly in the duct areas of the lower front teeth and the cheek side of the upper molars. Instead of wearing out our muscles, we grab the ultrasonic scaler. Patients jokingly call it our “jackhammer.”
Another situation where the ultrasonic scaler is helpful is with patients who have periodontal pockets.
These pockets are deeper and much harder to clean down at the base under the gumline. The bone has been eaten away, but the gums have remained in their original position, creating a periodontal pocket. The ultrasonic scaler helps immensely in these areas.
Deep pockets benefit from being flushed out with the water that the ultrasonic instruments project. Also, tartar removal from pocket depths of 6 millimeters or more will benefit from the ultrasonic instrument’s help.
If you have pocket depths that are 6mm or more, please take the time to read our SODA that has been spilled about periodontal disease. There you can find helpful answers on how to bring your mouth back to health.
In our practice, there are very few patients that we need to grab the ultrasonic instrument for. When we take the time to teach our patients how to correctly maintain their mouths, the hygienist-patient relationship becomes a beautiful thing. Cavities are found early. Cleanings are easy.
Many honest hygienists love their ultrasonic scaler, though, and use it often. We completely respect everyones’ preferences. So, PLEASE don’t go back to your next cleaning appointment, berating your hygienist. Just gently ask why the ultrasonic is their preference for your teeth. Hopefully, they will have a good explanation for you.
What we mostly want to warn patients of is this...
Just because a dental office uses this “fancy instrument,” which APPEARS to be doing a better job in a faster amount of time, doesn’t mean that it’s actually doing a GOOD job. Don’t fall for all the fancy gadgets.
Many dental offices that choose to clean teeth with the ultrasonic scaler only are hoping to up their profits. They are trying to get patients in and out quickly.
Many of these offices have morning meetings with “production plans.” Their dental hygienists are paid based on commission, so these “production plans” mean more money in their pockets. The more patients they see in a day, the more money they make. Do you see where things could go wrong here?
So please be sure that you have found an honest dentist and an honest dental hygienist. It’s important for you to have thorough cleanings and honest treatment plans.
The truth about dentistry is:
Patients either have a cavity, or they don’t.
Patients either need a deep cleaning or they don’t.
Patients DESERVE good, honest, thorough dental treatments.
This is what HEALTH CARE should look like.
There should be no “production plan.”
Your dental professional CARING about YOU when we provide your dental care, should be the ONLY “plan.”
This is why SODA always says “honest dentist.”
It is so important that you seek out an honest dentist. Don’t just choose one from a magazine advertisement or from your dental insurance “list.”
We’ve spilled a lot of SODA to help you navigate the dental world. Just head on over to our “All Advice” section and take a look.
You’ll find suggestions for how to find an honest dentist, what your dental cleanings should truly look like, and whether it’s worth it to purchase dental insurance on your own.
Though it would be best if we did, we’ll never claim to know it all, all of the time. NO ONE knows it all! We do claim honesty, though, and we sincerely want to help as many people as we can! Our patients have maintained beautifully, following our conservative recommendations :)
So, thanks so much for reading and letting us spill our SODA! Remember to take the time to find your HONEST DENTIST, and be sure to browse around our links and follow us on social media for answers to more of your exciting dental questions, like:
