1 Nordent Manufacturing, Inc.

2 Why should I sharpen my instruments?

3 A Sharp Instrument Will... allow you to work more effectively and improve tactile sensitivity. afford you better control. reduce procedure time. reduce strain and fatigue on your patient. greatly reduce strain and fatigue on YOU!

4 In dental hygiene... One of the main contributing factors to Cumulative Trauma Disorder is dull or improperly sharpened instruments.

5 In a recent survey by RDH Magazine... 41% of hygienists report suffering from carpal tunnel syndrome or having symptoms indicating future CTS problems.

6 Symptoms of CTS include... Nocturnal pain or numbness. Paresthesia (numbness, tingling, increased sensitivity) Hypesthesia (decreased sensitivity to touch) Hand clumsiness Hand weakness Pain or burning

7 Factors Known to Contribute to CTS Predisposing factors (diabetes, hypothyroidism, medications, injury, arthritis, etc.) Wrist ratio (the proportion between wrist depth and height). Length of time practiced. Number of days worked per week. Number of patients per day. Number of “heavy calculus” patients per day. Scaling technique (finger and wrist positioning). Instrument maintenance regimen. Instrument handle selection.

8 Nunn PJ, Hart CT, Gaulden GF, Perfect Instrumentation Can be Hazardous to Your Health. Access 1995; 9 (1) “Ergonomic instrument design can help reduce CTS in two basic ways. Lighter weight instruments require less muscle tension to place, angulate, adapt, and simply hold….Varying diameters allow the application of force through different joints of the same finger…This allows muscles to trade off and rest a little throughout the instrumentation session.” Light Weight – Large Diameter

9 Fredekind, Richard and Cuny, Eve, Ergonomics and the Dental Care Worker, Murphy, Denise C., Washington D.C., American Public Health Association, 1998 “It has been found for dental hygienists that the amount of force exerted is more likely to cause carpal tunnel syndrome than the number of repetitions. Therefore, any tool with a cutting edge should be kept as sharp as possible during the entirety of the procedure.” Sharp Instruments Mean Less Force

10 If I sharpen my instruments frequently, they won’t last as long.

11 Frequent and proper sharpening will make your instruments last longer and reduce replacement costs.

12 If you sharpen your instruments frequently... Sharpening will be quicker and easier. You will sharpen more accurately. You will need to remove less material to achieve a sharp cutting edge.

13 Many People Assume… High quality instruments are expensive. They really are not! Quality instrument manufacturers use the finest grade stainless steel available, and subject instrument tips to more extensive tempering and hardening processes.

14 High quality instruments require less maintenance and stay sharper longer! Example: High quality scalers can be used 450 and 1000 times! The average cost for a quality scaler is $ $24.00 divided by 450 uses = 5¢ per use 5 scalers per kit cost… 25¢ per patient

15 Factors Known to Contribute to CTS Predisposing factors (diabetes, hypothyroidism, medications, injury, arthritis, etc.) Wrist ratio (the proportion between wrist depth and height). Length of time practiced. Number of days worked per week. Number of patients per day. Number of “heavy calculus” patients per day. Scaling technique (finger and wrist positioning). Instrument maintenance regimen. Instrument handle selection.

16 A Quality Instrument Manufacturer... Uses the best materials available (440A grade stainless steel). Tempers and hardens instrument tips to exacting standards. Employs qualified instrument craftsmen and engineers. Employs rigorous quality control procedures. Designs instruments that are balanced and ergonomic. Produces innovative instrument designs. Will not retip instruments.

17 Disadvantages of Retipping Real liability risk. Inferior materials and workmanship. Lower hygienist satisfaction. Higher maintenance costs. Long term costs are much greater. In comparison, new, high quality instruments are more economical than retipping.

18 Professional Sharpening Services Do not retip instruments. Restore the original blade surfaces and sharp edge. Should be used in conjunction with an in-office maintenance program. Are very effective and relatively inexpensive.

19 Sickle Scaler

20 Jacquette Scaler

21 Universal Curette

22 Gracey Curette

23 Instrument Tip Anatomy Blade Face Lateral Surface Terminal Shank Blade Heel Blade Tip

24 To Sharpen Your Instruments You Need... A Sharpening Stone Arkansas India Ceramic Lubricating Fluid A Firm Working Surface Good Lighting A Relaxed Attitude!

25 Three Types of Sharpening Stones Arkansas is a natural stone, white to black in color. They are available in soft, medium, hard and ultra hard and must be lubricated with honing oil. India is a man made stone, brown in color. They are available in coarse, medium and fine grits and must be lubricated with honing oil. Ceramic is a man made stone in various colors. They are available in coarse, medium and fine grits and may be lubricated with water.

26 Stationary Instrument, Movable Stone 1 Inside blade face is held parallel to the floor. 2 Approach the instrument blade with the stone at the 12:00 position. 3 Angle the stone back to the 1:00 position.

27 Utilize a Table Edge for Stability Hand and forearm rest on the table top. Instrument hand is braced against the table edge. Angle the instrument toward you for easier access and better visibility. Grasp the stone from along the bottom to utilize both the front and back surfaces of the sharpening stone. Position yourself near a corner for additional access.

28 Move Back from the Table Position the Instrument in your Lap Forearms Parallel to the Floor Look Directly Down on the Instrument Blade Face Free-hand Sharpening Position

29 Proper Sharpening Grasp

30 Align Sharpening Stone at the 12:00 Position

31 Anterior Scaler Blade Face Parallel to the Floor

32 Anterior Sickle Scaler Position the Instrument Blade Face Parallel to the Floor Align the Sharpening Stone at 12:00

33 Begin at the 1:00 Position

34 Anterior Sickle Scaler Position the Sharpening Stone at 1:00 Begin at the Heel of the Blade Medium Pressure, Long Even Strokes

35 Begin at the Heel

36 Move Through the Middle of the Blade to the Tip or Toe

37 Posterior Sickle Scaler

38 Universal Curette

39 Sharpen the Toe of Your Curettes Separately

40 Gracey Curette Blade Face Parallel Sharpening Stone at 12:00 Sharpening Stone at 1:00

41 Test for Sharpness with a Test Stick

42 A Dull Edge Reflects Light…A Sharp Edge Will Not

43 Sharpen Your Explorers Stationary stone, moveable instrument Sharpening stone parallel to the floor Terminal shank parallel to the long axis of the sharpening stone Engage only the tip Drag explorer tip LIGHTLY toward you Utilize the clock method

44 Every Brand, Every Pattern, Every Time!

45 Every Scaler & Curette has 1 Thing in Common…

46 2 Unique Features Guarantee the Correct Angle Blade Positioner Sharpening Cone

47 Turn Knob to Raise or Lower Positioner Bar

48 Fit Jaws around Shank and Tighten Using Back Knob

49 Move to Cone & Sharpen

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