Assessment Instruments Explorers and Probes Presented by: Mellissa Boyd, RDH, BSDH

Objectives Recognize the different types of assessment instruments and their applications in patient care Describe the fundamental applications of the 2 explorers found in the Chatt State Instrument Kits Explain the design features of an explorer Indentify the parts of the explorer shank

Objectives Describe what is meant by “tactile sensitivity” Explain the design features of a calibrated periodontal probe Discuss the fundamental applications of a calibrated periodontal probe

Instrument Classification

Assessment Determine oral status and needs of patient Health? Disease? Consists of several steps Review MDHX Radiographs Head/Neck Cancer Exam Dentition Examination* Comprehensive Periodontal Examination* *Explorers and Probes used for Dentition exam and CPE

Periodontal Exam

Calculus 101 Plaque-Biofilm Calculus

Dentition Exam ?

Oral Cancer Screening

Periodontal Probe Design Features Working‐End – Blunt – Rod‐shaped Cross‐section – Round – Rectangular Types – Calibrated – Furcation

Periodontal Probe Design Features Working-End Blunt Rod-shaped Cross-section Round Rectangular Types Calibrated Furcation

Purpose Used in comprehensive periodontal exam or PSR Measurement – Sulcus/pocket depths – Bleeding – Exudate – Recession – Oral lesions

Periodontal Probe Determine health of periodontal tissues

Williams Probe What are the mm markings on a Williams Probe?

UNC 12 What are the mm markings on the UNC 12 probe?

UNC 15

Marquis Probe

WHO probe (PSR)

Probe Depth What is the PD indicated in the picture?

Sulcus vs. Pocket Sulcus Space between free gingiva and tooth 1-3mm Pocket Sulcus deepened because of disease 4mm+ Gingival vs. Periodontal

Probing Depths Entire sulcus probed Six sites recorded per tooth 3 buccal/facial 3 lingual Record deepest reading per site Depth rounded up to nearest mm

Bleeding on Probing

Explorer Design Features Fine wire-like working-end Flexible shank Circular in cross-section Straight or curved shanks Paired or unpaired working - ends

Working-End 1-2mm length used Often referred to as “tip 1/3” Calculus detection Side of tip 1/3 EXD 11/12 Caries detection Point of tip 1/3 #23 Shepherd Hook “Tip 1/3”

Shank Functional Shank Long, complex Begins below working end Extends to last bend in shank nearest handle Terminal Shank (lower) Part of functional shank nearest to working-end Functional shank Terminal shank

Calculus Detection EXD 11/12 Long, complex shank Curved Shorter, slightly curved shank

Calculus Detection Pigtail/Cowhorn Extremely curved terminal shank Orban-type Straight terminal shank

Explorer Applications Detection Texture of tooth/root surfaces Calculus Caries Faulty restorations Overhangs

Tactile Sensitivity Feel vibrations transferred from instrument tip, through shank, to handle Learned ability Accomplished by using very light grasp and lots of PRACTICE!!

Examples of Tactile Sensations Catching on overcontoured restorations Dropping into a hole (carious lesions) Bouncing over an elevated deposit Feeling roughness

Calculus Detection

Three Types of Formation

Supragingival Calculus Coronal to GM Rough, chalky white, beige, stained Visual detection Dry with air or cotton 2x2

Subgingival Calculus Apical to GM Located in sulcus or pocket Tactile feeling only May show in x-ray Brown or Black

Explorer Applications Evaluation Completed treatment Calculus removal Restoration margins

Caries Detection Shepherd Hook ( # 23)Straight

Caries 101 Visible Caries Obvious, frank, open lesions Chalky, white, gray, brown, black in color May retain food Shallow lesions Light pressure Feels soft, tacky, leather-like Do NOT explore large, frank lesions!

Caries Pit & Fissure Caries Catch/stickiness when tracing fissure with light pressure Smooth Surface Caries Visually check for discoloration May feel rough or soft

Caries Root Surface Caries Develop on exposed cementum Feel explorer “dip” in/out May feel rough or leathery Recurrent Caries Restoration margins Feel explorer “dip” or catch along margin