Welcome to Part II of Expanding the Perio-Focused Approach. 

In Part I we explored periodontal probing in depth and how we can expand this one simple step into a hygiene department that is perio-focused. When we shift from a prophy to a perio mindset we detect and treat disease early and proactively, our patients become healthier and more enrolled in their periodontal health and we increase the value of our care that extends beyond “just a cleaning”. Patients get it — loud and clear — that we are serious about their oral health and overall wellness.

In Part II we’ll take a closer look at ultrasonic instrumentation and how this skill can support us in expanding our approach.

Theory Evolution of Periodontal Disease

Over the decades the theory of periodontal disease (PD) has certainly evolved. Calculus was the original offender, leading to plaque and endotoxins and today, the current theories of the etiology of PD is host immuno-inflammatory response and epigenetics. Research is rapidly advancing our understanding of biofilm, the development of the disease along with nutritional factors and emerging concepts involving pharmacologic intervention — this is an exciting time to be at the forefront of periodontal health. We have an extraordinary opportunity to predict disease, tailor treatment and substantially improve the outcome for our patients and, it’s only going to advance from here. If there is one thing you can do to set yourself apart it is to commit to consistently and voraciously seek education and training for the life of your career.

So, how does this fit with ultrasonics?

Because as the theories evolved so has our method of treating the disease, including instrumentation of the roots and surfaces of the teeth. As we also expanded our understanding of biofilms, we’ve come to realize they are quite the sophisticated network of well-organized microcolonies. Ultrasonics have opened a pathway for a more comprehensive approach to more effectively and efficiently breakdown this biofilm matrix while minimizing the risk of over-instrumentation.

In fact, the clinical benefits have been repeatedly documented,

“…definitive root detoxification and maximal wound healing without overinstrumentation…”

“…flush the pocket during instrumentation…enhance pocket depth reduction and gain clinical attachment…”

Samuel B. Low, DDS, MS, MEd expands his view of, An Ultrasonic Revolution,

“An ultrasonic unit used correctly…the most effective strategy in removing biofilm during debridement.”

That’s right, the ultrasonic is no longer for the “lazy hygienist” (the perpetuated notion when I was in hygiene school), it’s for the progressive periodontal therapist on the team!

Additional Benefits:

• Ergonomically appealing to the clinician – less time scaling; less fatigue
• Enhanced patient experience  – greater comfort; seen as an advanced or high-tech procedure
• Advanced scaling – provides lavage; irrigation with the aid of antibacterial solutions

Types of ultrasonic scaling devices

The two types of ultrasonic scaling devices available are magnetostrictive and piezoelectric. The primary difference is the magnetostrictive scalers rely on an elliptical movement of the ultrasonic tip and the piezoelectric rely on a linear movement. Both require training and skill in order to fully maximize the benefits. If you are in the market for a unit that will best meet the needs of your practice, I encourage you to do diligent research, ensure all your questions are answered and the proper training is available to support you and your team.

Additional Resources:

Below are a couple of additional resources, made possible through ineedce.com, that compare different scalers, provide the rationale and resources available to learn more about ultrasonic instrumentation for your periodontal department.

Effectiveness and Efficiency in Ultrasonic Scaling, Betsy Reynolds, RDH, MS

Ultrasonic Periodontal Therapy – Benefits for the Patient and the Practice, Diane R. Mueller, RDH and Barry F. Bartusiak, DMD

Thank you for spending your time with me. If you enjoyed this article please like, share and comment below. For support in any of these areas and more reach out by calling or private message to connect with me at 866.809.4890 or Chris@hygienebydesign.com. And, be sure to follow us for the latest strategies and tips for growing a hygiene department and practice you love…by design!