Hand Dental Instruments vs. Mechanical Devices – Which To Use?
Since mechanical scaling devices came into being in the mid 1950’s there has been a debate over what to use. To this day, there are offices that strictly use hand instrumentation. There are offices that have almost no hand instruments at all, and in the middle, are the majority of offices that use both.
I must admit, I’m mostly a hand instrument guy. I was trained in that era. For me, I truly feel I can scale and root plane better and faster with sharp hand instruments (added emphasis to sharp!). You may feel differently about this and I can respect that. Hand instruments and mechanical devices have their advantages.
The literature supports the use of both. Both are very effective. Both have their strong points and their weak points. The astute clinician realizes this and is aware of the pros and cons of each. This awareness allows one to utilize the best of each in order to provide exceptional care. There is a place for both in our offices.
In my mind the major short coming of mechanical scalers is the loss of tactile sensation. If a clinician does not take this into account, calculus can be left behind. Worse than simply missing calculus is the burnishing of calculus which can make it nearly impossible to detect. This is more of a problem with the older style inserts. The newer triple bent tips and perio designed tips minimize this. Never the less, it is a problem that one needs to be aware of. The solution is the explorer. It needs to be sharp and used regularly.