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How to breathe new life into your ultrasonic
scaler without sending it in for servicing
Hints for more
effective use of ultrasonic scalers
by Nelson Gendusa, DDS
Director - Research
I just replaced my old Parkell inserts, and BOY are the new
ones fast! When I compared the new to the old, I discovered I’d
lost about 1/4" of tip. (I can’t even remember when I
bought the old ones.)
Please remind your readers that inserts DO wear out. By the way,
do you know the average lifespan?
Adrian Rose, DDS
Boca Raton, FL
Just last month we received a scaler for servicing. According to
the dentist, he couldn’t say specifically what was wrong with
it, but it was suffering a severe case of the blahs. Even at the
highest power settings, it just wasn’t blasting calculus like
it used to.
The scaler tested fine. When we examined his insert tip under a
microscope, however, we discovered that it was oscillating with
just half the stroke of a new tip.
That’s what happens when a tip wears out. It shortens, and
as it shortens, the ultrasonic stroke loses power.
Miniscule reductions in length and thickness, can create massive
reductions in power. Take a look at figure 1. The tip on top is
a couple of years old and totally wasted. It should have been replaced
long ago. The other tip is brand new. To illustrate the massive
difference in stroke, I put both tips into a cup of coffee and fired
them up using the same power. The worn tip sounded fine but produced
just a few ripples. In the photo (fig 2) it doesn’t even look
like the scaler is on. The new insert (fig 3) threw coffee all over
the place. (If you try this at home, I suggest you use water instead
of coffee.)
Here’s my point: Even serious wear is hard to detect by visual
inspection.
Furthermore, because wear is so gradual, you may not notice the
reduction in power ... until one day it suddenly dawns on you that
you’re working a lot harder and longer than you used to.
How often should inserts be replaced?
There isn’t an easy answer. Several factors conspire to cause
tip wear.
There’s simple abrasion. Tips used for calculus removal will
wear faster than tips used solely for plaque debridement.
Then there’s the stress-and-strain caused by vibrating at ultrasonic
speeds. Tips used at high power will wear faster than tips used
at low power.
And there’s the “cavitation factor.” Those imploding
ultrasonic bubbles that blast apart plaque and potentially rip bacterial
cell walls, also attack the metal.
So the life expectancy of an insert depends not only on how
much you use it ... but also on how you use it.
We asked Dr. Larry Burnett (author of “Advanced Ultrasonics
in General Practice Periodontics” video course - see side bar)
how he knows it’s time to retire a tip.
In his opinion, “feel” is the most reliable indicator.
Until you learn what a worn-out insert feels like, however, he suggests
keeping a new insert for reference. If an insert becomes suspect,
wait till a patient presents with heavy calculus and do a side-by-side
comparison. Switch back-and-forth between old and new inserts to
see how noticeable the difference is.
Using an insert whose time has passed is like handscaling with a
dull curette. Until you replace it, every job will take longer than
it has to. You’ll work harder ... at ever-higher power settings
and ever-increasing water-flow rates ... all to accomplish less.
ULTRASONICS AND THE PREGNANT
PATIENT
“At my prior job, the hygienists were cautioned not to use
ultrasonic scalers if a patient was pregnant. But here they seem
to feel it’s okay. Who’s right?”
RDH
Louisville, Ky
To the best of our knowledge, there has never been any research
that demonstrated danger either to mother or fetus from ultrasonic
scaling.
However, a weak magnetic field does occur around the handpiece.
Under certain unusual conditions this field might interfere with
old-style heart pacemakers and it can create inaccuracies in some
monitoring devices such as pulse oxymeters.
I suspect the caution at the prior office arose more for legal than
medical reasons. In a litigious society like ours, some dentists
question the wisdom of performing any intrusive quasi-medical procedure
on a pregnant patient unless it is absolutely necessary. Since ultrasonic
scaling isn’t absolutely necessary, they choose to err on the
side of super-caution.
We suggest that the office simply contact the patient’s Ob/Gyn
to see if they have any reservations about the matter.
For more information on Ultrasonic
Inserts click here.
©2002
Parkell, Inc. Notice
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