Buying a Scaler

Instruments on the market today come in a wide variety, allowing dental professionals to make informed, personal decisions as to which ones are ideal. Not every instrument design is well suited for every hand. Dental clinicians should consider visiting booths at conferences to try a variety of instruments to see which ones feel most comfortable. Many exhibitors have typodonts to try instruments on. Representatives from some instrument companies will visit dental offices upon request so dental hygienists can see the instruments and try them on a typodont before purchasing.

Before you buy, consider the following features of instrument design:

Diameter of the handle: Does the handle feel comfortable in your hand? Larger diameter handles are easier to hold and allow for increased grip strength. It has also been shown in controlled test studies that a larger-diameter handle reduces grip force, hand fatigue, and lateral pressure on the teeth being scaled.

Texture: Is the instrument textured? Is it smooth or soft with a silicone sleeve or resin coating? Texturing increases control and decreases hand fatigue.

Color coding: Colored resin or silicone coating allows for easier and quicker identification when moving from one instrument to another in a cassette while scaling. This feature can be beneficial for time management during appointments.

Balance: When the weight of the working end is proportional with the long axis of the handle, the balance of the instrument can be felt while scaling. Does the instrument feel balanced in your hand?

Weight: A lightweight instrument improves tactile sensitivity and reduces pinch force and load on the hand.

Shank design: The shanks of most periodontal instruments are bent in one or more places to facilitate placement of the working end against the tooth surface. What many clinicians do not know is that instrument companies that produce Gracey-designed scalers have their own Gracey version or design of shank curvature. This is another reason why I recommend trying instruments before purchasing them. The angulation and adaptation of the instrument blades on root surfaces can differ from one company to another.

Sharpness: Instruments need to be kept sharp with no exception to facilitate excellent results and prevent increased lateral pressure. Some instrument companies claim that their instruments remain shaper longer. Also, some companies offer instruments that never need to be sharpened. I have used sharpen-free instruments for many years and feel that they are wonderful and worth trying.

We now also understand that hand size and hyper-mobility of the hand, fingers, and joints need to be considered when purchasing scalers. Using instruments with handles that are 9 mm to 14 mm in width is important for a stable grasp and reduction in grip force and strain on the hand. Instruments with wide handles are advantageous for ergonomic hand protection and for increased ease of scaling. Studies have shown that the use of silicone handles improves hand comfort and reduces fatigue. I agree, having used both metal and silicone handles myself when practicing and teaching.

Studies have also shown—after years of research and randomized control trials on instrument handle designs—that lighter instruments with large diameter handles reduce pinch force and muscle load and prevent hand and upper body pain associated with dental hygiene procedures.

I value high-quality scalers that offer ergonomic safety, hand comfort, and scaling efficiency for career longevity. You will too, with the right instrument in hand!

Diane Millar, RDH, MA, is the owner of Innovative RDH Strategies and is an educator on advanced instrumentation and ergonomics. She is a temp dental hygienist in Orange County, California.