Finding Your Perfect Fit

Because hand instruments can be expensive, one of the most important features to look for is longevity. It can be difficult to persuade practice owners to see the benefits of investing in this necessary equipment, and knowing that our tools will last helps instill clinicians with confidence regarding such a purchase.

The sharpening factor is also important, especially if you work in a busy practice that does not send out instruments to be sharpened; that responsibility often falls on the hygienist, so the frequency with which it needs to be done is critical. I have often brought my personal instruments home to sharpen while watching television at night. If you prefer not to do that, then sharpen-free instruments that are available today are worth considering. However, it is important to understand how to use these types of instruments correctly. When I got mine, I did not like them at first, but then I learned that you need to use certain strokes, and now I really enjoy using them.

Using hand instruments involves repetitive motion, and ergonomics must therefore be considered. We need to work smarter, not harder. Our hands are our money makers, and taking care of them extends the longevity of our careers. Hand pain is one of the leading reasons why hygienists exit the field; in the past, many in our profession have needed surgery for carpal tunnel syndrome. With older instrumentation, the diameter is often very small, which requires more strain on the hand while gripping. The wider handles on newer instruments are easier to grip and can help with adaptation.

Utilizing the modern technology that is available to minimize the need for hand scaling is critical as well. Some veteran hygienists once considered ultrasonic scaling to be less effective and possibly even lazy; however, now it is considered the standard of care to use the ultrasonic prior to hand scaling. Guided biofilm therapy (GBT) also can reduce the need for extensive hand scaling and may soon be seen as the standard of care. Although it requires a significant investment, GBT is proving to be beneficial for both the patient and the clinician. Some have stated that it might help to extend your career, especially if you spend most of your time on scaling and root planing and periodontal procedures; if your equipment is outdated or unsharpened for those procedures, hand fatigue can be a major problem.

Of course, every hygienist is different. Some may prefer different grips for different procedures. Some may prioritize weight more than others. Some may prefer resin instruments, and others may like metal. It is all about operator preference. That is why manufacturers offer so many different options for instrumentation; everyone has their own preferences.

Portability and ease of disinfection are my highest priorities in choosing a handpiece. Because handpieces can be quite heavy, the freedom of movement offered by a portable unit can help decrease the strain on your body. A cordless option can also help with workflow efficiency when using a handpiece in multiple rooms.

Ease of disinfection is important because Centers for Disease Control and Prevention (CDC) guidelines state that handpieces that can be removed from the air and water lines of dental units should be cleaned and heat sterilized. We may have been taught in school to simply wipe down our handpieces between patients, but this can lead to cross contamination and is not considered the standard of care. Many companies make sheaths for sterilization or offer handpieces that can be disassembled to be sterilized in parts. More progress is needed in this area, however. I have been in certain situations at different offices when I have needed to remind everyone of the need to work at the standard.

Other features that can differentiate handpieces include wireless pedals, which can make them easier to operate, and reduced noise levels. I do not care as much about the noise, because so many other operations in the dental office are louder than the handpiece, but higher-quality handpieces tend to make less noise anyway.

As with hand instruments, there are many different options available when choosing a handpiece. I recommend trying different options at trade shows or by having representatives visit your office. Do not get stuck just using what you have always used. There are almost certainly options available that you might like much better.

Kari Carter-Cherelus, RDH, DA, is a clinical dental hygienist in West Palm Beach, Florida, and is a career coach, speaker, and author. She is chief executive officer and founder of the consulting firm KMC Strategic Solutions.