You will be assigned your own hand instruments. There are several advantages to you developing a good system of instrument organization.
1. Fewer instruments will need to be purchased in the future
2. Instruments will last longer
3. Less time will be spent hunting for instruments
We have one staff member designated as our cleaning/sterilization person, but our hygienists usually like to care for their own instruments. Review the section in chairside level 1 on cleaning/sterilizing instruments. Spend some time with this person to coordinate your needs. Make a list of instruments:
1. Number of basic setups you need for an average day
2. Number of setups of any special instruments needed
3. Special instruments needed occasionally
Benefits of using Sharp Instruments
Quicker, easier deposit removal
Decreases burnishing of deposits.
Improves client comfort
Improves your touch
Minimizes your stress and fatigue
We have a large number of hygiene instruments. Have your senior RDH show you our inventory. If you need some instruments that we don’t have then she will arrange for their purchase. Mark these instruments so they won’t be confused with those of the other hygienists. You will be responsible for sharpening your own instruments. Review your technique with any level 3 or above hygienist. Keep each set up separate. When you finish with a client, keep your instruments together so you don’t waste time sorting them out later.
Choose your hand instruments using these guidelines:
1. The more you can match what the other hygienists use, the easier to make up packs.
2. Use no more than 5 scalers and curettes in each pack. You’ll want 5 packs.
a. Sickle scaler 6-7
b. Posterior sickle 204S/204
c. Gracey 11-12 or 15/16
d. Gracey 13-14 or 17/18
e. Your “special” instrument
Gracey ½ or 5/6 or 7/8
Younger Goode 7/8
Suggested Sequence for Sharpening Instruments
STEP 1 Sterilize instruments
STEP 2 Test individual cutting edges on each blade.
STEP 3 Sharpen the dulled edges
STEP 4 Repackage and sterilize
At the end of your first week, answer the following questions with your team leader.
1. Do you have enough instruments?
2. Do you have a good place to store your instrument packs?
3. Are your instruments cleaned/sterilized quickly enough?
4. Are you safe when cleaning/sterilizing your instruments?
5. Do you have any questions about our cleaning/sterilizing technique?
One of our potential high overhead expenses is replacement of equipment. All equipment will eventually wear out. However, poorly maintained equipment breaks down and needs to be replaced much more often than well maintenanced equipment.
Your responsibility is to make the equipment assigned to you last as long as possible.
Worn out scalers will neither detect nor remove calculus. This will force you to use more pressure which will be uncomfortable to your client. Using this added pressure leads to stress on you and increases the chances you’ll develop carpel tunnel syndrome. Never re-tip. Save old instruments for trade in.
Hand instrument maintenance routine:
a. Remove any debris on instrument – hand scrub (gloves) or ultrasonic
b. Ultrasonic – instruments completely under solution
c. Inspect: corrosion, dull edges, thin blades, broken tips
d. Sharpen at the first sign of dullness. Hold instrument under light – sharp instruments don’t reflect
Also write out a maintenance schedule for all of this equipment. Hand instruments: 12-18 months
Responsible for handpieces/cash drawer
Clinical staff are assigned specific handpieces that they must keep track of their use, cleaning and whereabouts. Due to the high cost of a dental handpiece ($1,500 on average), we have a handpiece inventory system where clinical staff log in and out their handpieces daily in order to make sure we do not lose them. Whether you use this system or not, you will be financially responsible to replace this handpiece. For the first handpiece you lose, we will evaluate the need for replacement and cover the cost. For the second handpiece you lose, you will pay for 25%. For the third handpiece you lose, you will pay for 50%. For the fourth handpiece you lose, you will pay 75%. For the fifth and all subsequent handpieces, you will pay 100%. This cost will be subtracted from your bonuses and raises until it is paid.
List of handpieces I am responsible for: (and the approximate value of each)
Secretarial staff are responsible for maintaining the accuracy of the cash drawer. The team is responsible to keep the cash drawer locked and one secretary is responsible for keeping the cash drawer key at all times (often worn on her wrist). The team tracks this cash drawer in the morning and evening to make sure no money is missing. If the team’s calculations are off and the discrepancy cannot be figured out within one week, then the team is responsible for dividing up the amount the cash drawer is off and repaying the drawer. For example, if the drawer is off $5 and there are 5 secretaries on the team, then each person must repay the drawer $1. This repayment is due within one week or this amount will be held from your next paycheck.