The term “grasp” refers to how the instrument is held by the clinician. There are a number of techniques to grasp an instrument. They include the pen grasp, modified pen grasp, and the palm and thumb grasp:

In order to decrease the risk of injury and a musculoskeletal disorder, the wrist should always be in a neutral position. In this position, the wrist should be parallel to the long access of the forearm. Maintaining your working area at the level of the elbow assists in a neutral wrist position. The wrists should not be in flexion or extension while working (Fig. 5.2).

The support or point of finger contact on a tooth surface, on which the hand turns while moving an instrument. By providing a hand support, a proper finger rest position will allow for more precise instrumentation and tactile sensitivity of the working area.

Once you have ensured proper grasp and fulcrum point, it is time to adapt the instrument to the tooth surface. The instrument should be adapted for maximal efficacy of the working surface or blade of the instrument. Depending on whether the instrument is a diagnostic instrument or treatment instrument, this position may differ. No matter what instrument is being adapted to the treatment area, tooth form and anatomic variations should be considered so that the instrument can have maximal effective contact with the tooth surface.

Defined as the angle formed between the blade of an instrument and a tooth or tissue to provide increased access and optimal instrument efficiency. Proper instrument angulation is variable depending on the type of instrument being used.

This concept will be discussed in further detail when describing proper instrument technique for universal and area-specific curettes in section 5.4.2.1.

This refers to the pressure exerted on the instrument against the tooth. Lateral pressure is variable depending on the treatment being performed.

Once again, the stroke performed is dependent on the treatment being rendered and will be covered in detail under the description of each of these procedures.

The blade is composed of the toe or tip, lateral surfaces, face, back, and cutting edges.

For curettes and scalers, the blade can be further broken down in to the shank 1/3, middle 1/3, and toe 1/3 (Fig. 5.8).

There are many variants of the dental mirror in different sizes and mirror characteristics. Independent of the mirror selected, the dental mirror is used to provide indirect vision, retraction, and indirect illumination.

The air/water syringe can be useful in clearing saliva and debris and drying the treatment area for improved visibility.

The periodontal probe, introduced to the dental profession in 1925, by Dr. F. V. Simonton, has proven itself to be, over the following decades, an essential component of the modern dental diagnostic armamentarium. While its specific applications are varied, this single instrument has the potential to provide the clinician a vast array of information regarding the clinical health status of the supporting periodontal tissues. Periodontal probes are typically tapered rod-shaped instruments with millimeter markings to aid the practitioner in measuring the depth of a gingival sulcus or periodontal pocket. Flat periodontal probes have also been designed.

Examples of commonly used manual periodontal probes (Fig. 5.11):

Ten very important noninvasive applications of the periodontal probe are listed below. As all clinicians are responsible for monitoring the periodontal health status of their patients, they must be cognizant of the probe’s importance, be familiar with its applications, and have the knowledge to use it correctly. Furthermore, they must understand and appreciate the significance of the information derived from the careful use of the probe, which will then be coordinated, with the other clinical data gathered at a comprehensive examination, into recommendations to the patient that will best serve their interest in treating and preventing dental diseases. Periodontal probes are primarily used to make a detailed assessment of the periodontal pocket, its depth, and degree of inflammation as evidenced by bleeding on probing. This assessment is critical in determining the severity of gingival or periodontal disease; however, even more information is gathered by the clinician as evidenced by the following ten applications.

Automated periodontal probes have been designed to try to obtain more consistent probing measurements. Most automated probes do this by taking a reading utilizing a specified probing force. This can be helpful in standardizing probing depth measurements in a calibrated manner especially when doing research projects pertaining to probing depths.

Explorers are typically slender curved metal instruments used for tactile sensation and detection of calculus, caries, root anatomy, restorative overhangs, etc.

Commonly used explorers in periodontics are TU 17 (Tufts University) and ODU (Old Dominion University) (Fig. 5.12).