DH Theory 1 L2
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Questions and Answers

What is the recommended grasp for holding a periodontal instrument?

Modified Pen Grasp

What are the three parts of a periodontal instrument?

  • Blade, Grip, Handle
  • Tip, Shaft, Base
  • Handle, Shank, Working-End (correct)

The modified pen grasp is as precise as the grasp used for writing.

False (B)

What is the main function of the middle finger in the modified pen grasp?

<p>To feel vibrations transmitted from the working-end of the instrument.</p> Signup and view all the answers

The little finger contributes significantly to the modified pen grasp.

<p>False (B)</p> Signup and view all the answers

What is the primary purpose of the ring finger?

<p>To act as a support beam for the hand in the mouth.</p> Signup and view all the answers

The index finger and thumb should be overlapping in the modified pen grasp.

<p>False (B)</p> Signup and view all the answers

What is the problem with an U-shaped grasp?

<p>It causes the finger pads to lift off of the handle, making it difficult to control the instrument.</p> Signup and view all the answers

The instrument handle should rest against the hand to stabilize it.

<p>True (A)</p> Signup and view all the answers

A pinch-grip away from the hand is a recommended technique for holding dental instruments.

<p>False (B)</p> Signup and view all the answers

What are the functions of a dental mirror?

<p>Indirect Vision, Retraction, Indirect Illumination, Transillumination (B)</p> Signup and view all the answers

A concave mirror is the most commonly used type due to its good image quality.

<p>False (B)</p> Signup and view all the answers

Which mirror type is not recommended due to its double image?

<p>Plane (Flat) Surface (C)</p> Signup and view all the answers

What technique involves directing light off of the mirror surface and through the anterior teeth?

<p>Transillumination</p> Signup and view all the answers

Posterior teeth can easily be transilluminated due to their thin structure.

<p>False (B)</p> Signup and view all the answers

When practicing transillumination, using a student partner, you will likely see shadows on their teeth.

<p>False (B)</p> Signup and view all the answers

What is the most common reason for surgical glove injury?

<p>Ill-fitting gloves.</p> Signup and view all the answers

Flashcards

Modified Pen Grasp

The recommended grasp for holding a periodontal instrument. It's a sensitive, stable, and strong grasp due to the tripod effect created by the thumb, index, and middle finger.

Tripod Effect

The stable grip achieved by the thumb, index, and middle finger working together in the modified pen grasp.

Parts of a Periodontal Instrument

The different sections of a periodontal instrument, such as handle, shank, and working end.

Modified Pen Grasp vs. Writing Grasp

The modified pen grasp, used for periodontal instruments, is more precise than the way you hold a pen for writing.

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Accurate Finger Placement

The exact position of each finger in the modified pen grasp is critical for successful instrumentation.

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Thumb and Index Finger Placement

The thumb and index finger are opposite each other at or near the junction of the handle and shank, holding the handle lightly.

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Blanched Fingers

Indicates a grasp that is too tight, cutting off circulation in the fingers.

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Incorrect Finger Placement (Thumb and Index)

When the index finger and thumb are not across from each other on the handle, the instrument is difficult to control.

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No Overlap (Thumb and Index)

The thumb and index finger should not overlap, as it makes rolling the instrument handle difficult.

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Form a Soft C-Shape (Thumb and Index)

When holding the instrument, the thumb and index finger should form a soft C-shape.

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Incorrect Grasp: U-Shaped

Index finger and thumb should not curve inward towards the handle, as this creates an unstable grip.

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Handle Rests Against Hand

The instrument handle should rest against the hand to stabilize the instrument.

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Incorrect: No Handle Rest

Holding the handle in a pinch grip away from the hand creates a weak and unstable grasp.

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Middle Finger Placement

One side of the middle finger pad rests lightly on the shank, allowing the clinician to feel vibrations from the working end.

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Tactile Information

Feeling vibrations from the working end of the instrument through the middle finger.

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Incorrect: Middle Finger on Handle

The middle finger should not rest on the handle, as this reduces tactile information and control of the instrument.

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Middle & Ring Finger Contact

The other side of the middle finger pad rests against or slightly overlaps the ring finger, providing stability.

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Ring Finger Placement

The pad of the ring finger balances firmly on the incisal or occlusal surface of a tooth, acting as a support beam for the hand.

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Standard Intraoral Fulcrum

The ring finger rests on a tooth surface 1-3 teeth away from the area being worked on, providing stability.

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Ring Finger: Straight and Tall

The ring finger should stand straight and tall, not curved or limp.

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Incorrect: Curved Ring Finger

A curved or limp ring finger provides no stability for the hand and makes controlling the instrument stroke difficult.

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United We Stand

The index, middle, and ring fingers should be in contact at at least one point for stability and strength in the grasp.

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Incorrect: Split Fulcrum

No point of contact between the middle and ring fingers in the grasp, resulting in a weak grasp and stress on hand muscles.

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Little Finger Placement

The little finger has no function in the grasp and is kept relaxed.

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Review: Correct Finger Placement

Summary of the correct position of each finger in the modified pen grasp: thumb and index opposite each other, middle on shank, ring on tooth.

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Uses of Dental Mirror

A dental mirror has four primary functions: Indirect Vision, Retraction, Indirect Illumination, and Transillumination.

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Indirect Vision

Using a mirror to view a tooth surface or structure that cannot be seen directly.

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Retraction

Using the mirror to hold soft tissues (cheek, lip, tongue) out of the way to view teeth.

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Indirect Illumination

Using the mirror to reflect light onto a tooth or structure in a dark area of the mouth.

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Transillumination

Directing light through anterior teeth using the mirror to reveal hidden decay.

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Purpose of Transillumination

To reveal hidden interproximal decay (cavities) in anterior teeth.

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Transillumination: Anterior Teeth Only

Transillumination only works on anterior teeth because they are thin enough for light to pass through.

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Light Position for Transillumination

Position the unit light directly over the oral cavity with the beam perpendicular to the facial surfaces of the anterior teeth.

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Mirror Position for Transillumination

Hold the mirror behind the anterior teeth with the reflecting surface parallel to the lingual surfaces.

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Viewing Tooth During Transillumination

Look directly at the tooth, not in the mirror. The tooth should appear to glow due to the reflected light.

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Transillumination: No Shadows

If you don't see shadows on teeth during transillumination, it likely means the student has no untreated interproximal decay.

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Study Notes

Instrumentation Fundamentals: Modified Pen Grasp & Dental Mirror

  • The modified pen grasp is the recommended method for holding periodontal instruments.
  • It's a sensitive, stable, and strong grasp due to a tripod effect from the thumb, index, and middle fingers.
  • The grasp needs continual re-establishment on the instrument.
  • To use the modified pen grasp correctly, identify the instrument parts: handle, shank, and working end.
  • The modified pen grasp is more precise than a writing grasp.
  • Successful instrumentation depends on precision in finger placement.
  • Specific finger placement is crucial for technique.
  • Incorrect finger placement (e.g., index and thumb not positioned opposite each other on the handle) or overlapping fingers decreases control.
  • A "U-shaped" grasp (index and thumb curving inward) is also incorrect, making it difficult to control the instrument and lifting finger pads off the handle.
  • The instrument handle should rest against the hand for stability.
  • Holding the handle away from the hand makes the grasp weak and unstable.
  • The middle finger should rest lightly on the shank, allowing for the feeling of vibrations from the working end (tactile feedback).
  • The middle finger pad should rest against (or slightly overlap) the ring finger for stability.
  • The ring finger should be positioned ahead of the other fingers to properly support the grasp; it rests on the tooth for a stable fulcrum.
  • The ring finger should be in a straight manner and not curved or limp, providing stability for better control of the instrument.
  • The index, middle, and ring fingers should ideally contact each other at one point for solid stability and strength in the grasp.
  • The little finger plays no role in the grasp.
  • Correct finger placement includes the index and thumb opposite each other near the handle-shank junction, the middle finger resting lightly on the shank on one side and resting against the ring finger on the other side, and the ring finger positioned on the tooth.
  • Incorrect split fulcrum grasp (lack of contact between the middle and ring fingers) leads to a weak grasp and increased muscle stress in the hand.

Dental Mirror

  • The dental mirror's working end has a reflecting surface.
  • Common mirror types include front surface, concave, and plane (flat).
  • A front surface mirror creates a clear image with no distortion and is frequently used for its good quality.
  • A concave mirror produces a magnified image but causes image distortion.
  • A plane mirror creates a double image (ghost image) and is less preferable for its distracting double image.
  • Dental mirrors are used in procedures for:
    • Indirect vision.
    • Retraction.
    • Indirect illumination.
    • Transillumination.
  • To prevent fogging, the mirror's surface should be moistened.

Uses of Dental Mirror

  • Indirect vision allows viewing surfaces not directly visible.
  • Retraction holds cheeks, lips, or tongue out of the way.
  • Indirect illumination reflects light onto the oral structures.
  • Transillumination directs light through anterior teeth to detect hidden decay.
  • Correct light position for transillumination is at the 12 o'clock position (perpendicular to the tooth).
  • Correct mirror positioning in transillumination means the mirror should be behind the anterior teeth, with its reflective surface parallel to the teeth' lingual surfaces.
  • Observing the tooth in the mirror, rather than the mirror itself, produces a clear view of the tooth (with reflected light).
  • Transillumination doesn't easily reveal shadows on healthy teeth because interproximal decay is usually not present.
  • Transillumination finds hidden decay in anterior teeth as shadows.
  • Anterior teeth are fine enough to permit light passage.
  • Posterior teeth are too thick for light to pass through and are not ideal for transillumination.

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