Module 3—Instrument Grasp PDF

Module 3—Instrument Grasp Section 1 Grasp for Periodontal Instrumentation  Modified Pen Grasp -Facilitates precise control of instrument -Allows detection of rough areas on tooth surface -Lessens musculoskeletal stress...

Module 3—Instrument Grasp Section 1 Grasp for Periodontal Instrumentation  Modified Pen Grasp -Facilitates precise control of instrument -Allows detection of rough areas on tooth surface -Lessens musculoskeletal stress 2 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Modified Pen Grasp (cont.) The recommended method for holding a periodontal instrument 3 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Parts of an Instrument A. handle B. shank C. working-end 4 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company At first glance, it may appear that a periodontal instrument is held in the same manner as the grasp used for writing. This is NOT the case. The modified pen grasp is much more precise than the grasp for writing. 5 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Successful instrumentation technique depends to a great degree on the PRECISE placement of each finger in the modified pen grasp. 6 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Finger Identification for Grasp 7 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Thumb and Index Finger -Function is to hold the instrument 8 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Thumb and Index Finger (cont.) 9 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Thumb and Index Finger (cont.) The thumb and index finger are opposite each other at or near the junction of the handle and shank. 10 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Thumb and Index Finger (cont.) Hold the handle in a relaxed manner. Grasp the handle lightly. Blanched fingers indicate a grasp that is too tight. 11 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Joints of Index Finger and Thumb in Neutral Position 12 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Incorrect Finger Placement When the index finger and thumb are NOT across from each other on the handle, the instrument is difficult to control. 13 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Overlap of Thumb and Index When the thumb and index finger overlap, it is difficult to roll the instrument. 14 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Incorrect Grasp -Causes the finger pads to lift off of the handle -Makes it difficult to control the instrument -Makes it difficult to roll the handle between the fingers 15 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Handle Rests Against Hand The instrument handle rests against the hand to stabilize the instrument. 16 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Incorrect: No Handle Rest Holding the handle in a pinch-grip away from the hand creates a weak, unstable grasp. 17 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Middle Finger -Function is to guide the working-end and feel vibrations from the working-end to shank 18 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Middle Finger (cont.) One side of the pad of the middle finger rests LIGHTLY on the shank. 19 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Middle Finger (cont.) With the middle finger on the shank, the clinician is able to feel vibrations transmitted from the working-end. 20 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Incorrect: Middle Finger on Handle -Middle finger should NOT rest on the instrument handle -Middle finger is not used to hold the instrument -Reduces tactile information to hand -Reduces control of the instrument 21 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Middle Finger (cont.) The other side of the finger pad of the middle finger rests against—or slightly overlaps— the ring finger. 22 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Middle Finger (cont.) -One side of pad on the shank -Other side of pad against ring finger, for stability 23 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Ring Finger -Functions are to stabilize and support the hand for control and strength 24 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Ring Finger (cont.) The fingertip of the ring finger balances firmly on the incisal or occlusal surface of a tooth. 25 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Ring Finger (cont.) The ring finger acts as a support beam for the hand in the mouth. 26 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Stands Straight and Tall -Ring finger advanced ahead of the other fingers in the grasp -Ring finger held straight to act as a support beam for hand -Fingernail length must not impede ability to keep ring finger upright 27 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Incorrect Ring Finger -Held in a curved, limp manner -Provides no stability for hand -Makes it difficult to control instrument stroke 28 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  “United We Stand” The index, middle, and ring finger should be in contact at least at one point. -Provides stability and strength in the grasp 29 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Little Finger -Has no function in the grasp 30 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Little Finger (cont.) -Has no function in the grasp -Held in a relaxed manner close to ring finger 31 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Successful instrumentation technique depends to a great degree on the PRECISE placement of each finger in the modified pen grasp. 32 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Modified Pen Grasp -Allows precise control of working-end -Facilitates good tactile conduction 33 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Incorrect Split Fulcrum -No point of contact between middle and ring fingers in the grasp -Creates a weak grasp -Stresses the muscles of hand 34 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Impact of Finger Length on Grasp -A clinician’s finger length determines the location where he or she grasps the instrument handle -Each clinician must adjust finger rest and grasp according to their own hand size and finger length 35 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  -With shorter fingers the clinician will tend to hold knuckles of the index finger and thumb in a more curved “knuckles up” position, and grasp the instrument higher on the handle 36 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  -With longer fingers the clinician might hold the knuckles of the index finger and thumb in a less curved “knuckles flat” position, and grasp the instrument nearer to junction of handle and shank 37 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Proper Glove Fit 38 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Proper Glove Fit (cont.) -Important to avoid muscle strain during instrumentation -Gloves should be loose fitting across palm and wrist area -Better to wear right- and left-fitting gloves -Tactile sensitivity is enhanced with thin gloves and good fit at fingertip area -Nitrile gloves provide more grip friction than latex gloves 39 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  -Gloves should be loose fitting across palm and at wrist area -Index finger of other hand should slip easily under wrist area of gloved hand 40 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  -Gloves should not be tight fitting across palm or wrist area 41 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Joint Hypermobility of the Hand -Joints easily move beyond the normal range expected -Described also as “double-jointed” or joint laxity -Clinician counteracts joint hyperextension by bending thumb and index finger in grasp 42 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Joint Hypermobility of the Fingers 43 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Hypermobility and Grasp 44 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Hypermobility and Grasp (cont.) -Individual with hypermobility must learn to grasp the instrument without the joint of thumb and index finger collapsing inward -Do not want to grasp the instrument with too much force -A Lycra or silicone sleeve – Silipos sleeve – can assist grasping the instrument handle 45 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Silicone Sleeve 46 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Joint Hyperextension of Ring Finger 47 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Finger Rest with Silicone Sleeve 48 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Other Predisposing Conditions for Hand Injuries -Arthritis in hands may cause a hygienist to reduce work hours -Treatment and physical therapy may improve the arthritis -Women may have weak muscle strength in hands, especially with petite hands -Hand strengthening exercises are beneficial to improve hand muscles for all 49 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Fingernail Length -Long fingernails reduce hand strength during instrumentation -Results in decreased pinch grip strength -Long fingernails may interfere with correct grasp and finger rest technique 50 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company Long Fingernails and Grasp 51 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Summary -Modified pen grasp is recommended for holding a periodontal instrument -Correct grasp requires precise finger placement on the instrument -Correct grasp allows precise control of working end, a wide range of movement, and good tactile conduction 52 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Section 2 Grasp Variations  Practical Focus Analyze the grasps shown in these slides. 54 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Photo 1 55 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Photo 2 56 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Photo 3 57 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Photo 4 58 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Photo 5 59 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Photo 6 60 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Photo 7 61 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Photo 8 62 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Photo 9 63 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company  Photo 10 64 Copyright © 2016 by Jones & Bartlett Learning, LLC, an Ascend Learning Company