Oral Prophylaxis made easy

Oral prophylaxis, when thoroughly done, gives so much satisfaction to the dentist, and the patient feels the difference instantly. In routine dental practice where six to eight oral prophylaxis cases have to be attended daily, sonic and ultrasonic scalers are of immense value

Sonic scalers use compressed sir and water delivered through hose designed for high and low speed handpieces. Sonic units consist of a handpiece that attaches to a compressed air line and uses a variety of specially designed tips. Air moves rotor system within the scaler that vibrates the working tip in an elliptical pattern at a frequency of about 2,000 to 6,000 cycles per second(cps). To remove less tenacious deposits typical of patients treated frequently, this is well suited, though it is difficult to remove tenacious deposits. E.g.:- Sonicflex Lux (Kavo America Corp. and Densonic by Dentsply International).

Ultrasonic scalers are of two types.

1. Magnetostrictive (e.g.:- Cavitron by Dentsply Int’l) system where electrical energy is applied to coil in the special handpiece which magnetically changes dimension of a metal stack, creating elliptical movement of the tip at a frequency of about 25,000 to 30,000 cps. all the sides of the tip are active and will work when adapted to the tooth. Significant generation of heat necessitates water for cooling.
2. Piezoelectric (eg:- Piezon Master 400- Shofu and Suprasson P Max by Satelec) system where electrical energy is applied to a crystal which emits vibrations in a linear pattern at frequency of about 25,000 to 40,000 cps. In Piezoelectric units, the pattern of vibration of the tip is linear, or back and forth, meaning that only the two sides of the tip are active and will work when adapted to the tooth. There is almost no heat generation and water is for lavage only.

Ultrasonic scalers can remove tenacious deposits.

Advantages of using automated scalers:-

• Decreased chair time.
• Operator’s fatigue doesn’t come in way of providing a thorough prophylaxis.
• Increased patient comfort.
• Increased operator comfort.
• Simultaneous water lavage and scaling.
• Some systems allow to work with an antiseptic irrigating solution.

Disadvantages:-

• Ultrasonics may interfere with pacemakers.
• Reduced tactile sense.
• Less control in difficult access areas.
• Amount of water coolant necessary for magnetostrictive systems is more and can be difficult to suction.
• Cost of the system.
• Noise can be irritating to some people.

Suprasson P Max provides both non autoclavable and autoclavable handpiece and various instrument tips, which, apart from scaling, can do the functions of root planing, amalgam plugging, prosthesis loosening. root canal preparation and gutta percha condensation. It has provision to work with an antiseptic irrigating solution.

Myth about prophylaxis: In Asian countries, there is a widespread misconception= "teeth become loose after prophylasis", this is not at all correct. Oral prophylaxis machine are hight speed and have special tips. In right hands they do not cause any harm whatsoever to teeth. Routinely this procedure is needed to be carried out every 6-12 months to keep your teeth and gums in healthy state.

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Reference :-

• CRA newsletter 17(4):April 1993.
• Jotikasthira NE et al. J of Clin Periodontol 19:560-569,1992.