Welcome to the final installment of our dentistry guide. The last seciton will be looking at the modern dentistry “Laser Whitening Machines” and Animal dentisry. It will also cover the basic tools that the patient should be encouraged to use in between visits to the dentist, like the common “toothbrush”.

Laser Whitening Machines
Laser teeth whitening machines are relatively modern equipment costing several thousand pounds. Specially trained dentists perform laser whitening treatment to remove discoloration from a patient’s teeth. A hydrogen peroxide based gel is applied to the teeth. A laser light is focused onto the teeth, this reacts with the gel causing the hydrogen peroxide to break down. This process, which is harmless to the tooth itself, bleaches the discolourations and contaminants leaving teeth typically six shades lighter.

Animal Dentistry
Increasingly techniques and materials used in human dentistry are being used for treating animals. The world’s largest dental caps are half a meter long and weight over 13 kilos each. The metal caps were fitted to an the cracked tusks of an Asian elephant called Spike in Calgary Zoo in Alberta, Canada in 2002.

Toothpicks
Probably the oldest and the simplest dental tool is the humble wooden toothpick. The toothpick is a small stick with a sharpened point, or points, made from wood, plastic or other material. The toothpick is used by the individual to remove detritus from the teeth usually after eating. Conversely, often they are used for eating food at parties examples include appetisers such as cheese and pineapple or small sweet onions.

The toothpick predates modern man, the ‘Homo Sapiens’ as the skulls of Neanderthal man show evidence of teeth that have been picked with a tool. It is thought small animal bones were often used as toothpicks. All well known cultures have used the toothpick, even toothpicks made of bronze have been excavated from ancient remains. By the 17th Century some toothpicks were also seen as fashionable luxury items crafted by artisans from precious metals and encrusted with expensive jewels. Before the toothbrush was invented, soft and hard dental woods were used by some people to clean their teeth. Modern toothbrushes and floss are generally made from plastics.

Floss Picks
Floss Picks are a modern re-incarnation of the tooth pick and feature a plastic body with two extended prongs. Between these prongs is a piece of taut dental floss which itself may have a wax or fluoride coating.

Toothbrushes
The most commonly used dental tool is the humble toothbrush. Featuring an ergonomic handle and a head with a soft bristled surface they are typically used along with cleaning products and polishes known as ‘toothpaste’. Toothbrushes are often made from synthetic materials. Softer bristles may be recommended as firmer bristles may cause damage tooth enamel and irritate the gums. As well as manual toothbrushes, electric or battery powered units are increasingly common. The dentist also often uses a type electric toothbrush to clean and polish a patient’s tooth enamel after the ’scale’ and dental plaque have been removed, this is known as a ’scale and polish’.

Before the toothbrush became so popular, twigs or wood with antiseptic properties was chewed, or substances such as baking soda, chalk, salt or even soot were rubbed onto the teeth to clean them. The first ‘toothbrush’ was thought to have been invented in China in the 15th Century. If was made from a bamboo stick and the stiff hairs from a hogs neck!

In this part of the dental-tools.co.uk 7 step guide we will be covering the instruments used to make the dentists life easier. These will include different lights and an appropriate dental chair. Such tools are also designed in a way to make the dental environment a comfortable place for the patient to be in.

Bite Block
A bite block may be used by the dentist to keep a patients mouth open to allow better access when administering treatment. This is sometimes used in longer treatments where the patient may struggle to keep the mouth open for the duration. The block is horseshoe shaped and made from various synthetic materials. Especially useful regarding the occlusion of the teeth, bite blocks can also be used to record the spatial relation between the jaws. Dental bite blocks vary in size to facilitate their use on both children and adults.

Curing Light
A Curing Light resembles a small hand drill, but instead of drilling they emit a powerful beam of light from their halogen bulbs. This light is used to harden or ‘cure’ the filling material. Materials that a curing light tool would be used upon are; non amalgam, white or tooth coloured fillings, and sealants used for other treatments.

Being liquid based these sealants and synthetic materials known as composites are very soft. The use of the curing light tool hardens them into a shell like substance. Layers of material can be added to ‘build up’ a larger filling. Curing Lights often feature; intensity controls, shields and have ergonomic pistol grips. Shields are usually clamp attachable and are used to block reflection and UV radiation. The shields can be completely sterilised as they are made from a single piece of material.

Condenser
A condenser or ‘plugger’ is used by the dentist to press the silver amalgam filling material into the cavity of the tooth. It is typically a stainless steel rod with thin, angled, flattened points on either end. These points vary in size to allow the dentist to complete the work efficiently before the material hardens.

Matrix Bands
The dentist uses Matrix Bands in situations where the cavity is located between the teeth. The band prevents filling materials from bonding to the other tooth. The band is removed by the dentist when the filling has been completed.

Bone Chisel
Bone Chisels are used in oral surgery such as Corrective Jaw Surgery ‘Dentofacial Osteotomy’. The Bone Chisel is used to cut, modify, re-align or even move dentofacial deformities.

Dental Excavators
Excavators are dental tools used to remove soft decayed tissue from a patients mouth. Visually they are a stainless steel rod with a tip fashioned into a very small spoon shape. They are used to open up the teeth as part of the preparation when administering a filling.

Dentist Chairs
One of the largest tools the dentist will use on a daily basis is the renown ‘Dentists Chair’. Dentist Chairs are ergonomically designed for the comfort of both the patient and the dentist. Modern chairs have control panels on either side for use by the dentist and their assistant.

Attachments for mounting hoses, syringes and even x-ray viewers can be part of the modern dental chair, making it a multi purpose work station for the dentist. Many dentists suffer from occupational poor posture leading to back, neck, arm or hand pain. Using a suitably designed seat and adjustable dental chairs can help alleviate these conditions.

Dental X-ray Luminators and Holders
A Dental X-ray Holder is used to position a patients dental x-rays against a back-lit screen know as a Luminator. This allows a dentist to view the x-rays quickly whilst treating the patient. The equipment may be free standing or wall mounted and usually work with both panoramic and intra-oral mouth x-rays.

Dental Lamps
Dental Lamps are high intensity light sources used for a wide variety of dental applications. They provide ‘task lighting’ providing luminance and contrast for the dentist work area.

This part of the guide will be focusing on the dental tools that make sure the patient is kept safe at all times. We will cover Tooth shields, which are designed to protect from drills, right up to spatulas which are used as a hygeinic way of mixing materials used for fillings and other dental substances.

Tooth Shields and Angled Wedges
Tooth Shields and Angled Wedges are used by the dentist to protect adjacent teeth when performing a variety of procedures. Wedges are made from materials including both plastic and stainless steel and prevent the burr of the dentist’s drill from damaging adjacent tooth enamel. The plastic wedge portion is inserted between the teeth leaving the metal shield exposed to protect the teeth.

Dental Spatulas
Dental Spatulas are used by the dental professional to prepare and ‘mix up’ specific materials used for creating fillings. This dental tool is not used in the patients mouth. Usually made from stainless steel pole a typical spatula is a rod of approximately 6 inches long with shaped flattened areas at one or both ends.

Cotton Pliers
To avoid contamination, a dentist uses cotton pliers to remove materials such as cotton padding from a patients mouth. These materials are often used to control moisture when performing examination or dental work. They resemble tweezers but are referred to as cotton pliers. They are also useful for picking up small items.

Root Canal File
Root canal files are small dental instruments used by dentists and endodontist who specialise in root canal work. They feature a stainless steel metal rod tapered to a point and have a knurled handle. The diameter of the rod decreases towards the tip allowing it’s insertion into the root canal area. The ‘rough’ edges of the rod are used to file away decayed material from the tooth. The pulp of the tooth is removed to ensure all bacteria is cleared away before the root canal filling can be performed.

Dental Syringe for Anaesthetic
The Dental Syringe is a tool used for administering an injection of  local anaesthetic to a patient ahead of treatment such as fillings or extractions. The dental syringe comprises a sealed cartridge containing the anaesthetic solution and a breech loading unit.

Dental Syringe for Air or Water
Also referred to as a Dental Syringe is the ancillary tool used to supply water or air to the oral cavity during dental surgery. When drilling into a decayed tooth the dentist needs to remove the debris from the area being worked on. The dental syringe is a tool the dentist can use for this purpose. The tool features a three way syringe system with separate channels supplying air, water or a mist of air and water combined. The tip of the syringe can be separated from the main body and  is usually replaceable.

Amalgam Well
An Amalgam Well is a small metal vessel used to store the amalgam used for filling teeth. Once the amalgam has been mixed by the dentist or his assistant it is briefly stored here to allow the dentist to scoop it up using his amalgam carrier and insert it into the previously prepared tooth.

Amalgam Carriers
Amalgam Carriers are used by the dentist to transfer the filling material to the opening that has been created in the patient’s tooth. These often used tools are made from stainless steel and can be double ended. The dentist scoops up material from the amalgam well and squeezes it into the cavity of the tooth. These tools are particularly useful for moving larger amounts of material. As the amalgam ‘goes off’ or hardens very quickly, the dentist can rotate the tool and use the contents stored in both ends to allow larger amounts of material to be inserted without delay. To add additional smaller pieces of amalgam the dentist may also use his probe.

Probably the most common reason for someone visiting the dentist, is for cleaning. Thats why in part 4 of our 7 part guide we our covering the tools used in this kind of work. The tools mentioned below are likely to be used at even a standard dental checkup.

Periodontal Curettes
The periodontal curette is a dental tools used to clean and treat the area of the mouth just below the gum line called the gingiva. The tool employs a rounded tip to reduce the trauma to the patient. Used in prophylactic and periodontal tooth care to remove accumulated calculus from the subgingiva area around the tooth’s base.

Curettes are often have angled terminal shanks supplied with posterior analogues to enable the dental practitioner to successfully complete their task. If the curette’s blade is perpendicular to it’s shank this will facilitate the blade’s operation on the mesial or distal surface of a tooth. If the blade is laterally offset by 70 degrees to the shank this results in a tool with a lower cutting edge and a upper edge that is non-cutting. These tools are used to clean mesial tooth surfaces.

Similar tools for distal surface work are also used. Different sized curettes are used for the various types of teeth with their varying requirements.

Dental Mirrors or Mouth Mirrors
One of the most common dental tools is the mouth mirror. A mouth mirror is usually a small, round mirror attached to a slim handle. Various sizes are used to allow the dental practitioner access to view hard to see areas of the mouth such as the back molars, third molars, or areas where an obstruction such as a dental dam is blocking the view.

Apart from viewing teeth and the surrounding oral structures, the dental mouth mirror can also be used to retain soft tissue such as the tongue and cheeks. It can also be used  to reflect light onto surfaces of teeth being worked on; especially beneficial when there is no direct vision of an obscure area of the mouth.

The use of mirrors also saves the dental professional from having to repeatedly adopt a poor postural position to see the other teeth saving them from developing chronic back and neck problems. These mouth mirrors are commonly used by other professionals such as engineers and by technicians in laser and optical laboratories.

Dental Mirrors with LED Lighting
Modern dental mirrors are using LED technology to generate pure white light to illuminate the mouth and tooth structures. LED light is shadow and glare free and can be powered by battery, allowing tools to be operated without cables.

This diminishes the need to repeatedly adjust both the patient and overhead lighting in order to be able to clearly see into the mouth. These mirrors are often coated in titanium to prevent corrosion and tarnishing and still allowing the unit to be autoclaved or ’sterilised’ to ensure utmost hygiene standards.

These dental tools are often supplied with an autoclavable handle and, as with most mirrors, they have a knurled grip to ensure ease of use. Depending on the tool, the mirrors may be supplied in batches and have disposable heads.

These mirrors are ideal tools for all types of oral examinations, restorative dentistry, air-abrasion, trans-illumination and identifying calculus build up, occlusal decay and checking root canal orifices. When used as a trans-illuminator they are also useful tools to high light areas where the tooth has fractured.

Dental Excavators
Dental excavators are used by the dental professional to remove soft carious decayed tooth material. Examples of dental excavators are spoon, half hollenbach, bin angle, straight and wedelstaedt chisels.

In part 3 of our 7 part dentistry guide we will begin to look at Dental Handpieces. These include the tissue shaping carvers. We will also delve in to a brief history of the Dental Drill.

Dental Drills or Dental Handpieces
The often feared dentist drill is a small, high speed, dental handpiece. It is used to remove decayed tooth material ahead of a dental filling being inserted. Dental drills use rotary burs made from hard metal alloys. These burs are rotated at high speeds to make decisive cuts in the tooth material.

It is thought that their high-pitched shrill sound is one of the main reasons why many people fear going to the dentist. There are many different types of drills and burs employing a variety of shapes specifically designed for the dentists many specialist requirements. The burs are usually made from a steel alloy with tungsten carbide coatings. Some burs are made entirely from tungsten carbide, some have a bur comprising of diamond segments used in their coating to increase their cutting efficiency. Common bur classifications are round or inverted.

History of the Dental Drill
From cavities containing 3.5 mm concentric grooves uncovered during archaeological excavations, it is thought that as far back as 7000 BC the civilisations of the Indus Valley used foot-powered dental drills to cut teeth. These early machines may have been operated by skilled craftsmen using stings and bows. Reconstructions of these machines have proved these methods would have successfully operated.

More recently man developed mechanical hand drills operation at speeds up of to 15 revolutions per minute. By the late 1800s clockwork drills were invented, these were much faster, however they were also very noisy. Both pedal powered drills and pneumatic powered drills soon followed, all to be out-shadowed by the invention of the revolutionary electric drill in 1875. These electric drills developed further through the first half of the 20th century, increasing in speed and power.

Then followed the air turbine drill handpiece which was driven by compressed air. Also developed was the contra angled air turbine handpiece which became the first commercially manufactured dental drill. Modern high speed precision drills operate at several hundred thousand revolutions per minute. However some lower speed units are used to provide higher torque for certain applications.

More recently still, other technologies using laser ablation or air abrasion have been used as tools in dentistry. Air abrasion is a technique that uses high speed compressed air to wear away at the surface of the decayed tooth.

Important factors to be considered when buying a dental handpiece include; motor life and checking the number of holes for the attachment to the unit in the high speed units and in the low speed units, checking that the type of attachment to the motor is suitable.

Dental Retractors
Dental retractors are dental tools used to manoeuvre soft tissues in order to allow inspection or to make room to work on areas of the mouth. Examples of dental retracting equipment are; Dental Mirrors, Lip Retractors, Mouth Props, Cheek and Tongue Retractors.

Carvers
Carvers are a stainless steel tool that is used by the dentist to finish or ’shape’ the amalgam filling when performing dental restoration work. They feature a rod with different sized, strong points on both ends.

Cleoids
A Cleoid is a type of Carver tool used to carve anatomy on silver fillings. They are made from stainless steel and resemble a rod with a point on one end and small hook on the other.

Welcome to part 2 of our 7 part guide to dentistry. In this article we will be looking at the basics in dental tools, and looking at the standard instruments used in all dental practices

Standard Instruments
Standard dental instruments are used in dental examinations, restoration work, tissue manipulation and tooth extraction operations.

Examination Instruments
Examination instruments are dental tools such as mouth mirrors that allow the dental professional improved visual access to the mouth during examination and treatment.

Periodontal Probes
A Periodontal Probe is a common dental tool used to investigate and measure a patients gum just below the tooth. It is a long, thin metallic instrument with a blunted end made typically from stainless steel. The Periodontal probes has measurement markings which are used to show the depth of the pockets around each tooth.

The instrument’s tip is pressed lightly into the gingival sulks parallel to the contours of the tooth’s root, and is then pushed down to the base of the pocket area. The gingival sulks is potentially an area of space between the tooth and it’s surrounding tissue. These measurements are an important part of determining the health of the patient’s periodontium.

The first marker visible on the tool, once it is in-situ, indicate the pocket’s depth. The many different periodontal probing tools use various shading systems or circumferential lines to represent pocket depths. In people with health gums a three millimeter depth is usual with no bleeding when performing the probe. There is a possibility of attachment loss between the alveolar bone and the tooth if these depths are shown to be increased.

This is often the case with patients with periodontitis or gingival hyperplasia. Left untreated the tooth can become loose and would eventually be lost. Other periodontal tools are curved and are used to measure the furcation area between the roots of a tooth. The sickle probe and the straight probe are examples of different types of periodontal probes.

Periodontal Scalers
A periodontal scaler is a frequently used dental instrument adept at removing calculus build-up from a patient’s teeth. The scaler is typically a triangular cross-sectioned tool which employs sharp tips to access restricted embrasure spaces between the teeth. Used primarily in prophylactic and periodontal tooth care, the scalers’ narrow tips are different from the blunt tips found in periodontal curettes.

Periodontal Scalers are used to physically scrape away the calcified build-up deposited on teeth above the gum line over the course of  time. Their blades have scraping edges on both sides enabling them to be used on both the distal and mesial surfaces of the teeth being worked on. Various dental scalers such as anterior and posterior scalers are employed to allow easy access to the different types of teeth.

A skilled dentist ensures that the last section of the handle attached to the blade, called the terminal shank, is held parallel to the tooth’s long axis. Posterior analogs which feature angled terminal shanks are often utilised to complete the procedure thoroughly. Periodontal scalers should not be used below the gum-line as they may caused damage to the gingiva.

Dental Burrs
Dental Burrs are the cutting surfaces used on dental drills to allow the dentist to cut into decayed tooth tissue. The burs are classified by their shapes, sizes and the type of shank used. Their cutting surface is  made from various hard compounds including tungsten carbide, they may feature a stainless steel multi-fluted rose head, and may employ a diamond coated tip for improved cutting ability.

Over the next few weeks dental-tools.co.uk will be issuing various articles covering the different types of dental tools available on the market, and various other issues in dentistry. These exclusive articles are intended to help dentists and dental practices get to know the facts and to get the best from their dental tools. This article is part 1 of 7 and will cover the basics in dentistry and dental tools.

Dentistry
Dentistry is the area of medicine dedicated to the study and treatment of diseases of the mouth and it’s surrounding area. Good dental health is vital for a persons overall health. A dentists primary role is to perform examination, diagnosis, prevention and treatment of all conditions relating to the mandible ‘jaw’, oral cavity, maxillofacial area and the surrounding soft tissue areas. Treatment may involve surgery along with other medical professionals such as oral health hygienists, dental assistants, technicians, therapists and anaesthetists.

Prevention
A key part of a dentists role is to help people maintain proper oral hygiene and to avoid the need for treatment and ultimately the loss of their teeth. Proper brushing and flossing techniques are encouraged by Dentists and Oral Hygienists. Excessive brushing could result in the gums themselves being damaged. Dental sealants may be applied to the teeth to prevent dental cavities and other forms of decay. These sealants are made from synthetic materials and can be applied to just a single tooth if required. Other preventatative products such as anti-bacterial mouthwashes may also be prescribed by the dentist.

Dental Surgery
Although a key part of dentistry is to work with the patient to maintain a healthy mouth, including of course, the gums and teeth, it may be necessary to perform surgery to treat or improve a dental issue. Many different dental tools are used daily by every dentist, from the simple dentists explorer and mirror to drills and more complex machines such as the x-ray or radiograph.

Common surgery is for treatments of dental cavities or caries of the teeth. After removing the decayed material the tooth can be filled with dental amalgam, dental composite, dental porcelain, non-precious metals or even precious metals such as silver or gold. Dentists are authorised to prescribe medications such as antibiotics and administer x-rays in their surgeries. Common dental surgery includes performing prosthetic and restorative work, periodontal, endodontic and exodontia.

Increasingly most dentists are performing more complex surgery such as extracting third molars ‘wisdom teeth’ or installing implants. Due to the complex and serious nature of dentistry all dentists must be qualified and certified by the relevant authorities to ensure they have the relevant skills and follow correct practices. More specialised consultants and dental surgeons are often referred to where a patient requires oral or maxillofacial surgery.

It is often said that a persons mouth or teeth can be a good indicator of their state of health. Many serious diseases such as bilateral odontogenic keratocysts and abnormalities such as several unerupted teeth may indicate neural or systemic diseases.

Dental Tools and Equipment
There are many different types of dental equipment. Often these intricate hand tools are used in other professions or by enthusiasts such as in model making and sculpting.

Dental Phobia
The fear of going to the dentist is called dentophobia.

Explorers
One of the dentists’ and hygienists’ most commonly used tool s is the dental explorer. As well as counting teeth, this tools is used to check the teeth to see if there are any ’sticky spots’. If the point of the tool sticks to the tooth this could indicate that there is tooth decay present. Other uses of Dental Explorers are; to check the margins of crowns and to verify that fillings are not leaking. They are not used on the gums. Made from stainless steel they feature a handle with thin curved points on either end.

Every dentist and dental hygienist uses a variety of dental tools to clean, polish and repair teeth with. These instruments are expensive and need constant repair. If you are looking for a new career or a small business that requires little start up money then you may want to consider starting a repair business that focuses on the repair and maintenance of dental hand pieces.

To start up your dental hand piece repair business you will first need to learn about the dental hand pieces that you will be repairing. You can gain this information by simply reading the user’s manuals distributed by the manufacturers of dental equipment. These manuals can usually be found free of charge online.

The second step that you will need to take to set up your repair business is to learn basic maintenance and repair skills for dental hand pieces. There are several low cost courses that you can take to learn the skills needed to maintain these tools. Some of the repair courses that you may want to look for include repairing air turbine motors and replacing dental ball bearings.

The final step for setting up your repair business for dental hand pieces is to find customers. To help get the word out you will also want to design a brochure that lists your prices, repair services and information about your training. You can hand out these brochures to local dentists. You may also want to start by approaching your dentist or dental specialist. Having a business card can also help you to develop referral and repeat business.

There are a lot of supplies, tools and materials that dental practices need in order to operate properly. Some of the most important dental tools are dental ball bearings. These small tools are needed for dental handpieces to work properly. A smooth running dental practice requires the proper tools for every job including administrative tasks. Administrative tasks include things like setting up patients’ files, filing insurance forms for payment, managing costs and ordering supplies.