Bass Method Using a soft bristled brush, the bristles are pointed in an apical direction at a 45 degree angle. Using 20 short back and forth strokes the bristles enter the sulcus and partially into the embrasures. Recommended for any patient with or without periodontal disease.
Charters Method Using a soft bristled brush, the bristles are placed on the gums and are pointed in a coronal direction at a 45 degree angle. A vibratory motion should be used. Recommended for gentle plaque removal following periodontal surgery.
Modified Stillman Method A soft bristled brush is placed at the cervical portion of the tooth, pointing in an apical direction. Apply gentle pressure against the gums then roll towards the crown of the tooth. With this method, the sides of the bristle not the ends do the work. Recommended for cleaning in areas with progressing gingival recession.
Contraindications for Ultrasonic Scaler Use
You can check out the ultrasonic scalers from the sterilization window, but you should know the contraindications for its use. You need a slip signed by a periodontist to check out the ultrasonic scalers.
1. Communicable diseases – such as tuberculosis and respiratory infections
2. High susceptibility to infection. Debilitated individuals with chronic medical conditions or immuno-suppressed individuals (possible increased risk for respiratory infection)
3. Respiratory risk – Individuals who have difficulty in breathing such as asthma, history of emphysema, cystic fibrosis.
4. Oral conditions – Avoid contact of instrumentation tip with porcelain crowns, composite restorations, demineralized enamel surfaces or exposed dentinal surfaces. Not for use with titanium implants. These restorations could sustain chips, scratches or loss of material.
5. Difficulty in swallowing or prone to gagging- individuals with multiple sclerosis, muscular dystrophy, or paralysis
6. Unshielded Pacemaker – Check with cardiologist since magnetostrictive instruments may effect certain styles of cardiac pacemakers. (Piezoelectric instruments to do not interfere with pacemaker function).
7. Young, growing tissue – Vibrations may damage growing tissue in children
8. Age – primary and newly erupted teeth of young children have large pulp chambers that are more susceptible to damage from the vibrations and heat produced by ultrasonic instrumentation.
9. Periodontal surgery – Sterile water required if used in surgery (not live water).