Basic Dental Exam Instruments

There are a huge variety of instruments in the dental world. However, there are some key examination instruments that you should be aware of when it comes to practising. This post shall look at these instruments, providing some further information with regards to usage and design. In the future, there will be more information about specialist instruments for different dental disciplines.

Majority of hand instruments have a basic structure outlined in the image below:

The working end is the part of the instrument that is actively doing the work and usually is at an angle to the contact surface. The shank is the connection between the handle and the working end and often has many bends to allow access to different areas of the mouth. The handle is the portion held by the operator.

Basic Examination Kit

The basic examination kit contains 4 main instruments:

• Mirror
• Probe
• Periodontal Probe
• Tweezers

Mirror

The mirror is a crucial part of the exam kit, available in different sizes, with many functions:

• It allows extra light into the mouth to allow improved vision.
• It has the obvious advantage of allowing vision in to difficult to access areas and indirect vision.
• It can be used to retract tissue out of the working environment e.g. tongue and cheek.

Probe

The dental probe is another important instrument:

• It allows basic examination of the tooth surfaces
• It can help identify areas with calculus and decay (although care should be taken to prevent cavitation)
• It can be used to check for marginal failures/overhangs on restorations

Periodontal Probe

The standard probe used is the CPITN probe (also known as the WHO probe):

The CPITN probe is used to check the basic periodontal state of the patient. The probe consists of a 0.5mm ball at the tip. There is then a black band from 3.5mm to 5.5mm. Some probes also feature a black band from 8.5mm to 11.5mm. This probe is used to provide patients with a Basic Periodontal Examination (BPE Score).

Tweezers

These are used for things like picking up burs, cotton wool pledgets or anything else that you don’t want to put your hands on!

Other Important Instruments

Air-Water Syringe/3-in-1 Syringe

This has the ability to clean areas with water as well as dry areas through air. The 3-in-1 is useful in a huge number of applications, examples include:

• Drying teeth to diagnose decay
• Wash away acid etch
• Dry tooth before composite placement

Airotor/High-Speed Handpiece

Although not used for examinations, it’s important to know about the dental drills. The first of these are the high-speed, air driven, drills.

The high-speed handpiece functions at high speed, but has reduced torque compared to the low-speed handpiece. Speeds can be anywhere up to 500,000 revolutions/minute. As such high-speeds are used, the bur inserted into the drill MUST be cooled down by a water spray (otherwise this can be damaging to the tooth and materials used). Additionally, the bur can only rotate in a clockwise direction. High-speed handpieces also often have a fibre-optic light built into them.

Low-speed Handpiece

These can either be straight or contra-angled. The contra-angled handpiece is used inside the mouth, while the straight handpiece is used outside the mouth (e.g. to adjust dentures).

They have reduced speed, compared to the high-speed handpieces, but they have much higher torque. Usually an electric motor is used, however, there are air driven handpieces available too. The handpiece can rotate in both clockwise AND anticlockwise directions.

Handpieces (both low and high-speed) need to be lubricated before and after being sterilised to ensure proper function.

Summary

• There are a huge number and variety of dental instruments
• This page just looked at the VERY basics, primarily focussing on examination
• Use the right instrument for the right job

References and Recommended Reading

• Single Best Answer Questions for Dentistry
• Pickard’s Guide to Minimally Invasive Operative Dentistry
• Dental Instruments: A Pocket Guide to Identification