Ultrasonic Cleaners

Tippytoes

Hi

I would like to hear peoples' experience and views about dental ultrasonic cleaners used for scaling. I'm generally happy with my NHS dentist. However, I have EXTREMELY sensitive teeth and I just cannot tolerate the pain of ultrasonic cleaners. My dentist used to give me a local anaesthetic and scale my teeth over two separate appointments. Good results and pain free. But, my dentist has now decided that he doesn't want to use anaesthetic so I have the choice of excrutiating pain or a less effective manual scrape.

Does anyone else have the same problem?

welshdent

What I CAN tell you is there is no way I could provide that for you i.e. 2 visits for a simple scale and polish with local anaesthetic for 1 UDA. My suggestion is to use an electric toothbrush twice a day and floss once a day and dont need ANY scaling.

brook2jack

For tartar to build up plaque needs to be left undisturbed for 24 to 48 hours in other words if your cleaning was effective you would never need a scale and polish.

90% of people do not floss properly and most people do not brush properly unless they are shown how to. The common mistake people make us they clean the teeth not the gums or they get scared when gums bleed when they floss or brush and avoid the area.

My husband needed a scale and polish every 6 months until he met me! I have never needed one. Cleaning effectively is the key.

welshdent

like brook I have never needed a scale and polish. Occasionally I run a polishing cup over myself for the odd stain but given I am in my 30s, I have done that maybe 3 times so its not a regular things. I didnt mean to sound patronising OP, just trying to get across that the best way to avoid needing an uncomfortable scaling is to stop the deposits building up in the first place. For a check up and scale and polish I am pain 1 UDA of which 60% of the fee goes to my boss. That works out at just under a tenner. You own dentist is probably in a similar boat. We simply can not provide that service of 2 vists plus anaesthetic

Toothsmith

welshdent wrote: »

Occasionally I run a polishing cup over myself ....

You want to watch that! :rotfl::rotfl:

Toothsmith

A 2 visit clean up under L.A. could justify the Band 2 £45odd cost. Which would be slightly better from the dentist's point of view.

But if a single visit with hand instruments keeps things healthy, then that is the objective of NHS treatment met.

brook2jack

Well no, it all comes down to effective cleaning which means
A you won't need a scale and polish
B your teeth will become much less sensitive because tartar hasn't built up and the gums don't shrink any further.

NICE decided that most nhs scale and polish had no clinical benefit just cosmetic because all that was happening was once every 6 months tartar was removed but then was allowed to build up again immediately afterwards. In my opinion the most important part of a hygiene visit is not the scaling but the education however the government is unwilling to pay for either.

What is certain is gum problems are curable but it is 75% your effort and 25% your dentists. If your teeth are so sensitive are you using a desensitising paste properly ie rubbing it in at night and not rinsing? If you are of "a certain age" do you wear your glasses when cleaning your teeth so you can see the build up? Have you ever used disclosing tablets?

Less tartar equals less pain and sensitivity and no need or much reduced need for scaling.

Apollonia

The vibration from an ultrasonic scaler is produced from either a piezo-electric or a magnetostrictive system. As a dental hygienist I hate using piezo-electric scalers because the noise and vibration always seems much more intense than the other. It might be worth asking your dentist which he uses and if it is piezo, does he have access to the other type.


Where on earth did you get "it all comes down to money" from? That is not what was said at all - simply that 2 visits could justify a Band 2 charge.
Also, what makes you think that scaling with hand instruments only will be less effective? Any kind of scaling means removing deposits from the tooth surfaces and whether done by hand or by ultrasonic scaler so long as the deposits are removed the outcome is the same.

As has been said above, if someone is cleaning efficiently then there is no build up of tartar to be scaled. Try using disclosing tablets to check how efficient your cleaning really is - fresh plaque is invisible to the naked eye and teeth that look clean very often aren't.

Finally, what treatments have you tried for your sensitive teeth? Reducing the sensitivity is something I would be keen to do if it were me.

welshdent

Tippytoes wrote: »

So it all comes down to money at the end of the day.

Thanks to all of you for taking the trouble to explain from a professional's viewpoint.

Not really but brook sums it up well. What you are asking for is above and beyond what the NHS administrators feel appropriate. If you were being seen privately then the overheads would be included in the price.

Look at it like this ... you walk in to tesco for a melon. You can buy a melon for X pound for a whole, un cut one. Alternatively you can buy a pre cut one which will cost you 2X. Now to many this may be deemed un necessary and they are happy enough to cut it up themselves but some want extra. Some want the convenience of it being cut and de pipped. For this you have to pay extra because its above and above the standard. The problem with the NHS is you do not decide what is paid for and what isnt, a third party do that for you. The government/DOH do it and they have decided that a scale and polish is just that ... a scale and polish and as such thats all they are prepared to pay for. If you want extra then thats above the norm but its US that have to make up the short fall. Now it may seem like a nice idea we should cover the costs as we are providing the service ... but would you be happy if it was you? I dont know what you do for a living but if someone came in to your place of employment and expected you to pay for their demands I am sure you would have something to say about it. The anaesthetic and 2 visits are not clinically necessary and as such we can not provide it on the health service.

Also hand scaling is NOT less effective. It just takes more effort for us as its more of a manual task. Many advocate ultrasonic for gross removal and then fine scaling with hand instruments to get that higher end finish. If you were having periodontal disease treatment then in my hands almost all the scaling would be done by hand.

jugglebug

Apollonia wrote: »

The vibration from an ultrasonic scaler is produced from either a piezo-electric or a magnetostrictive system. As a dental hygienist I hate using piezo-electric scalers because the noise and vibration always seems much more intense than the other. It might be worth asking your dentist which he uses and if it is piezo, does he have access to the other type.

Just goes to show how important perceptions are and how variable they are.
i have just ditched a cavitron in favour of a piezo unit.
it is far quieter. (In fact I didnt think it was working at 1st ) and the patients have commented.
I suspect like many the practice I work at has been guilty of using the tips a little longer than we should leading to greater vibration in the handle leading to the noise, plus the energy is wasted and so the tip less efficient. So I didnt wait for the practice owners to replace. I bought my own
I think maintenece is more important than technology

welshdent

yup! I need to use a piezo as I have my endo attachments for it I am not going to get a second scaler unit just for scalings though LOL