1. Assessment Instruments Explorers and Probes Presented by: Mellissa Boyd, RDH, BSDH

2. Objectives Recognize the different types of assessment instruments and their applications in patient care Describe the fundamental applications of the 2 explorers found in the Chatt State Instrument Kits Explain the design features of an explorer Indentify the parts of the explorer shank

3. Objectives Describe what is meant by “tactile sensitivity” Explain the design features of a calibrated periodontal probe Discuss the fundamental applications of a calibrated periodontal probe

4. Instrument Classification

5. Assessment Determine oral status and needs of patient Health? Disease? Consists of several steps Review MDHX Radiographs Head/Neck Cancer Exam Dentition Examination* Comprehensive Periodontal Examination* *Explorers and Probes used for Dentition exam and CPE

6. Periodontal Exam

7. Calculus 101 Plaque-Biofilm Calculus http://www.edwardbyrne.com/plaque.htm

8. Dentition Exam ?

9. Oral Cancer Screening

10. Periodontal Probe Design Features Working‐End – Blunt – Rod‐shaped Cross‐section – Round – Rectangular Types – Calibrated – Furcation

11. Periodontal Probe Design Features Working-End Blunt Rod-shaped Cross-section Round Rectangular Types Calibrated Furcation

12. Purpose Used in comprehensive periodontal exam or PSR Measurement – Sulcus/pocket depths – Bleeding – Exudate – Recession – Oral lesions

13. Periodontal Probe Determine health of periodontal tissues

14. Williams Probe What are the mm markings on a Williams Probe?

15. UNC 12 What are the mm markings on the UNC 12 probe?

16. UNC 15

17. Marquis Probe

18. WHO probe (PSR)

19. Probe Depth What is the PD indicated in the picture?

20. Sulcus vs. Pocket Sulcus Space between free gingiva and tooth 1-3mm Pocket Sulcus deepened because of disease 4mm+ Gingival vs. Periodontal

21. Probing Depths Entire sulcus probed Six sites recorded per tooth 3 buccal/facial 3 lingual Record deepest reading per site Depth rounded up to nearest mm

22. Bleeding on Probing

23. Explorer Design Features Fine wire-like working-end Flexible shank Circular in cross-section Straight or curved shanks Paired or unpaired working - ends

24. Working-End 1-2mm length used Often referred to as “tip 1/3” Calculus detection Side of tip 1/3 EXD 11/12 Caries detection Point of tip 1/3 #23 Shepherd Hook “Tip 1/3”

25. Shank Functional Shank Long, complex Begins below working end Extends to last bend in shank nearest handle Terminal Shank (lower) Part of functional shank nearest to working-end Functional shank Terminal shank

26. Calculus Detection EXD 11/12 Long, complex shank Curved Shorter, slightly curved shank

27. Calculus Detection Pigtail/Cowhorn Extremely curved terminal shank Orban-type Straight terminal shank

28. Explorer Applications Detection Texture of tooth/root surfaces Calculus Caries Faulty restorations Overhangs

29. Tactile Sensitivity Feel vibrations transferred from instrument tip, through shank, to handle Learned ability Accomplished by using very light grasp and lots of PRACTICE!!

30. Examples of Tactile Sensations Catching on overcontoured restorations Dropping into a hole (carious lesions) Bouncing over an elevated deposit Feeling roughness

31. Calculus Detection

32. Three Types of Formation

33. Supragingival Calculus Coronal to GM Rough, chalky white, beige, stained Visual detection Dry with air or cotton 2x2

34. Subgingival Calculus Apical to GM Located in sulcus or pocket Tactile feeling only May show in x-ray Brown or Black

35. Explorer Applications Evaluation Completed treatment Calculus removal Restoration margins

36. Caries Detection Shepherd Hook ( # 23)Straight

37. Caries 101 Visible Caries Obvious, frank, open lesions Chalky, white, gray, brown, black in color May retain food Shallow lesions Light pressure Feels soft, tacky, leather-like Do NOT explore large, frank lesions!

38. Caries Pit & Fissure Caries Catch/stickiness when tracing fissure with light pressure Smooth Surface Caries Visually check for discoloration May feel rough or soft

39. Caries Root Surface Caries Develop on exposed cementum Feel explorer “dip” in/out May feel rough or leathery Recurrent Caries Restoration margins Feel explorer “dip” or catch along margin