by Ann-Marie C. DePalma, RDH, MEd, FAADH
Periodontal instrumentation. As dental hygiene students we spent hours upon hours differentiating instruments and developing the psychomotor skills to obtain optimum results in periodontal debridement. Depending on when you graduated, ergonomics were encouraged. But in the “real world” of hygiene, many principles taught in school fall by the wayside as time and other issues seem to be more important.
Instrumentation skills are often compromised, and bad habits can develop. In her lecture “New Concepts in Periodontal Instrumentation” and hands-on course “Periodontal Instrumentation Camp,” Cindy Biron, RDH, MA, introduces participants to effective scaling and good ergonomic principles. The four-hour program provides participants with new instrumentation techniques that make hand scaling seem almost effortless.
Cindy’s techniques are based on the physics of leverage and the precise placement of instruments for effective deposit removal with minimum lateral pressure. In the courses, hygienists learn how to work more effectively to provide the best periodontal treatment for their patients with state-of-the-art instrumentation techniques. The hands-on program provides 12 hours of one-on-one instruction and critiquing of participants’ instrumentation techniques. The camp allows a six student to one instructor ratio to allow for maximum individual attention.
Given over two days, the camp is designed for the grass root hygienist, but also for any clinical dental hygiene faculty member who wishes to hone his or her techniques and impart the skills to students.
Participants in the programs will be able to:
- Name the type, cause, treatment and prevention of repetitive strain injuries common to hygienists
- Perform exercises that strengthen the hands and improve flexibility
- Describe optimum patient/operator positioning to provide the best leverage and least operator effort for performing periodontal instrumentation
- Describe the physics involved in the precision placement of the instrument, which results in less clinician effort during the working stroke
- Describe the importance of advanced fulcrum finger grasps
- Correlate instrument handle placement and chair side clock positioning for neutral wrist alignment and decreased lateral pressure with more controlled stroke activation
- Demonstrate the opposition fulcrum placement for reduction in pinch stress
- Demonstrate the technique for separating calculus deposits from the tooth surface with minimal loss of cementum
- Apply alternative fulcrum techniques to provide optimum instrument parallelism for access into deep periodontal pockets.
Cindy has seen many hygienists overwork due to improper physics and instrumentation, which can lead to burnout both mentally and physically. She has met many hygienists who provide wonderful services to their patients, but sacrifice their bodies while doing it. She believes that neither the latest equipment nor the best magnification can compensate for the improper use of the hands due to inadequate knowledge of precision, fulcrum and isometric physics. After participating in Cindy’s programs, hygienists are equipped with new techniques for effortless hand instrumentation and self-evaluation tools so they can continue to improve long after the course.
Cindy worked for many years with several periodontists before becoming a dental hygiene educator. She provided pre-surgical scaling and root planing for patients. She became very frustrated many times during surgical procedures when a doctor would call her in after doing a flap procedure to show her the calculus remaining on the tooth surface due to poor precision placement of instruments. To solve this problem, Cindy spent extensive periods of time devising new techniques with fulcrums she invented to access calculus in deep pockets.
After Cindy worked on the revised instrumentation for a time, the periodontist would smile and call her in during a procedure to say, “I’ve flapped after you and you do good stuff!” Cindy decided it was time to teach others what she had learned. In addition, she was fortunate enough to begin working side-by-side with Jill S. Nield-Gehrig, RDH, MA, author of the textbook Fundamentals of Periodontal Instrumentation and Advanced Root Instrumentation. Combining her experiences with Jill’s expertise of breaking down every aspect of instrumentation has brought Cindy joy beyond her wildest dreams.
When she moved to Florida and became chairperson of the dental health programs at Tallahassee Community College, she and the TCC dental hygiene faculty developed terms for all of the instrumentation taught during the programs. These terms are now part of the instructor’s CD in Jill’s textbook and enhance any hygienist’s ability to instrument effectively. Cindy has even developed a DVD that is used as a teaching tool with the textbook and is provided to participants during the instrumentation camp program. She uses PowerPoint, video and hands-on components during her programs, and provides a notebook with materials and research information. She loves being engaged with the audience and encourages dialogue throughout her presentations.
In addition to her administrative duties at TCC, Cindy teaches clinical dental hygiene, dental hygiene theory, medical emergencies and allied health pharmacology. She is a graduate of New Hampshire Technical College’s dental hygiene program, received a BA from Notre Dame College in New Hampshire, and an MA in Adult Higher Education from the University of Texas at San Antonio. She also received certification from UT as an emergency medical technician.
She is a contributing author to several textbooks, and served as a columnist and is currently a consulting editor for RDH magazine. Additionally, Cindy provides continuing education courses to both private practitioners and dental hygiene educators in the U.S. and Europe in clinical dental hygiene, pharmacology and medical emergencies. Her program opportunities arose from being a columnist for RDH. Her first column was “Pharmacology,” which became “Medical Alert” and ran for about seven years. She still occasionally writes articles for RDH.
While Cindy’s No. 1 passion is her husband, Ron, from a career aspect she enjoys sharing what she has learned about teaching and programs for educators and instrumentation techniques. She hopes that the techniques she promotes will be passed on to future generations of dental hygienists. She is a member of ADHA and wishes that all hygienists would join. Her fear is that without the financial support from membership to pay for lobbyists to fight for legislative initiatives, ADHA goals and objectives will not be accomplished. Hygienists everywhere need to make ADHA a priority in their lives. How can fewer than 30 percent of hygienists support the whole profession?
Cindy’s motto for her company, DH Meth-Ed, Inc. (Dental Hygiene Methods of Education) is “Becoming a master at imparting clinical skills.” She certainly empowers hygienists and educators to do just that.
For more information about Cindy or her programs, contact www.dhmethed.com.
After writing this column I had the opportunity to participate in Cindy’s instrumentation camp. Her command of the instrumentation process is incredible and her ability to impart that knowledge to participants is amazing. She takes instrumentation to the next level and makes scaling and difficult areas less of a problem and much more fun! That is ultimately what hygiene and scaling are all about -- helping patients achieve health while preserving our bodies and loving what we do. Thank you Cindy for sharing what you have learned.
About the Author
Ann-Marie C. DePalma, RDH, MEd, FAADH, is an assistant professor at Northern Essex Community College. She is a Fellow of the American Academy of Dental Hygiene, member of ADHA and other professional associations. Ann-Marie presents continuing education programs for hygienists and dental team members and has written numerous articles on a variety of topics. She can be reached at [email protected]. unm.edu or (505) 272-8147.