Staying sharp: A guide to instrument maintenance for dental hygienists

Musculoskeletal disorders (MSDs) are prevalent in the dental hygiene community. A systematic review in 2009 found that 60% to 69.5% of dental hygienists reported hand and wrist pain.¹ Common ailments include carpal tunnel syndrome, trigger thumb, pronator syndrome, lateral epicondylitis, and carpometacarpal osteoarthritis.²

Maintaining sharp instruments can help reduce musculoskeletal pain, but creating and implementing a regimen in the office can be difficult. Here’s a guide to help you set up a system that keeps hygiene instruments sharp.

Keeping hygiene instruments sharp

1. Get organized. Gather and label all instrument kits. If they’re in cassettes, number the cassettes by etching on them or writing with a permanent marker. (Note that permanent marker will fade over time due to sterilization and will need to be touched up.) If they’re bagged, use colored bands. Labeling kits will facilitate equal rotation of sharpening.

2. Create a log. Create a Google or Excel spreadsheet to track the kits. Access the log online or print it and post it in the office. List the kits (the number and/or color) in the first column and the date each kit was sharpened in the right. As each kit is sharpened, add a new date to the right of the previous date. Doing this will show how often kits are sharpened and indicate which one needs to be sharpened next. In most busy offices, instruments need to be sharpened at least once a month.

3. Choose a sharpening guide. A guide will ensure that anyone who sharpens uses the correct angle, which prolongs the life of the instrument. There’s an array of guides to use, including ErgoSharp, InstRenew, HoningRX, SideKick, Gleason Guide, Diamond Pony, D.I.S.C. sharpener, Speed Wheel sharpener, or a paper guide with a 110-degree/70-degree angle. Alternatively, you can send out the instruments for sharpening.

4. Determine who will sharpen and when. Dental assistants can be trained to sharpen and may sharpen whenever time permits. The task can also be delegated to the hygienist(s). Prioritize sharpening over other tasks when a patient cancels or find time outside clinic hours to sharpen a few kits. If you choose to send out instruments, appoint one person to oversee this process.

5. Observe nonscaling instruments. As each kit is sharpened, examine the mirror, explorer, and probe. Replace mirror heads when they become scratched or cloudy, explorers when they become too short, probes if the markings are wearing off, and colored bands as they wear thin. All the instruments in a hygienist’s kit are important and should be replaced when worn.

6. Keep extra instruments on hand. Instead of ordering instruments when they’re needed, keep three to five of each instrument on hand to replace immediately when others are being sharpened. Instruments need to be replaced when the blade is reduced by 20%, either in length or width.

7. Sharpen often. Sharpening frequently extends the life of instruments. When they become excessively dull, more metal needs to be removed to create a cutting edge. This leads to thin instruments that can’t be sharpened again. When instruments are touched up regularly, less metal is removed, instruments retain their width, and they can be sharpened many times before needing to be replaced. 

Instead of chasing the goal to sharpen instruments more often, create a system the entire office can follow to keep instruments rotating through the sharpening process. Use the guidelines here to create a system and adjust the system to suit the needs of your office. Doing so will result in happier hygienists who develop fewer MSDs.

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