Dental hygiene assessment, treatment planning and instrumentation
What this domain tests
This domain tests systematic assessment, treatment planning and safe instrumentation for scaling, root debridement and polishing.
Core rules
- Assessment includes medical history, extraoral and intraoral examination, periodontal charting, plaque and bleeding scores, and caries risk.
- Treatment plans prioritise urgent needs, consent, and phased care; re-evaluate before deciding on further treatment.
- Instrumentation requires a stable fulcrum, adaptation to the tooth surface, correct angulation (about 60-80 degrees for curettes), and controlled strokes.
- Gracey curettes are site-specific; universal curettes are not. Ultrasonic scalers require water coolant and careful tip selection.
- Polishing is selective: avoid demineralised enamel and use a low-abrasive paste; it does not remove calculus.
Worked example
A 6 mm pocket is on the distal of 47. Select a Gracey 13/14 for the distal of a mandibular molar, establish a fulcrum, adapt the toe, and use overlapping strokes. Reassess after healing.
Traps
Using one universal curette for all sites; angulation too shallow, causing burnishing; overpolishing; treating without re-evaluation.