Each dental hand instrument has a defined use in a dental procedure.  The dental assistant is responsible for knowing what each dental hand instrument does and which one the dentist will need during a procedure. Most dental hand instruments are used to examine the mouth and teeth, to professionally clean the teeth, to cut the teeth or remove cavities, to place filling materials, and to carve dental fillings. Most dental hand instruments are made of stainless steel, carbon steel, or plastic and must be strong enough to withstand constant use and sterilization procedures.

The dental assistant should set up the dental hand instruments on a tray in order of use in part to not delay the procedure. A procedure tray is set up from left to right. The dental assistant will use their left hand to transfer instruments to the dentist.

Many manufacturers assign a universal part number to most instruments and the dentist will often refer to the number rather than the name of the instrument. A dental assistant will want to learn the number and name of all dental hand instruments. Most dental hand instruments fall into four categories, they include examination instruments, hand cutting instruments, restorative instruments and instrument accessories.

Examination Instruments

Examination instruments are the most often used instruments on the dental tray. They allow the dentist, dental hygienist or dental assistant to thoroughly examine the patient’s mouth. These instruments include the Briault probe, cotton forceps, explorers, mouth mirror, periodontal probe and straight probe.

• Briault Probe – used to detect the junction between the enamel and dentine.
• Cotton Forceps – used to manipulate small objects including cotton pellets, gingival retraction cord, matrix bands, and wedges.
• Explorers – used to detect decay in the tooth’s surface. If the explorer sticks in the surface of the tooth, the tooth may have some decay that needs to be removed.
• Mouth Mirror – used in the mouth to view the oral cavity, reflect light and retract the cheek.
• Periodontal Probe – used to measure the pocket depth of the gums around each tooth. A healthy gum will have less than 2 mm of pocket depth.
• Straight Probe – used to examine cavities in the dentine region and to check the margins of fillings.

Hand Cutting Instruments

Hand cutting instruments allow the dentist, dental hygienist or dental assistant to remove decay manually from teeth for final restoration. The hand cutting instruments include the chisel, excavator, elevator, gingival margin trimmer, hand piece, hoe, hatchet, scalar, and Wilson.

• Chisel – used to break down the enamel margin of the tooth preparation, to form sharp lines and point angles, and to place retention grooves.
• Excavator – used to remove soft dentin, debris and decay from the tooth.
• Elevators – used to extract a tooth from the mouth
• Gingival Margin Trimmer – used to cut enamel and to place bevels along the gingival enamel margins of the preparation.
• Hand Piece – also known as a dental drill. Used to eliminate decay, prepare a tooth for a crown and to reconstruct the surface of a tooth after the bonding process.
• Hoe – used to prepare the tooth and to plane the walls and floors of the tooth preparation.
• Hatchet – used to cut enamel and to smooth the walls and floors of the tooth preparation.
• Scalar – used to scrape solidified plaque and tarter off the surface of the teeth.
• Wilson – used to pry back the gum tissue when performing an extraction.

Restorative Instruments

Restorative instruments are used by the dentist or dental assistant to restore a tooth by placing, condensing and carving a dental material to the tooth structure. Restorative dental hand instruments include the amalgam carrier, burnisher, condensers, composite placement instruments, carvers, and Woodsen.

• Amalgam Carrier – used to carry an increment of amalgam directly into the prepared tooth.
• Burnisher – used to smooth the surface of a freshly placed amalgam restoration.
• Condensers – used to pack down freshly placed amalgam into the preparation.
• Composite Placement Instrument – used for the placement of composite restorative materials.
• Carvers – used to remove excess material, to contour surfaces, and to carve anatomy back into the amalgam.
• Woodson – used for carrying dental materials to the prepared tooth structure.

Dental Hand Instrument Accessories

Accessory instruments are miscellaneous parts and instruments that are used to complete a procedure. Some of the additional accessory instruments include air and water tips, amalgam well, articulating paper holder, Howe pliers, mouth prop, retractors, scissors, spatula, syringe and Willis gauge.

• Air & Water Tips – the dental assistant will use to blow air or squirt water to remove debris from the mouth during a dental procedure or cleaning.
• Amalgam Well – used to transfer the newly mixed amalgam to transfer to the dentist.
• Articulating Paper Holder – used to hold and carry articulating paper to the mouth. Helps check a patient’s bite following the placement of a new restoration, crown, bridge or denture.
• Howe Pliers – also known as 110 pliers, they are used to carry cotton products, for removing matrix bands and for manipulation of a wedge.
• Mouth Prop – a wedge-shaped bite block used by the dentist for patients that have a difficulty keeping their mouths open wide during a procedure.
• Retractors – used to retract the cheek, tongue and lips to better view the teeth during a dental procedure.
• Scissors – used for cutting dental dam material, retraction cord, and stainless steel crowns.
• Spatula – used to mix liners, bases, and cements.
• Syringe – used to inject analgesic to the gums surrounding the teeth that will be worked on and allow the patient to not feel pain during the procedure.
• Willis Gauge – used to measure the vertical dimensions during patient assessment prior to denture construction.

Are you interested in learning how to use different dental hand instruments? Are you ready to learn more about how to become a dental assistant?  The Dental Assistant training program at Meridian College provides extensive hands-on training including a school externship at a dental office where you will assist the dentist in treating actual patients.

Contact Meridian College today to learn more about becoming a dental assistant.