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4. Periodontic and Endodontic Instruments


a. Preparing for the Patient. Preparation for the patient includes cleaning and sterilizing of instruments and equipment used for the previous patient, and the placement of linens, headrest covers, and bracket table covers for the new patient. It also includes setting out the patient's records and radiographs for reference by the dentist and preparing appropriate instruments and equipment setups. All unit instruments such as handpieces and air and water syringes should be wiped vigorously with an alcohol-saturated sponge. If the unit is not to be used immediately, alcohol-saturated sponges should be draped or wrapped around the unit instruments to keep the unit clean.

b. Use of Auxiliary Aids for Diagnosis.

(1) The pulp tester is frequently used in the endodontic service as an aid to diagnosis.

(2) If a cold thermal test is required, the dental assistant should have a small pencil of ice ready. The pencil should be small enough to allow the dentist to apply it to one tooth at a time and should be prepared with a gauze pad to facilitate handling. To prepare a pencil of ice, remove the rubber plunger from a 1.8 cc anesthetic Carpule™ with an explorer. Fill the glass Carpule™ with water, place it in a paper drinking cup, which is set in the freezing compartment of the refrigerator. When a pencil of ice is needed, the frozen Carpule™ is run under tap water. The ice slips from the Carpule™ to present the pencil of ice.

(3) If a warm thermal test is needed, either a piece of temporary stopping (gutta-percha) or an egg-shaped burnisher warmed over the flame of a Bunsen burner may be used. During this procedure, the dental assistant should have the water syringe ready to cool the tooth if the test causes too much pain.

c. Use of Anesthesia. If the endodontist plans to use a local anesthetic, the dental assistant should have the necessary instruments ready.

d. Application of Rubber Dam. After the administration of the local anesthetic, the dental assistant should have the rubber dam equipment ready for use by the dentist. Once the dam is applied, the operative area is rendered aseptic by swabbing with 70 percent isopropyl alcohol or other suitable antiseptics. If a rubber dam clamp is used and a multiple appointment method of treatment is to be followed, recording the number of the rubber dam clamp used may save time at later appointments.


David L. Heiserman, Editor

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Revised: June 06, 2015