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Richard L. Pascoe DDS MS's Blog (47)

Make Your Own Sickle Scaler

Curette Sharpened To Sickle Scaler

I like to keep it simple. I don’t use sickle scalers. I can’t remember the last time I used one, especially in a posterior area. I used a universal curette, a University of California 5/6 (virtually the same as the Columbia 4R/4L)* and the ever so versatile Gracey 13/14. Actually, I had four curettes in my setup, one each of the above and one each of the above that had been sharpened to the point where their blades were narrow. I referred to the…

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Added by Richard L. Pascoe DDS MS on December 13, 2016 at 12:48pm — No Comments

Dental Industry Truth, Hyperbole, and Responsible Publishing

There is an old saying in the academic world, “publish or perish”. There is a much more current saying in the tech world, “garbage in, garbage out”. They both are true and, unfortunately, pertain to much of our “academic” literature.

When I ponder this, two things come to mind. First, there are many things that we were taught simply because the people teaching us were taught the same thing. And many of these so called facts go back several generations of educators. It’s amazing how…

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Added by Richard L. Pascoe DDS MS on December 5, 2016 at 2:44pm — No Comments

formats Curettes That Never Need Sharpening???

Never Sharpen Curettes and Scalers – Too Good To Be True?

I’m sure you have heard the claim from some instrument manufactures that they now can produce scalers and curettes that never need sharpening. When you take a moment to think about this is it possibly true? I tend to doubt it. Come on, a blade that never gets dull? Where is the research that supports this outlandish claim? I haven’t seen it but I have seen research that reports the opposite.

A study by independent…

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Added by Richard L. Pascoe DDS MS on November 4, 2016 at 6:36am — No Comments

Improve Dental Patient Care And Your Bottom Line

Improve Dental Patient Care And Your Bottom Line

Over the years I have emphasized the importance of using sharp scalers and curettes. With sharp instruments you scale and root plane better, you work faster, you are more efficient, and your procedure is more comfortable for you and dental patient care improves.

I’ve talked indirectly about the economic benefit of using sharp instruments. One economic benefit is the fact that you can work faster.…

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Added by Richard L. Pascoe DDS MS on October 24, 2016 at 2:30pm — 1 Comment

Bad Dental Habits To Chat With Patients About – Part 3

Addressing Bad Dental Habits

This blog is a follow up to Parts 1 and 2, which are based on an article on MedicineNet.com that discusses bad dental habits to avoid. 

We’re moving into the cold and flu season. Many of us will be seeking relief of a sore throat and coughing. Do yourself and your patients a favor – talk to them about choosing sugar-free lozenges and cough drops.…

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Added by Richard L. Pascoe DDS MS on September 30, 2016 at 10:44am — 1 Comment

More on the Flossing Controversy

Cheers For The Floss Controversy

A few days ago I wrote a blog about the recent Associated Press report indicating that insufficient research data exists to support the effectiveness of using dental floss. Because of this, the government has removed flossing from its Dietary Guidelines.

The Government’s position is not that they all of a sudden feel flossing doesn’t benefit oral health; they are simply saying that the scientific data to support its use doesn’t exist. This may…

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Added by Richard L. Pascoe DDS MS on August 15, 2016 at 3:25pm — No Comments

To Floss or Not To Floss

Should You Floss?

Much of the dental community is upset about the recent Associated Press report questioning the efficacy of flossing. Is the Flossing Study a disservice or a blessing in disguise? I choose to look at it as a blessing. What else could possibly bring flossing into the forefront of the social media more than something like this? Within 24…

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Added by Richard L. Pascoe DDS MS on August 5, 2016 at 2:59pm — No Comments

Being the Dental Implant Patient

My Turn Being a Dental Implant Patient

Recently, I had the experience of being a dental implant patient. Sure, I’ve had regular prophies over the years but have not needed any restorative treatment for some time.

Many years ago I had an asymptomatic periapical lesion involving tooth #23. Endo was done and all was fine until about 6 months ago. I started to experience a slight tenderness over the apex. I went to my endodontist friend and after his evaluation we agreed that the…

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Added by Richard L. Pascoe DDS MS on July 15, 2016 at 1:58pm — 3 Comments

Bad Dental Habits To Chat With Patients About – Part 2

Addressing Bad Dental Habits

This blog is a follow up to Part 1, which is based on an article on MedicineNet.com that discusses bad dental habits to avoid. 

We’re in the heart of the summer season when barbecuing and snacking are enjoyed by many. These activities present challenges to maintaining dental health and we should all make our patients aware of them.

First on…

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Added by Richard L. Pascoe DDS MS on June 29, 2016 at 12:55pm — 1 Comment

Dental Instrument Sharpener Properties – Part 3

How Coarse Should Your Dental Instrument Sharpener Be?

Last time we discussed how the hardness of the dental instrument sharpener affects its performance. Now let’s discuss the grit. The coarser the grit, the faster the stone sharpens. The coarser the grit, the more imperfect the sharpened edge is, in other words, the rougher the edge. So, is there a happy medium? I think there is.

Most of us were taught to use a fine grit sharpening stone in order to end up with a fine edge.…

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Added by Richard L. Pascoe DDS MS on June 7, 2016 at 4:00pm — No Comments

Dental Instrument Sharpener Properties – Part 2

The Ideal Dental Instrument Sharpener

I started a series with my last blog about the properties of the ideal hand sharpener. I discussed the hardness of the sharpener and its ability to break down during use. This controlled wearing down of the sharpener creates a fresh sharpening surface for each stroke. The result of this is a more efficient sharpener.

In future blogs, I’ll touch on other properties and benefits of the ideal hand dental instrument sharpener. Before we…

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Added by Richard L. Pascoe DDS MS on May 23, 2016 at 12:22pm — No Comments

What To Look For In a Dental Instrument Sharpener

How To Avoid “Loading”

There are several properties to look for in a dental instrument sharpener that help make the sharpening task simple and efficient. One is the sharpeners tendency to resist a phenomenon called “Loading”. You may have experienced this. Have you used a new sharpener that works great for a short while then becomes inefficient, making it more and more difficult to get a good, sharp edge? This is most likely the result of loading.

Loading occurs when fine…

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Added by Richard L. Pascoe DDS MS on May 16, 2016 at 1:42pm — No Comments

Bad Dental Habits To Chat With Patients About – Part 1

Addressing Bad Dental Habits

I’m always on the lookout for dental health info to share with dental professionals. I came across an article on MedicineNet.com on bad dental habits to avoid.

The article got me thinking of conversations I’ve had with patients over the years and what dental hygienists may be advising patients regarding prevention of dental problems. What may seem…

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Added by Richard L. Pascoe DDS MS on April 29, 2016 at 1:50pm — 1 Comment

Antibiotics and Periodontal Therapy

Is There A Place For Antibiotics In Periodontal Therapy?

The answer is yes but not early in treatment. What I mean is that antibiotics are not a solution for incomplete or inappropriate treatment. Antibiotics are more of, for lack of a better term, a last resort.

There are no short cuts to an appropriate treatment protocol. Thorough scaling and root planing, along with plaque control instructions, should be the foundation of our treatment approach. When I say thorough, I’m…

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Added by Richard L. Pascoe DDS MS on April 5, 2016 at 9:29am — No Comments

Acceptable Plaque Control

Is There An Acceptable Level Of Plaque Control?

What level of plaque control can we accept from our patients? The simple answer is – the best they are willing to perform. What is the minimal level of plaque control needed to control disease? The answer is – it depends. It depends on several factors none the least being the patient’s level of resistance. Another major factor is the frequency and quality of maintenance visits.

For years we would see our patients for their…

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Added by Richard L. Pascoe DDS MS on March 22, 2016 at 9:51am — No Comments

Periodontal Treatment Planning

Questions To Ask In Periodontal Treatment Planning

Up to this point I have posted several blogs concerning the periodontal assessment. We’ve talked about periodontal charting, the evaluation of radiographs, the assessment of local factors, etc. I like to refer to the accumulation of this information as the science of the periodontal assessment. It is black or white. A 5 millimeter pocket is a 5 millimeter pocket. A class 2 furcation exposure is a class 2 furcation exposure. The exam…

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Added by Richard L. Pascoe DDS MS on February 17, 2016 at 10:18am — No Comments

Periodontal Evaluation – Inflammation

Periodontal Evaluation – Inflammation Management

Our periodontal evaluation needs to include an evaluation of the inflammatory response. This is an interesting subject because inflammation is both good and bad. Inflammation can martial the forces, so to speak, that attack and destroy invading bacteria. Inflammation can clean up diseased and dead tissue.

On the other hand, inflammation also destroys healthy tissue, a sort of collateral damage. Actually, there is a benefit to…

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Added by Richard L. Pascoe DDS MS on February 1, 2016 at 2:11pm — No Comments

Periodontal Examination Of Attached Gingiva

Analyze The Attached Gingiva

A periodontal examination includes evaluation of the attached gingiva. Is the attached gingiva adequate in quantity and quality? The amount of attached gingiva necessary to maintain periodontal health has been debated. From a practical perspective, the attached gingiva is adequate if the gingival complex can remain inflammation free and there is an absence of gingival recession over time. In order to properly monitor gingival recession, accurate…

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Added by Richard L. Pascoe DDS MS on January 21, 2016 at 12:38pm — No Comments

Periodontal Radiograph Analysis

Radiograph Analysis In A Periodontal Setting

Periapical and bitewing radiographs provide a wealth of information about the patient’s dental condition. They are indispensable for diagnosis and treatment planning. They are indicative of the patient status at the time they were taken. Radiograph analysis does not predict future disease progression.

When reading radiographs the obvious things we look for are caries, periapical lesions, and bone loss. There is additional…

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Added by Richard L. Pascoe DDS MS on January 14, 2016 at 2:22pm — No Comments

Managing Continuing Periodontal Care

Periodontal Care Is All About Documentation

We’ve gone through a series dealing with the periodontal evaluation. Of course, we next need to formulate a diagnosis and proceed with appropriate treatment. When all is said and done, the patient is then placed in a maintenance program where his/her progress is monitored and documented.

I don’t have to tell you how important documentation is. I’ve learned over the years that lawsuits aren’t always won or lost based on the treatment…

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Added by Richard L. Pascoe DDS MS on January 8, 2016 at 5:07pm — No Comments

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