When I first picked up a handpiece it was a scary sight. I’d spent 10 or so years watching dentists prep thinking nothing of it. Robotic, simple and quick.

Then, there I am, sitting in Sim Clinic looking at a margin that goes up and down like the Himalayas wondering if Dentistry is for me.

I’ve come a long way, and although my preps no longer look like a mountain range, I’m no Tony Rotondo.

I’m improving so there’s hope for all of us!

The ML has a slight bump. Taking photos helps as does digital images – with Cerec I get immediate feedback and can adjust this on the spot on the fly.

For me, the significant improvements came with getting used to the equipment (I now use a redband for most of my work) and in positioning and finger support.

Finger support

The most important factor in smooth, controlled, safe preparation of a tooth is finger support. Oral surgery, Periodontics and Prosthodontics all had their own method. The bottom line is you need one finger resting on a hard surface to stabilise your hand.

But that isn’t always as easy as it sounds.

Finger rest when there is no finger rest

A crown margin on the buccal of quadrant 1 has been a challenge in the past. For lefties this would be the buccal of quadrant 2. Everyone seems to have their own way in this situation.

I place an extraoral or gingival finger rest then use a finger from my other hand to support the head of the hand piece. I find this to help in the anterior as well.

Using the opposite hand to support the head of the drill i can comfortably get a smooth margin. Often the right ring finger sits directly on my left pointer finger too.

At a recent course a few notable specialists were saying they do this for anterior preparations routinely.

Learning your equipment

If you’re a dental student and a little worried about smooth margins and controlled preps I want to give some words of support. It takes time but even those without the steadiest hands can do excellent preps. I certainly do not have the steadiest hands around however I’m quite confident I provide sound dentistry. What matters is choosing the right equipment and getting used to the tactile feedback.

I find I can prep much more refined margins with a redband hand piece. I also use a red band diamond for the margin finishing and although not routinely, I may lower the RPMs to perfect an area.

Rest assured, with good (finger) support and some repetition creating ideal margins will be no problem at all.

This Tip was mentioned in the most recent Dental Head Start Podcast -  
#5 – The Noobie Dentist Podcaster, Dr Omid Azami.
 

You can find it on Spotify, Itunes, Android

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David is a recent graduate dentist working in private practice in regional NSW, Australia. Read more at www.dentalheadstart.com/meet-david/

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