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How to Scale Teeth

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HealthWiki > Where There Is No Dentist > Chapter 8: Scaling Teeth > How to Scale Teeth

Tartar starts to form inside the gum pocket. There it builds up, because the gums protect it. So you often must feel rather than see the tartar when you scale a tooth.

You must remove all of the tartar so the gums can heal. New tartar grows faster when there is old tartar left behind for it to build upon.

Lay out what you need ahead of time:

DENT Ch8 Page 129-2.png your instruments: scalers, mirror, probe, tweezers
sharpening stone
cotton gauze

Your light must be good enough to see the tooth and gums around it clearly. Scaling teeth requires time and practice. Make yourself and the person comfortable. You can sit next to a special chair that lets the person lean back.

  1. Explain what you are going to do. Tell the person what to expect. There will be some bleeding and possibly some pain. However, you can stop and rest, or inject local anesthetic, if it is painful. Remember: first wash your hands and your instruments!
  2. Feel under the gum for tartar. Tartar feels like a rough spot on the root of the tooth. Since tartar can form anywhere inside the gum pocket, feel for it on all sides of the tooth.

    You can check for tartar two ways:
    illustration of the below: using gauze and a probe.
    a. Use your probe. Slide the point up and down along the root surface under the gum. Feel for places that are rough. Teeth without tartar are smooth.
    b. Use cotton gauze. Twist a corner and press it between the teeth. The gauze lowers the gum and soaks up the spit. You can then see more tartar.

  3. holding the scaler between the thumb and the first and second fingers.
  4. Place the scaler under the tartar. You must learn two important things: how to hold the scaler and how to slide the scaler into the gum pocket.
    Hold the scaler almost as you would hold a pen. You can then pull it against the tartar with both power and control.
    DENT Ch8 Page 130-2.png

    Control is very important. The ends of the scalers are sharp. If you are not careful, the blades can cut the gums. Be gentle and do not hurry. Always hold the tip of the scaler on the tooth to avoid poking the gums.

    Rest your 3rd finger against a tooth. This will steady your hand and let you slide the sharp scaler under the gum with care.

    using a mirror in one hand to hold the lip up while scaling with the other hand. FOR AN UPPER TOOTH using a thumb to hold the lip up while scaling with the other hand.
    DENT Ch8 Page 130-5.png FOR A LOWER TOOTH using an index finger (number 1) to hold the lip down while scaling with the other hand.

    The edge of the gum, near the tooth, folds under to form a pocket. This gum pocket goes completely around each tooth. The gum pocket can be shallow or deep. A deep pocket means there has been an infection for a while.

    Tartar starts forming deep inside the gum pocket. If you remove tartar that you can see above the gum, it is helpful, but not good enough. You must remove the rest of the tartar, or the infection will continue. If part of the tartar stays on the tooth, the infection will continue.

    a tooth with tartar on it, with parts labeled.
    gum pocket
    root fibers
    First, use the pointed-tip
    scaler to remove the
    tartar that you can see.
    Then, go back with your rounded-tip
    scaler and scrape away the
    remaining tartar.
    scaling above the pocket. scaling inside the pocket.

    Be careful when you place the rounded end of the scaler inside the gum pocket.

    DENT Ch8 Page 131-4.png DENT Ch8 Page 131-5.png
    a) Put the sharp face of the blade against the tooth. Slide it along the tooth down into the gum pocket. b) You can feel the edge as it goes over the rough tartar. Stop when you feel the bottom of the gum pocket.

  5. Hold the end tight against the side of the tooth and pull the scaler. Try to break free as much tartar as possible at once. It is a bad idea to remove the tartar a bit at a time, because the remaining tartar becomes smooth and harder to scrape away.
    1. Tighten your fingers
    on the scaler.
    2. Pull the scaler with a
    firm short stroke.
    DENT Ch8 Page 132-1.png
    DENT Ch8 Page 132-2.png
    3. Wipe the end of the
    scaler with cotton gauze.
    4. Press against the gums
    to stop the bleeding.
    DENT Ch8 Page 132-3.png
    DENT Ch8 Page 132-4.png

  6. Check to be sure the tooth is smooth.

    DENT Ch8 Page 132-5.png

    With your probe, feel under the gum for any place that is still rough.
    When all the sides of the tooth feel smooth, move to the next tooth.
    Do not hurry. It is more important to take your time and carefully remove all the tartar. If the person has a lot of tartar, scale only half the mouth now. Do the other half on another day, as soon as the person can return.

    Finally, make the tooth look clean. Use the sharp edge of either scaler. Scrape away the dark material on the front and back sides of the tooth.

    DENT Ch8 Page 132-6.png

    The tooth itself has not turned dark. It is just a stain. People most often get these stains when they eat meat, drink tea or smoke tobacco.

    You can scrape away this old food and uncover the white tooth. But remember: the teeth will turn dark again if not cleaned carefully every day.

  7. Talk to the person about what you have done and what to expect. The gums will be sore for the next few days. That is normal.
    Then explain to the person what to do to make the gums strong and tough again.
    • Clean your teeth better with a soft brush. Reach with the brush into the gum pocket, and behind your front teeth. That is where tartar collects most often.
    • Clean between your teeth. Use your brush, the stem from a palm leaf, or a piece of strong, thin thread.
    • Rinse your mouth with warm salt water. Start with 4 cups a day, to make the gums strong. Then use 1 cup a day to keep them strong.
    • Eat local foods that give strength to gums. Fresh fruits like guava and oranges, and fresh vegetables with dark green leaves are good for the gums.

This page was updated:19 Feb 2018