Clinical improvement of gingival conditions following ultrasonic vs hand instrumentation of periodontal pockets. Torfason, T. et al, Journal of Clinical Periodontology; 1979

Conclusion:No significant differences between the effect of ultrasonic root debridement and hand instrumentation in the treatment of 4-6 mm deep periodontal pockets.

I started dental school in 1984, 5 years after this study came out. I was taught that hand scaling was the only way to go. And, I kept this with me for decades. I was proud that we were a hand scaling-type of practice because the only practices utilizing primarily ultrasonics during their hygiene appointments were “lower end” practices that took HMO plans. They liked ultrasonics because it was faster and more efficient. For us, we were happy to take extra time to do it right, right? No, we were wrong.

The outcomes were the same. This information was out there but I had never seen it. As hygiene superstars we need to be aware of information that is already out there and also more aware of what is going on and doing some of our own investigating to see what works and what doesn’t. Now that I don’t just sit on my hands waiting for definitive research, if I wasn’t aware of these studies, I would have run my own little experiments to see what works and what doesn’t on my own patients.

I know, you might be saying, how can you experiment on your own patients without them knowing it, is that ethical? It is called the practice of Dentistry for a reason. Nothing is written in stone. I scraped cementum off of roots for decades before I started to think about the damage I was causing. The key is to keep a tight leash on your patients, observe them often, consider the down side and make sure their is not a huge risk involved and talk it over with your dentist. If you thought, “wow, this grout cleaner that I just used on my kitchen floor worked great, I wonder how it would do in the mouth.” This, obviously is not the in-office experimentation that you should be doing. The consequences of being wrong could be very bad. Don’t do this. But experimenting with doing the coronal polishing first instead of last, yeah, that has a low/no risk downside.

Hand Instrumentation vs ultrasonic debridement in the treatment of chronic periodontitis. Ioannou, I., et al. Journal of Clinical Periodontology; 2009

Conclusion:Both treatment modalities provided comparable results in the treatment of chronic periodontitis.

These studies show comparable results when using ultrasonics the way we used to use them, but hygiene superstars us ultrasonics in a much different and more effective way. Get your self a Superstar Subscription and start learning the way they should be used.