A full range of dental instruments is used when performing cosmetic dental procedures. Many of them have multiple purposes and can be applied in numerous treatments. The basic instrument lineup is explained below and categorized by routine use.
The basic set-up consists of three instruments that are utilized for every dental procedure. The patient’s treatment typically begins with a comprehensive exam and prophylactic cleaning. These three instruments are essential for proper diagnosis of any oral conditions and discrepancies.
Mouth Mirror – Needed to obtain a closer view of the tooth surfaces, pits and fissures as well as periodontal pockets and surrounding tissues. Mouth mirrors are manufactured in a variety of sizes and can accommodate any personal preferences of a dental professional.
Explorer – This instrument is typically employed for verification of soft spots in the enamel that may indicate the presence of decay or minute fractures invisible to the naked eye. The explorer is generally double-handed and may have a cavity finder or periodontal probe on the other end.
Cotton (College) Pliers – This device resembles tweezers and is used to pick up small objects such as cotton rolls, gauze or segments of fractured teeth.
Whether digitally or traditionally taken, several devices and equipment is used to take radiographs. The X-rays are vital to the treatment plan as the cosmetic dentist can properly determine if the patient is a good candidate for any cosmetic procedures.
XCP Holders – Dental film is held in position by using appropriate XCP (Extension Cone Paralleling) holders. These appliances are designed to take bitewing and periapical X-rays. Bitewing X-rays show the crowns of the posterior teeth in both maxillary and mandibulary arches. The periapical X-rays project the entire tooth structure including the root and the apex.
Panorex (Panelipse) – This devise takes the picture of the entire head including the nose and sinus region. It is ideal for detecting any abnormalities within the oral region such as impacted wisdom teeth, TMJ discrepancies or supernumerary teeth that are hidden within the palate or alveolar bone and not visible otherwise.
Cephalometric – The X-rays taken with this apparatus show the sides of the head and are often recommended to observe the cranial development of pediatric patients.
Other Methods – If none of the above methods are applicable, the substitute film holders may be used to complete an exam. These devices are fabricated from paper or styrofoam and are disposable. They also do not offer the precise positioning of the XCP and are typically used as the last resort if the patient cannot tolerate other techniques.
The cosmetic procedures, such as composite restorations, veneers, crowns or bridges require very few instruments and are routinely chosen at the discretion of the dentists. Below is a list of most common instruments used for cosmetic dental treatments.
Plastic Instrument – This instrument is used for molding and contouring the composite material or applying the cement. It can be double-headed with a plugger for compressing the material into the prepared cavity.
Burnisher – Numerous varieties of burnishers are used to condense and smooth the dental materials. One of the most frequently appliedis an Appleseed Burnisher where the head of the instrument is rounded at one side and pointed on the other for easier contouring.
Temporary Crown Remover – resembling pliers, this instrument has two beaks that firmly grasp the acrylic temporary restoration to be discarded.
Chisel – A small-headed chisel may be used in some cases to remove the existing crown which has to be sectioned to be taken off.
High Speed Handpiece – Also called a drill, the handpiece is a vital instrument in cavity preparation for any dental procedure. Laser versions are now available which produce less sound or discomfort to the patient.
Slow Speed Handpiece – It is used in hygiene for polishing the crowns of the teeth or in cosmetic treatment to clean the surfaces of the teeth with powdered pumice in preparation to receive a restoration.
In some cases, before the cosmetic procedures can be completed, some of the affected dentition may have to be removed. Simple extractions are usually performed by a general dentist. More complicated cases are referred to an oral surgeon who is better equipped to contribute to the treatment plan. Most commonly used surgical instruments are as follow:
Syringe – Used to administer local anesthesia.
Periosteal – This double-headed instrument is used to retract the tissue surrounding the tooth prior the extraction. The activity partially exposes the root allowing the dentist to better grasp the tooth structure with forceps.
Upper Universal Forceps (#150) – The forceps are used to extract upper posterior teeth in one quick motion. Many variations of this instrument have been manufactured to aid with the surgery.
Anterior Forceps (#1) – These are implemented for the removal of anterior teeth only.
Lower Universal Forceps (#151) – These forceps are angled appropriately for the extractions of lower posterior teeth.
East/West Elevators – The set contains two pointed instruments. Each is angled in a different direction and can be used to dislodge sections of the tooth after it has been segmented with the drill. East/West elevators are frequently used in complex surgical extractions.
Root Tip Elevators – If during the procedure, the tip of the root fractures off, this instrument serves as a valuable mechanical aid to force the tip out of the alveolar bone.