Know Your Scalers: All-Star Posterior Sickles Every Hygienist Needs To Try

In Part Two of our Know Your Scalers series we’ll review several lesser-known posterior sickles, which each offer specific advantages in clinical practice. In Part One, we discussed the systemic lack of clinician exposure to scaler designs available, and how this can lead to musculoskeletal issues, extended time scaling due to non-ideal adaptation, and increased hand fatigue. In an industry where every minute counts, hygienists must familiarize themselves with the true spectrum of available instruments and construct cassettes and setups that really meet the everyday needs they have in practice. Also, having an armamentarium ready for any anatomical challenge they may face when scaling is crucial. Below are just a few of those underutilized all-star designs.

1.  The Sickle #204. This sickle is the original design from which the ever-popular Sickle #204S was derived. It is, however, a useful design in its own right. The more open blade and terminal shank allow it to adapt better around posterior teeth- especially those pesky distals of terminal molars. It is also offset from the handle at only 30° as compared to the 204S at 40°, making it easier to adapt posteriorly without the need for a direct upright fulcrum (which hygienists simply cannot always achieve in far distal areas). Its long reach is great for clinicians with larger hands, patients with gag, or pediatric or petite dentitions, when keeping fingers more anterior is of greatest value.

2.  The Sickle #204SD. These mirror-image offset sickles, much like its relatives the 204 and the 204S, are handy around the entire dentition and into anteriors, making a wonderful full-mouth supragingival instrument. It is even more open than the Sickle 204, at a 25° offset. With a shorter terminal shank, clinicians with short fingers will have no issues adapting this with ease and maintaining a proper fulcrum. The shorter blade (hence the “S” in the name) also helps protect patients against tissue trauma through the contacts when scaling. All in all, this is a wonderfully thought-out design for distal instrumentation (hence the “D” in the name).

3.  The Posterior Scalette N135. This long-reach Nordent®-original design is another mirror-image offset sickle with shank bends similar to those of the well-known Barnhart 5-6, though it has a longer reach and a thin tapered blade. It also adapts perfectly around premolars thanks to its short blade. This is great for those Barnhart lovers who just can’t get into contacts or into crown margins well enough and would like a sickle companion to their Barnhart. It can also be paired with the Nordent®-original Anterior Scalette for general prophy instrumentation in just two instruments.

4.  The Sickle Doeppler #M-23. These mirror-image sickles are offset to 25° from the handle, on a medium-reach shank. This shallow, more open angle allows for posterior reach without a fulcrum directly on posterior teeth. This is great for small mouths or patients with third molars where clinicians may need to fulcrum more anteriorly. The medium-reach shank is just long enough to allow adaptation around terminal molars without feeling too long for the proper grasp. In comparison, the popular 204S sickle has a short-reach shank and a 40° offset. For those clinicians that have been wanting a sickle with better adaptation around terminal molars than the 204S, this instrument is for you!

5.  The Remington #3-4. At first glance, the exaggerated shank bends on this unique scaler can seem intimidating, but these 13mm tapered blades allow for reach into some of the most difficult-to-access areas in otherwise impossible scaling areas. The curves allow for wonderful adaptation around even the most posterior wisdom teeth, and oblique or horizontal strokes are easy. There is no concern about the bends becoming caught on the occlusal while trying to scale distals. Experienced clinicians who are comfortable with advanced fulcruming may find this becomes a go-to for areas they can’t seem to access otherwise.

6.  The Sickle N129. This Nordent®-original truly offers the best of most of the other designs detailed above. Like the Remington #3-4, it has unique bends in the shank and allows for effortless posterior distal adaptation. However, it is very well-rounded in that it offers medium reach, easy blade angulation to both mesials and distals, and more. In fact, it is a particular standout in scaling maxillary surfaces “towards” with a palm-down fulcrum, as it offers one of the most stable grasps in that area of any instrument available.

In an industry of ever-increasing time management expectations for clinicians, hygienists need to both know and proactively explore their arsenal of instruments. Those listed and detailed above are all great starting points for this endeavor. Beginning with Nordent® brand instruments will ensure the premium quality craftsmanship clinicians want. Our instruments are made in the USA, by master craftsmen with decades of experience. Additionally, we have introduced ground-breaking technologies such as the Posterior Scalette, the first-ever ergonomic instrument handles, and our XDURA® line—one of the longest-lasting scalers in the world. We also demonstrate an unbeatable level of support for our clinicians and products: our fast-turnaround sharpening program is one-of-a-kind, and is available free of charge for our XDURA® and Relyant® lines of instruments! We are also the only manufacturer with a 100% customer satisfaction guarantee, and 95% success rate for resolution of customer questions in only one inquiry.  Lastly, we provide knowledgeable and trustworthy advisors for your practice. We prioritize practice efficiency solutions, furthering your return on investments, and remaining an industry partner by keeping you up-to-date on industry trends.

We hope we have inspired your curiosity and motivated you to reach for more versatility and performance from your cassettes. Look out for our next lineup- universal curettes. Until then—happy scaling!