The firm but light hold a dental clinician has on their instruments is referred to as "grasp". A proper grasp enables the clinician to maneuver the instrument around the tooth and correctly direct pressure application for calculus removal without damaging the periodontal tissues.

Three specific grasps are used. They are the pen grasp, the modified pen grasp, and the palm-thumb grasp. The modified pen grasp is the most useful.

The resting of the third finger on a firm intra- or extraoral site acts as a fulcrum. This improves control of the instrument and application of forces by the working end against the tooth.

The instrument/wrist/ forearm complex must act as a unit rocking firmly but smoothly on the fulcrum. Wrist twisting or independent finger movement should be avoided. This would result in pain, muscle fatigue, and inflammation of the ligaments and nerves of the wrist.

This refers to the placement of the working end of the instrument in the correct relationship to the tooth.

This is the angle formed by the plane of the tooth surface and the plane of the face of the blade. Efficient cutting angulation is between 45, 90, and 70 degrees is considered ideal. Less than 45 degrees is considered "closed" and more than 90 degrees is considered "open".

To avoid damaging the soft tissues when entering the sulcus with a large, sharp instrument, the working end is inserted into the sulcus with the face of the blade "closed" or flattened to the tooth surface. Once in the depth of the pocket or sulcus, the blade is opened 45 to 90 degrees for working strokes.

This is the action of the working end on an instrument as it is moved across a tooth surface. Exploratory strokes provide light tactile feedback from the instrument tip. Working strokes provide controlled pressure against a tooth surface using an appropriate cutting angulation. Scaling strokes are short pulling strokes made with firm pressure to remove increment from root and enamel surfaces. Root planning strokes are made to remove deposits and smooth the root surface. Working strokes are ideally a series of overlapping strokes covering the entire tooth surface.

The author wishes to acknowledge the contribution of Dr. David Isaacs, in editing this lecture.