for gripping and removing the tooth after it has been loosened. It can also be used for cracking and dislodging heavy dental calculus. Power instruments Ultrasonic scaler – used for removing calculus above the gumline. It utilizes a removable tip that vibrates at high frequencies by converting sound waves into mechanical vibrations, allowing for more rapid removal of calculus. It generates a substantial amount of heat and may cause thermal damage to the pulp if left on the surface of the tooth for too long. Sonic scaler – used for removing calculus above the gumline. It utilizes compressed air and operates at lower frequencies than an ultrasonic scaler. It is also less likely to cause thermal damage. Low-speed handpiece – utilizes a rubber tip called a prophy angle that polishes microabrasions and small grooves on the surface of the tooth. High-speed handpiece – utilizes a variety of removable dental burs to section teeth and remove alveolar bone during extractions. Dental charting All findings from an oral examination should be recorded on a dental chart. These include missing, rotated, and fractured teeth, probing depths of gingival recession, enamel hyperplasia or other enamel defects, mobility, furcation involvement, and other oral pathology. Charting not only records the current state of the dentition and soft tissues of the oral cavity, allowing the formulation of a treatment plan, but also provides a permanent record for future comparisons. The severity of gingivitis is scored by using the Gingival Index (GI), which consists of four stages: Stage 0 (GI0) – characterized by normal gingiva. Stage 1 (GI1) – marginal gingivitis with mild swelling of the gum tissue, some color change, and no bleeding upon probing. Stage 2 (GI2) – moderate swelling and inflammation of the gum tissue, and bleeding upon probing. Stage 3 (GI3) – severe gingivitis with marked swelling and inflammation, as well as spontaneous bleeding. The severity of periodontal disease is scored by using the Periodontal Disease Index (PD), which consists of five stages: Stage 0 (PD0) – characterized by the absence of disease. Stage 1 (PD1) – characterized by presence of gingivitis. This stage can be treated with dental scaling, polishing, irrigation, and home health care. Stage 2 (PD2) – early periodontal disease with less than 25% attachment loss of the tooth from the alveolar bone. The treatment for this stage includes the addition of locally applied antimicrobials and subgingival scaling. Stage 3 (PD3)