A dental curette is a specialized hand instrument used extensively in dentistry, particularly for treating gum disease and in various surgical procedures. This tool is designed to precisely scrape or scoop material from the surfaces of teeth and the surrounding soft tissue. The curette is fundamental for accessing and cleaning areas below the gum line, a region inaccessible to ordinary brushing and flossing. Its design allows the dental professional to effectively remove hardened bacterial deposits, known as calculus or tartar, that contribute to periodontal disease.
Defining the Dental Curette
The physical design of the curette is intentionally structured for delicate work within the mouth, especially in the periodontal pocket—the space between the tooth and the gum tissue. It consists of a handle for the operator to grip, a shank that connects the handle to the working end, and a spoon-shaped blade with rounded edges and a rounded toe. This rounded toe is a distinguishing feature, permitting the instrument to be inserted safely into the gum pocket without lacerating the delicate soft tissues.
The two primary categories of curettes are differentiated by their adaptability to various tooth surfaces. Universal curettes feature a blade with two cutting edges that can be used on all surfaces of any tooth, offering great versatility. In contrast, Area-Specific curettes, commonly known as Gracey curettes, have a blade offset at a precise angle to the shank, meaning only one cutting edge is used.
Each Gracey curette is designed for a specific area, such as the front teeth or the back surfaces of molars. This allows for superior adaptation to the complex curves of the root surfaces, enabling thorough cleaning in deep or intricate areas.
Primary Use in Non-Surgical Periodontal Therapy
The most frequent application of the dental curette is during non-surgical periodontal therapy, which includes the procedure known as Scaling and Root Planing (SRP). This treatment, often referred to as a deep cleaning, is necessary when periodontitis has caused the gum tissue to pull away from the tooth, creating deep pockets. The presence of calculus and bacterial biofilm in these pockets sustains the inflammation and bone loss characteristic of gum disease.
The first phase of SRP is scaling, where the curette mechanically dislodges and removes hardened calculus deposits from both above and below the gum line. The rounded working end allows the instrument to slide safely into the periodontal pocket to access deep subgingival deposits, reducing the bacterial challenge that causes inflammation.
The second phase, root planing, involves using the curette to smooth the root surface after calculus removal. This process creates a clean surface that is biologically acceptable for the reattachment of gum tissue. A smooth root surface is less likely to harbor new bacterial colonies and promotes the healing of the periodontal tissues, which is the ultimate goal of the therapy.
Specialized Surgical Applications
Beyond routine deep cleaning, the curette has specific uses in various surgical dental procedures, where its scraping and scooping function is applied to soft tissue and bone. One application is soft tissue curettage, which involves removing the inflamed or diseased inner lining of the periodontal pocket. This debridement of the pocket wall can be performed to help reduce the depth of the pocket and encourage healing.
Curettes are also routinely used in oral surgery to clean extraction sites following the removal of a tooth. After the tooth is pulled, the surgeon uses a specialized surgical curette, such as a Lucas curette, to carefully remove any infected tissue, granulation tissue, or foreign debris from the empty tooth socket. This step is performed to ensure the socket is clean before it heals, preventing complications like a dry socket.
The instrument is also employed in complex procedures, such as periapical surgery, to address infection around the tip of the tooth root. Specialized surgical curettes, which often have larger, more robust working ends, are used to clean out diseased bone tissue or cysts from the jawbone area surrounding the root apex.