dentalcare.ca logo

Advanced Instrumentation for the General Practice Dental Hygienist
Alternative Fulcrums

Course Author(s): Vickie Parrish Foster, RDH, MEd

Alternative Fulcrums

There are many auxiliary or alternative fulcrums that aid in scaling areas that have difficult accessibility. These include:

  • Cross arch: The fulcrum finger is placed in the same arch on the teeth, but on the opposite quadrant in which you are working (Figure 61).
Figure 61. Cross Arch.
Figure 61 A photo of an open mouth with cross arch fulcrum method
  • Opposite arch: The fulcrum is placed in the opposite arch from which you are working (Figure 62).
Figure 62. Opposite arch.
Figure 62 A photo of an open mouth with opposite arch fulcrum method
  • Finger-on-finger: The fulcrum is placed on a finger of the opposite hand which is resting on the same arch as you are working (Figure 63).
Figure 63. Finger-on-finger.
Figure 63 A photo of an open mouth and demonstrating the finger-on-finger fulcrum method
  • Reinforced fulcrum: The fulcrum is placed on the same arch as you are working and close to the working area. The index finger from the opposite hand is pressed onto the shank of the instrument and gently applies pressure. This increases the lateral pressure when scaling (Figure 64).
Figure 64. Reinforced Fulcrum.
Figure 64 A photo of an open mouth and demonstrating the reinforced fulcrum method
  • Extraoral fulcrums: The back of the hand or a finger is placed extra-orally to stabilize and obtain the most correct instrument angulation for activation and stroke (Figure 65).
Figure 65. Extraoral Fulcrum.
Figure 65 A photo of an open mouth and demonstrating the extraoral fulcrum method

Alternative fulcrums provide enhanced access to the working area, increase the likelihood of proper instrument angulation and activation and also help to provide increased power in the stroke. But they can also increase the risk of patient or operator injury and instability in the working area.7

Print