Is the Cavitron safe for use with composite restorations?

Greetings Dr. Hall:

My query is in relation to the Cavitron Ultrascaler for cleaning. I have a couple of class 5 restorations on my front teeth but am concerned that the metal tip of the Cavitron will damage the composite restoration. I am getting conflicting information online that the Cavitron will damage the composite and will not damage the composite, as long as a low power setting is used. Also, it is safe to use only if a plastic sleeve or carbon composite tip is used? I am confused. Given my particular circumstance, under what conditions is the Cavitron safe to use and not to use? I do thank you, sir, for your input and time on this concern of mine.

Cordially,
– Cara from Pennsylvania

Dear Cara,
The reason you’re getting conflicting answers in your online searches about the effect of a Cavitron on composite restorations is that there isn’t a straight answer to the question.

Yes, a Cavitron can damage porcelain veneers or composite restorations. A class V composite which is right at the gumline could be especially vulnerable. But it depends on the operator whether it actually will or not. I can help explain that with an analogy. I had a barber when I lived in Iowa who, every time I had him cut my hair, he would shave the back of my neck with a straight razor. Now that’s a nasty instrument and used improperly he could have really caused some damage. But he knew how to use it, and because of his skill I was more likely to cut myself with my own safety razor than be cut by him with his straight razor. That’s similar to the Cavitron issue.

I used to include Cavitron on my list of no-nos for people with porcelain veneers and other cosmetic dental work, but I don’t any more. That comes from my personal observation of three different dental hygienists who have used Cavitrons on me with great care and skill. If they’re smooth in their hand motions and light with their touch, they won’t cause a problem. If they’re not, they can damage more than restorations – they can nick and gouge the cementum on your teeth, giving you sensitive areas that attract plaque and calculus.

To give me a little more perspective, I asked my current hygienist, Courtney at Dr. Kelly’s office in Scottsdale, to comment on your question. She said that yes, a Cavitron can damage restorations if it is used improperly. The way she handles it is that she doesn’t use the very tip of the instrument on the restoration, and she is careful not to dwell on any restoration. She added that she has patients who will share with her that they feel uncomfortable with certain procedures and they will tell her they don’t want her using the Cavitron around certain restorations, for example, or they want her to thread the floss through their teeth in a certain way, and she honors those requests. Being her patient, I can say that I feel that the Cavitron is a safe instrument in her hands, and I let her go where she feels she needs to go with it.

What I would recommend, if you have any anxiety about this, is to ask your hygienist what he or she would do around class V composites. Listen to the explanation, and if you detect a level of confidence that reassures you, let them go ahead. If, after the explanation, you have any doubts, then ask them to stay away from those areas and they should respect that request.

Dr. Hall

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