When it comes to periodontal therapy, there are multiple steps that are required prior to activating a proper working stroke on the teeth. First, a modified pen grasp position must be achieved before starting periodontal instrumentation; this position involves the thumb and the index finger placed on the instrument handle, the middle finger resting on the shank, and the little finger neutral and relaxed near the ring finger.[1] By holding periodontal instruments in this manner, it allows for precise control of the instrument, effective detection of rough areas on the tooth structure (i.e. calculus or irregular tooth anatomy), and reduces musculoskeletal stress on the clinician.[4]