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Sickle Scalers Explained: H6/H7, 204S, 204SD, M23 – Which to Use Where

The sickle scaler is the first instrument on the tray for supragingival calculus. Here is what the classic designs are for, how they differ from curettes, and which versions exist for implants.
September 17, 2026 by
Sickle Scalers Explained: H6/H7, 204S, 204SD, M23 – Which to Use Where
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The sickle scaler removes supragingival calculus – the deposits you can see. Its triangular cross-section gives two cutting edges that meet at a pointed tip, strong enough to shear tenacious calculus from enamel and from just below the gingival margin. The pointed tip is also the reason it is not a subgingival instrument: it would traumatise the pocket. This guide explains the classic designs, when to use which, and what to look for when buying.

Scaler vs curette

Sickle scalerCurette
Cross-sectiontriangular, pointed tipsemicircular, rounded toe
Cutting edgestwotwo (universal) or one (Gracey)
Area of usesupragingival calculus, interproximal on anterior teethsubgingival scaling and root planing
Typical usegross deposit removal before fine scalingpockets, root surfaces

Both belong on a scaling tray. See our guides to Gracey curettes and universal curettes; ErgoDenta's English article Sickle scalers vs curettes – when to use each gives the manufacturer's view.

The classic sickle designs

H6/H7

A slender anterior sickle with a straight shank. The classic choice for the anterior region and for interproximal calculus between incisors. Available as double-ended H6/H7 and single-ended H6 and H7, and in titanium for implant patients.

204S and 204SD

Posterior sickles with a contra-angled shank that reaches around premolars and molars. 204S is the standard; 204SD is a slimmer version for tighter interproximal spaces. Both are available double-ended, as A/B single-ended halves, and in titanium.

M23 and M23A

A medium, versatile sickle with a straight shank – the "all-rounder" many hygienists reach for first. M23A is a variant with a slightly different blade; the range also includes a universal curette M23A for operators who prefer a rounded toe.

Mini and micro sickles

Mini sickle 11/12 and micro sickle 01/02 have shorter, finer blades for narrow interproximal areas and crowded anterior teeth. Also in the range: Nebraska 128, Crane-Kaplan (a pocket marker, see below), Furcator scaler, Sharp Jack and Mini Excess scaler.

All are listed under sickle scalers.

Titanium sickles for implants

Stainless steel can scratch an implant neck or abutment. For implant maintenance, H6/H7, 204S and 204SD are available in titanium (blue-coded), alongside titanium mini Gracey, Columbia 4L/4R and Langer 1/2 curettes. Keep the titanium set in its own cassette – see our guide to titanium instruments for implant maintenance.

Crane-Kaplan – not a scaler

The Crane-Kaplan is listed with the scalers because of its shape, but it is a pocket marker: a pincer-like instrument used to mark pocket depth on the gingiva before a gingivectomy. It does not remove calculus.

Choosing a sickle for your tray

  • Anterior teeth and interproximal deposits: H6/H7.
  • Posterior teeth: 204S, or 204SD for tight contacts.
  • One instrument for most supragingival work: M23.
  • Crowded anteriors: mini sickle 11/12 or micro sickle 01/02.
  • Implant patients: the titanium versions.
Handles: sickle scalers are used with lateral pressure, so many operators prefer the larger ErgoX Plus (13.7 mm) grip for scaling and the slimmer ErgoX (11.5 mm) for probes and mirrors. Diameters at ergodenta.dk/ergohandles; see our handle guide.

Series

Sickle scalers are available in the ErgoDenta, ErgoLite (ultra-light, about 14 g) and ErgoRazor® series and as replaceable ErgoTip tips. ErgoRazor® blades are developed to hold their edge longer – see ergodenta.dk/ergorazor.

Keeping the edge

A sickle with a dull edge burnishes calculus instead of removing it. Sharpen both edges a little at a time, keep the pointed tip (do not round it into a curette), and replace the instrument – or the ErgoTip tip – when the blade has become thin. Reprocess according to the IFU; ErgoDenta's guidance is at ergodenta.dk/care.

Common mistakes with sickle scalers

  • Working subgingivally with the tip. The pointed tip is for supragingival and marginal deposits; deeper work belongs to the curette.
  • Rounding the tip when sharpening. A sickle that has been sharpened into a rounded toe is neither a good scaler nor a good curette – keep the point.
  • One sickle for the whole mouth. H6/H7 is designed for the anterior region and 204S for posterior teeth; using either everywhere costs adaptation and time.
  • Steel sickles on implants. Use the titanium H6/H7, 204S or 204SD.

Sickle scalers on the hygiene tray

A practical scaling tray pairs sickles with curettes and a probe: H6/H7 and 204S for supragingival deposits, Columbia 13/14 or Langer 1/2 as the universal curette, Gracey 11/12 and 13/14 for deep posterior pockets, and an explorer 23 + CP-12 combination for examination. ErgoDenta's article Top 7 hygienist instruments describes the same tray from the manufacturer's side. Complete sets in a cassette are available as perio kits.

Single-ended or double-ended?

Double-ended sickles (H6/H7, 204S/204SD) carry mirror-image blades for the two sides of the arch and save a slot in the cassette. Single-ended versions (H6, H7, 204S A/B) are useful when an operator wants a specific end on a dedicated handle, or in the ErgoTip system, where each tip is single-ended and clicks into a reusable handle.

Glossary

  • Sickle scaler – triangular cross-section, two cutting edges meeting at a point; supragingival use.
  • Contra-angled – a shank bent in two planes to reach posterior teeth (204S/204SD).
  • Straight-shanked – a shank in one plane, for anterior teeth (H6/H7, M23).
  • Micro/mini – shorter, finer blades for crowded or narrow areas.

Frequently asked questions

What is the difference between 204S and 204SD?

Same contra-angled posterior design; 204SD has a slimmer blade for tighter interproximal spaces.

Can a sickle scaler be used subgingivally?

Its pointed tip is designed for supragingival and marginal deposits; subgingival work is the curette's job.

Which sickle should a new clinic buy first?

H6/H7 for anterior teeth and 204S for posterior teeth cover most cases; M23 is a good single all-rounder.

See all sickle scalers
H6/H7, 204S, 204SD, M23, mini and micro sickles, titanium versions.
Shop sickle scalers

Sources and notes

Product range and item numbers: InstruDent/ErgoDenta product records, September 2026. Handle dimensions: ergodenta.dk/ergohandles. Reprocessing: ErgoDenta Care / instructions for use (ergodenta.dk/care). Instrument design and classic areas of use follow standard periodontology and operative dentistry textbooks.

Professional note: instrument selection and treatment technique are clinical decisions. This guide describes instrument design and intended use, not treatment protocols.

Universal Curette vs Gracey Curette: Columbia, Langer, Barnhart and McCall Explained
Two cutting edges or one? A practical comparison of universal and Gracey curettes, with the differences between the four classic universal designs.