Instrumental genesis, a psychological construct that describes the process of how an artifact becomes an instrument, illuminates the ways technological tools support mathematics learning. Teachers have vital roles in designing suitable tasks, assisting students in making connections between their work with the artifact and the mathematics they are learning, and making careful teaching moves in organizing instrumental genesis. The current study examines secondary mathematics teachers' instrumental integration when they utilize student-created dynamic geometry sketches in technology-rich classrooms. The results demonstrate that some teachers view moments when students experienced technological or mathematical confusion as an opportunity for mathematical learning while other teachers maintained a focus on technology. Implications for future research are provided.