Tag Archives: Dental

dental health

Dental Air Polishing in Orthodontics

Air polishing units typically generate a stream of pressurized air, carrying specially graded particles of a mild soluble abrasive, such as sodium bicarbonate. The abrasive is directed, in the presence of a stream of water, at a tooth surface to be cleaned. The mixture of water and powderladed stream occurs on the tooth surface and forms a “slurry” that is responsible for the cleaning action.

Rapid and simple plaque and debris removal allows the orthodontist to work in a clean esthetic field. The remnants of recent meals or in-between snacks need no longer waste valuable chairside time. No need to set up a hygiene appointment, a few moments with the Jet polisher 2000 is all that it takes to clean the field.

Frequent cleaning with a dental air polisher resulted in a greater reduction in gingival bleeding and marginal redness compared with pumice and rubber cup technique. This was attributed to the more thorough removal of plaque. It is virtually impossible to adequately adequately clean around fixed appliances using a rubber cup technique. The Jet polisher 2000 is an invaluable aid in the prevention of enamel decalcification around orthodontic appliances.

More recent technology produces a slurry by introducing the water stream into the powder-laden air stream, within the spray head at a critical moment, to produce a fully homogeneous stream that is emitted from a single nozzle. This stream technology configuration has not only been shown to prevent nozzle clogging by preventing the buildup of deposits, but also results in a much more efficient cleaning action because the slurry is formed prior to emission.

Air polishing devices were originally designed to be standalone tabletop units. Air polishing devices are used routinely in general dental practice for plaque and stain removal and for every situation when enamel is cleaned, such as prior to bonding procedures.

Air polishing has been compared to scaling and rubber-cup polishing for efficiency and effectiveness of stain and plaque removal. The literature overwhelmingly supports the use of the air polisher as an efficient and effective means of removing extrinsic stain and plaque from tooth surfaces. Air polishing requires less time than traditional polishing methods and removes stain three times as fast as scaling with comers. In addition, less fatigue to the operator has been mentioned as an important benefit of air polishing.

Dental Autoclve

The Sterilization Information about Dental Autoclave Sterilizer

Today’s busy dental practices face a serious challenge: to maintain or increase productivity while ensuring that patient safety remains a top priority. At times, these may seem like incompatible goals. Advances in dental processing equipment, however, have empowered practices to develop safer processes while realizing efficiencies and ultimately, saving money.

A cleaning and sterilization process that meets ADA and CDC guidelines is vital to an effective infection control program. Streamlining of this process requires an understanding of proper methods, materials, and devices. Many methods of instrument reprocessing are available. Use of a complete system that encompasses and fulfills all elements that are critical maximizes efficiency and minimizes risks. Closed cassette systems provide a more efficient and safer way to process, sterilize and organize instruments in a dental office – these eliminate manual steps during instrument reprocessing such as hand scrubbing and time-consuming sorting of instruments, thereby improving safety and increasing efficiency.

Care must be taken by the dental healthcare professional to ensure that all instruments are cleaned prior to sterilization, and that this is carried out in a safe manner to avoid injury and puncture wounds. Use of closed-system cassettes reduces the risk to dental healthcare professionals when executing infection control programs. When using ultrasonic cleaners, washers and sterilizers, it is important to always follow the manufacturer’s instructions.

It is also important to consult with the manufacturer of dental instruments and devices as needed to ensure complete sterilization and to avoid damage to these items. Assurance of sterility of instruments and devices can be obtained through the use of one of several tests, and these tests must be performed regularly to ensure that the sterilizer is sterilizing all instruments and devices and that these are safe for use on patients.

Parameters such as time, pressure and temperature vary according to the type of autoclave sterilizer, materials being sterilized and individual models within sterilizer brands. The first step in determining the settings for the sterilizer is to refer to the manufacturer’s instructions. Sterilizers are medical devices, requiring clearance by the Food and Drug Administration before manufacturers may offer them for sale. The FDA requires rigorous testing to ensure an adequate margin of safety in each cycle type described in the instructions. Failing to follow the instructions of the manufacturer is ill advised, since it may result in inadequate sterilization of the instruments or devices in the sterilizer. It is never appropriate to use a household device, such as a toaster oven, for sterilization of dental equipment.

dental tips

The Uses of Dental Air Polisher

Use of dental air polishers decreased as the clinician’s age and experience increased. Curricula in many dental hygiene schools do not include clinical instruction in the use of this polishing device due to inadequate numbers of units and difficulty in moving units between clinic stations. Inadequate or insufficient knowledge and experience, therefore, appears to be a major factor in the underutilization of the air polisher.

In an attempt to provide a suitable knowledge base for practicing dental hygienists, the primary purpose of this article is to provide a comprehensive summary and critique of the research on all aspects of air polishing. In addition, a suggested technique, common concerns, and possible solutions will be discussed.

Discussions are based on a review of the relevant literature on air polishing. Tables organize the data into categories to facilitate access of needed information. Because of the various research designs employed and the number of variables that must be controlled, comparative analyses of the studies are difficult. However, where possible, analyses of the validity and reliability of the studies are provided. It should be remembered that while laboratory (in vitro) investigations are useful, the most definitive conclusions must be obtained through clinical (in vivo) studies. Case reports or opinion articles have limited applications.

Because polishing with a rubber cup and prophylaxis paste has been shown to remove the fluoride rich layer of enamel and cause marked loss of cementum and dentin over time, this method of stain removal has been challenged Rubber cup polishing with prophylaxis pastes, therefore, may not be a suitable method for moderate-to-heavy stain removal on enamel, cementum, or dentin. One study, however, contradicted these findings and suggested that rubber cup polishing with chalk is equally effective in decreasing root-surface roughness caused by sonic scaling. Chalk is not a common polishing agent and no comparison of the abrasiveness was made between it and the sodium bicarbonate used in air polishing powder. This study, therefore, may not simulate actual clinical situations.

Numerous investigations have examined the effects of the air polisher on a variety of restorative materials. Some results have been positive, while others have recommended caution near restorations. Although some studies are contradictory, most suggest caution or complete avoidance when air polishing on or near composite restorations. On composites, surface roughness or pitting was the most common result seen. One study concluded that, although marginal microleakage was greater for composites than for amalgams, this loss was not statistically or clinically significant. More research is recommended since previous studies do not support this conclusion.

dental equipment

Some Tips about How to Choose Dental Equipment

With so many different models and manufacturers to choose from, you want to make sure you’re investing in something of quality that is best for your practice. While some products may do the same function, some perform and last better than others simply because of how they were made.

As good as a deal that company you don’t recognize or haven’t seen any reviews on may offer, do not buy from them unless you are sure the decision is right for you.

Choose a manufacturer who has an established reputation and has been in business for a number of years. These companies have the knowledge and experience to help recommend the best products. This also benefits you because they know exactly how each product functions and how it benefits the different dental practices.

When contemplating the change to digital dental in your practice, the choices can be confusing for the dentist. Dental radiography has evolved from film and chemical developers into a highly technical process that involves various types of dental x-ray machines, as well as powerful dental software programs to assist the dentist with image acquisition and diagnostic analysis of the acquired images. When making the decision to purchase x-ray equipment, the doctor needs to research the available options thoroughly, in order to make an informed choice for the “right” machine for his or her practice.

Although “top of the line” dental chairs may cost between $7,000 to $9,000, you may benefit more from buying a used dental chair instead. This is because many used and portable folding chair are made of more durable materials than many of the mass-produced products on the market now.

One of the best ways to make sure you are buying quality materials is to ask other professionals within your practice. This can come from directly contacting them or simply reading reviews from others in the industry. Make sure that the individuals you are getting advice from are also established and reputable, just as you would with choosing a manufacturer.

Those with years of experience will be able to tell you which products are best and which are not. In many cases, they have already used the product and have the best knowledge of whether it is a good investment and the pros and cons of the products.

Dental Autoclve

The Sterilization Methods in Dentistry

Disposable dental supplies are also used whenever possible. Tools that are not disposable are generally scrubbed by hand and placed in a machine known as an autoclave. This machine then disinfects the tools by spraying them with very high-pressure steam, which kills most micro-organisms. Any tools that can not be subjected to high heat or moisture are usually disinfected with chemicals.

Disposable dental tools and supplies are some of the most important items when it comes to sterilization in dentistry. Some disposable dental supplies include bibs and masks wrapped in sterile packaging. Once these are used with one patient, they are simply thrown away.

Maintain sterilized instruments in the pouches or wrapping in which they were sterilized by autoclave sterilizer. If the packaging becomes torn or wet, the items must be repackaged and heat sterilized. Avoid mingling non-sterile packages with sterile ones. There should be a visible indicator, such as chemical indicators or color-change autoclave tape on the outside of each package to allow staff to easily discern sterilized instrument packages from those that have not yet been heat-processed.

Tools that can’t be thrown away, such as dental drills, are generally put through a very intensive dental sterilization process. First they are usually vigorously scrubbed by hand. This is usually done with hot water and detergent, and it helps remove any large particles, such as plaque. They may also be placed in a vibrating tray filled with cleaning solution, which can help remove very small particles.

The Centers for Disease Control and Prevention (CDC), the American Dental Association (ADA), OSAP, most state dental licensing boards, and dental handpiece manufacturers all recommend heat sterilization between patient uses. Virtually all handpieces currently in production are heat-tolerant, and those that are not can be retrofitted to allow heat-processing. Autoclaving and chemical vapor sterilization are considered accepted methods of heat sterilization. High-level disinfection via chemical germicides cannot be biologically monitored to assure sterility. Further, extended contact with chemical germicides may corrode handpiece components.

Sterilization in dentistry also involves killing the invisible germs on tools. Autoclaves are machines that are commonly used during sterilization in dentistry. These machines are usually made from large metal cylinders, and they are similar to pressure cookers. Once the tools are placed in the autoclave, they are sprayed with high-pressure steam. The high pressure inside this machine helps raise the steam to very high temperatures that are necessary for killing disease-causing micro-organisms.

dental equipment

Knowing more Information about Sterilization in Dentistry

Today’s busy dental practices face a serious challenge: to maintain or increase productivity while ensuring that patient safety remains a top priority. At times, these may seem like incompatible goals. Advances in dental processing equipment, however, have empowered practices to develop safer processes while realizing efficiencies and ultimately, saving money.

Most dental offices have a designated area for instrument reprocessing that is separate from the dental treatment room. This is ideal, since cleaning, sterilizing and storing instruments in the same room where the delivery of patient care is provided increases the risk of cross-contamination. The removal and disposal of single-use sharps such as needles, blades, orthodontic wires and glass must be done at the point of use, typically in the dental treatment room.

A cleaning and sterilization by dental autoclave process that meets ADA and CDC guidelines is vital to an effective infection control program. Streamlining of this process requires an understanding of proper methods, materials, and devices. Many methods of instrument reprocessing are available. Use of a complete system that encompasses and fulfills all elements that are critical maximizes efficiency and minimizes risks. Closed cassette systems provide a more efficient and safer way to process, sterilize and organize instruments in a dental office – these eliminate manual steps during instrument reprocessing such as hand scrubbing and time-consuming sorting of instruments, thereby improving safety and increasing efficiency.

Using mechanical means of instrument cleaning rather than hand scrubbing should minimize handling of instruments. If procedures are used whereby hand scrubbing is necessary, heavy-duty (utility) gloves, mask, eyewear and gown should always be worn while cleaning. Minimize the risk of puncture injury by scrubbing only one instrument at a time while holding it low in the sink.

Use of a system utilizing locked cassettes eliminates the need to sort, handle and hand scrub individual instruments – reducing the risk of infection from contaminated instruments – and results in savings of, on average, five minutes during instrument reprocessing, as well as fewer damaged instruments, since the instruments are locked in position during reprocessing. As with any standardized procedure, a standardized instrument reprocessing protocol also results in easy staff training and cross-training.

In general, three classifications of mechanical cleaning devices are available for the dental office. They are the ultrasonic scaler, instrument washer and instrument washer/disinfector.

Dental Curing Light

The Advantages of LED Dental Curing Light

Dental curing lights allow us to initiate the polymerization reaction “on demand” for a vast array of materials. However, there is, perhaps, more misinformation and hype regarding this type of equipment compared to just about anything else we use on a daily basis. Most of these controversies center on how long you have to cure specific types of restorations as well as how deep you can cure specific types of materials.

Manufacturers continue to make outlandish claims of their curing capabilities, most of which fall into the “too good to be true” category. An example is the claim that a new light can accomplish a “5mm depth of cure in 3 seconds”. Please don’t be fooled by these ads – you absolutely, positively cannot cure a composite in three seconds.

There is the issue of LEDs not being able to cure all materials. There is no doubt that the vast majority of light-cured materials can be fully polymerized with an LED. However, the few materials that cannot be cured with an LED mandate that you still have a halogen around for these contingencies. This may be just a nuisance as long as you know which material falls into this category, but it won’t compromise patient care. But what if you don’t know that a material can’t be cured properly with an LED? More than likely, it will still get pretty hard, but its degree of cure will be compromised along with its long-term performance.

The obvious solution to this problem is to buy an LED light that is capable of curing all materials. Unfortunately, only a few of them have this capability and it may require using a special tip. Therefore, it is still somewhat of a guessing game and you just have to hope that you don’t guess wrong.

This brings us back to halogen lights, which have something that it will take LEDs a long time to duplicate: a solid track record. Introduced just about 25 years ago, halogen lights have been the mainstay for curing resin-based materials. What you see is what you get – without any unpleasant surprises. And while many lights along the way have been introduced with various bells and whistles to make them stand out from the crowd, probably the only relatively new design is possessed by the Swiss Master, with its water cooling and monster light bulb. But with a price tag at the top of the food chain, it is clearly not for everyone.

Dental Autoclve

The Sterilization Methods in Dentistry

Since many germs can be transferred simply by touching contaminated surfaces, dentists and dental assistants are typically very fastidious about disinfecting the surfaces in their offices and treatment rooms. Solid surfaces, such as counters and sinks, are generally wiped down with antibacterial spray. Portable folding chairs are also usually covered with disposable paper covers that are discarded after each patient. Dentists and their assistants also usually wear protective barriers, such as gloves and face masks, to help prevent spreading germs to their patients.

Disposable dental tools and supplies are some of the most important items when it comes to sterilization in dentistry. Some disposable dental supplies include bibs and masks wrapped in sterile packaging. Once these are used with one patient, they are simply thrown away.

Tools that can’t be thrown away, such as dental drills, are generally put through a very intensive dental sterilization process. First they are usually vigorously scrubbed by hand. This is usually done with hot water and detergent, and it helps remove any large particles, such as plaque. They may also be placed in a vibrating tray filled with cleaning solution, which can help remove very small particles.

Maintain sterilized instruments in the pouches or wrapping in which they were sterilized. If the packaging becomes torn or wet, the items must be repackaged and heat sterilized. Avoid mingling non-sterile packages with sterile ones. There should be a visible indicator, such as chemical indicators or color-change autoclave tape on the outside of each package to allow staff to easily discern sterilized instrument packages from those that have not yet been heat-processed.

Dry heat sterilizers have been used effectively in dental office for many years. Just as with any other sterilization method, dry heat sterilization is highly dependent upon the operator following the manufacturer’s instructions for cycle time, temperature, instrument packaging, and loading technique. Because dry air is not as efficient a heat conductor as moist heat at the same temperature, a much higher temperature is required for a dry heat unit to accomplish sterilization.

Sterilization in dentistry is very important, and dentists and dental assistants typically clean and disinfect most surfaces in a their offices and treatment rooms to help prevent the spread of germs. Disposable dental supplies are also used whenever possible. Tools that are not disposable are generally scrubbed by hand and placed in a machine known as a dental autoclave. This machine then disinfects the tools by spraying them with very high-pressure steam, which kills most micro-organisms. Any tools that can not be subjected to high heat or moisture are usually disinfected with chemicals.

dental equipment

The Effectiveness and Efficiency of Dental Air Polisher

Dental air polisher has been compared to scaling and rubber-cup polishing for efficiency and effectiveness of stain and plaque removal. The literature overwhelmingly supports the use of the air polisher as an efficient and effective means of removing extrinsic stain and plaque from tooth surfaces. Air polishing requires less time than traditional polishing methods and removes stain three times as fast as scaling with comers. In addition, less fatigue to the operator has been mentioned as an important benefit of air polishing.

Most investigators agree that intact enamel surfaces are not damaged when stain removal is accomplished with an air polisher. Even after exposure to enamel for the equivalent of a 15-year recall program, surfaces were not altered.

Still, researchers and manufacturers caution against prolonged use of the air polisher on cementum and dentin. When moderate to heavy stain is present on root surfaces, dental hygienists are often faced with the problem of removing it with the least alteration of cementum. One choice is to leave the stain and explain to the patient that stain is not associated with oral disease and will not harm the teeth or gingiva since it is only a cosmetic concern. To many patients, this is not a viable choice since appearance is considered so important in today’s society.

Other choices include removing the stain with a rubber cup polisher and prophylaxis paste; sonic, ultrasonic scalers; Dental Hand Instruments or the air polisher. Wilkins recommends removing as much stain as possible during root planing with curets. However, in one in-vitro study, air polishing was shown to remove less root structure than a curet in simulated three-month recalls for three years. Woodall agrees that the air polisher may be preferable to curets in this situation. Since less root structure is removed, decreased root-surface sensitivity also may be a benefit.

Clinical studies to evaluate soft tissue usually provide generalizable conclusions. Gingival bleeding and abrasion are the most common effects of air polishing. These effects are temporary; healing occurs quickly and effects are not clinically significant. No complications were seen with healing at extraction sites following air polishing of teeth prior to extraction. To avoid tissue trauma, the manufacturer recommends pointing the tip of the air polisher at the facial, lingual, or occlusal surfaces, thus avoiding the gingival margins.

Effects of air polishing on gold foil, gold castings, porcelain, amalgam, and glass ionomers have been studied. Air polishing of amalgam alloys and other metal restorations has produced a variety of effects, including matte finishes, surface roughness, morphological changes, and structural alterations. One study found no detrimental changes to the marginal integrity of amalgams. Surface roughness, staining, pitting, and loss of marginal integrity were seen on porcelain surfaces. One study reported only minimal changes in porcelain and gold alloys. Hand instrumentation at the gingival margins and caution were recommended when working around these restorations. The surface roughness of glass ionomers increased following either air polishing or rubber-cup polishing. Until research findings on air polishing’s effect on these restorative materials are unequivocal, clinicians should follow manufacturer recommendations to “avoid prolonged or excessive use on restorative dental materials.

Dental Curing Light

The Different Choices for Dental Curing Light

There are numerous manufacturers in providing some type of hardness disc to verify that a dental curing light will polymerize a specific thickness of composite in a specified amount of time. Most of these discs have a small hole in the center. For this test, you fill the hole in the disc with the composite, cure it for a specified time period, and then turn over the disk to check whether the bottom surface of the cured composite “feels” like the disc when scratched with an explorer or other sharp instrument. If it does, then this presumably indicates the composite is adequately cured for intraoral( intraoral camera ) use.

However, this is a dangerous test that could give you false and misleading information. Consider what we found with the Demetron Hardness Tester, which is essentially a round white plastic disc with three holes. We filled the three holes in the disc with our test composite and cured each composite specimen 5 seconds, 10 seconds, or 40 seconds. We then turned over the disk and tested the bottom of each cured composite disc as well as the Hardness Tester itself for Knoop hardness. Finally, we asked three of our research staff to scratch the bottoms of the specimens with a sharp explorer and compare the “feel” to that of the Hardness Tester.

Measure the power baseline for your light when it is new using a radiometer and remeasure it on a weekly basis. For halogen types, if there is a significant decrease in output, change the bulb. If that doesn’t help, try a different curing tip. If it still does not register an adequate reading, try cleaning the tip and filter with a kit designed for that purpose. If all your remedies are not successful, you should send the light back to the manufacturer for a check-up.

Even with this testing, it is prudent to send your lights back to the manufacturer at specific intervals, such as every 24 months or after five bulb changes (if halogen), whichever comes first. This type of maintenance will keep your curing light in top condition and allow it to deliver maximum power.

Many directions include some strange safety measures such as using the light for 20 seconds and letting it rest for 60 seconds. Another one tells you not to use the light if the patient is on N2O/O2. These stipulations are mandated by various government regulations and manufacturers must comply if they want to sell the product internationally. Don’t let these warnings stop you from using the lights in a normal manner.

On the other hand, with LEDs that do not have fans, you are typically advised to limit their continuous use to several minutes and then allow them to cool off. While we have subjected these lights to extended curing tests and many of them have passed these tests, it is probably prudent to heed this type of warning and not subject the equipment to heat challenges that can shorten their useful lives.