It's dark back there! OSAP has introduced a free patient handout to help explain how care in the dental practice has changed during the pandemic. While this may not seem remarkable, more and more patients are scheduled on a quarterly basis for hygiene appointments. While the right-angle design has been popular for years, Young Dental was the first company to develop the Contra disposable prophy angle that features a small bend in the body of the angle. Returning to clinical practice in the “new normal” requires hygienists to take care of themselves inside and outside of the dental office to maintain physical and mental well-being. Which is it? Manufacturers are developing more and more latex-free products. This dental hygienist wonders if it's time to move on from the profession, even though she's only been practicing less than two years. Approximately one person every hour of every day dies from oral cancer in the US. Manufacturers of both direct and indirect composite materials, commonly known as ceramers or polyglass restorations, are very concerned about the indiscriminate use of polishing pastes on these types of materials and are looking for ways to educate clinicians about this issue. This more than doubles the risk of destroying vulnerable tooth structure. Besides the obvious differences like flavor and consistency, it is important to know about abrasivity. Some polish makers went through the expense and effort of testing their brands and flavors to ensure a gluten-free style of polish. Perlite doesn't start with sharp edges such as pumice, and it crushes faster (3M's Clinpro). Dianne Glasscoe Watterson, MBA, RDH, fields a question from an RDH dealing with frustration with periodontal patient no-shows and reluctance to schedule maintenance appointments. In 1978, Indiana University researchers modified the ADA testing methods to determine the relative dentin abrasion (RDA) and the relative enamel abrasion (REA) on tooth structures. Wearing a headlight is really helpful, but until you have a light on the polishing handpiece, you're still polishing in the shadows; that's not ergonomic. The new GUM Hydral dry mouth system may provide relief for sufferers of xerostomia. NADA paste is simply pumice, water, and glycerol, but works like a typical prophy paste and is appropriate to use on sensitive patients before etching, orthodontic bonding, or sealant placement. There sure is. Preppies™ Flour of Pumice Paste has been specifically formulated for dental professionals requiring a cleaning agent that contains no flavoring agents, oils or fluoride. There have been new strides in air polishing that can make polishing this way the best way to remove stain and rehab teeth. Polish like a pro... progress, that is. There are still two main types of powders for air slurry polishing-calcium carbonate and sodium bicarbonate. Polishing Media. In addition to damaging natural tooth structures, pumice-based prophy pastes can have a negative effect on tooth-colored restorations by reducing the gloss on many restorative materials. A change in practice: Reducing the burden of dental caries with silver diamine fluoride. There's a way to turn down the pressure from the air compressor before it goes into the machine. Time savings at the front end can have some less-than-desirable results for the patient over the long run. Shirley Gutkowski, RDH explains how safer concepts are emerging for enamel polishing. It also is important to limit the amount of polishing time to stain removal only, and to decrease the pressure applied to the tooth surface. Polishing has the potential to destroy valuable tooth structure as well as damage cosmetic restorations. While some may view tooth polishing as a simple, straightforward procedure that has a limited amount of risk, there are many factors that can affect the safety and comfort of the patient as well as the clinician. Since none of us know when or if we might become sensitive to natural rubber, wouldn't it make sense to convert to latex-free products to reduce your overall exposure as well as that of your patients to this potential allergen? The untold secrets of managing hypersensitivity: Part 1 of 2. Superinfections, COVID-19 severity, and oral health: Are there connections? Top 5 breathing exercises during critical times, Managing fearful patients during the pandemic, Thursday Troubleshooter: Discouraged new dental hygienist tries hard, yet receives no encouragement. Anyone who picks up a prophy angle should be concerned about the potential to abrade both natural tooth structure as well as cosmetic restorations. Or, we provide the enamel a supportive salivary replacement that is built into the polish. Television glass and other critical grinding and polishing applications use carefully graded pumice. Lisa Hecker, MA, RDH, CDA, tackles this controversy with sound advice for the dental professional. If your patients are doing all the "right" things but still battle caries, consider that their troubles may be coming from an unexpected source. Decades ago, there were very few choices for polishing pastes, angles, or handpieces. All rights reserved. There are also masks for patients to protect them from all aerosols that occur during a visit with the dental hygienist. Safe, effective polishing involves more than shoving a prophy angle onto a handpiece, dipping the spinning cup into a tub of paste, and running it over the tooth surface. What we eat has a direct effect on the oral cavity. Prophy cups are no exception. Amber Auger, RDH, MPH, found the trick to falling in love with clinical hygiene again after feeling unhappy in her career. Polishing handpieces should be operated below 3,000 RPM. Shirley Gutkowski, RDH, BSDH, is a practicing dental hygienist specializing in orofacial myofunctional therapy. Patients deserve our best clinical judgment. While the abrasivity of toothpastes can vary just like prophy paste, dentifrices still do not have as deliterious of an effect on the dentin as prophy paste. Significant abrasion of the tooth can occur if the spinning prophy cup is held at an angle to the tooth surface. Saliva is the determining factor for your choice of polishing pastes, unless your patient has a lot of esthetic prostheses. For traditional polishing, use a contra angle with a small cup. In addition to damaging natural tooth structures, pumice-based prophy pastes can have a negative effect on tooth-colored restorations by reducing the gloss on many restorative materials. The air polishing powder should also be switched based on the patient in the chair, and maybe per tooth. For regular patients with regular stain from morning coffee or tea, for example, a double cup of fine and medium polish can save enamel and contribute to a beautiful end product. Many of us used pumice mixed with mouthwash. Anne Nugent Guignon, RDH, MPH, practices clinical dental hygiene in Houston, Texas. Pumice … Several of the newer handpieces have the prophy angle head integrated into the handpiece body. Swapping out sodium bicarbonate for calcium carbonate can be time consuming if the powder is not easy to remove from the machine. However, one must remember that teeth are exposed to toothpastes on a daily basis while exposure to prophy paste may be several times a year at the most. For most, a press of a button blows out the remaining powder and gets you ready for your next patient in practically no time at all. It is important to know exactly where these restorations are located in a patient's mouth before damaging the materials or reducing the gloss with a conventional prophy paste. By asking the right questions, dental hygienists can raise awareness and save lives. To the patient with undiagnosed oral cancer, this is the most important part of the appointment—but most hygienists don't do it. Dumping out the powder, cleaning out the line, and reintroducing a second powder take precious time and introduce infection control issues. Nada™ Pumice Paste – Fluoride Free, 200/Pkg - Preventech/Preventive Technologies Nada™ Polishing Paste contains a unique blend of polishing and cleaning agents designed for use by dental professionals to prepare the tooth … Soft cups that are thin at the edges flare more easily, adapting to the tooth structure more effectively. This is a major selling point, so when you're ordering, check the ad (Young Dental's D-Lish and Vera, Preventech's Nada, and Denticator's SureClean). This allows clinicians to maintain an ergonomically correct neutral wrist position. Science and technology have given us wonderful products to work with that help us preserve our patients' dentition and cosmetic restorations, reduce the risk of workplace-related injuries, and give our patients the dazzling smiles that they all expect. Here's how to defuse the situation. It is important to use a soft brush and limit the use to cleaning an occlusal surface prior to sealant application. Although there are differences in particle size between fine, medium, coarse, and extra coarse pastes, there is currently no industry standard defining the particle size used for a particular type of paste, so company A's medium paste could, in fact, be either more or less abrasive than company B's. They like the look and feel of polished teeth. New safer concepts are emerging in enamel polishing. Many aspects of the COVID-19 pandemic—anxiety, isolation, self-medication—have the potential to impact healthy salivation. It is, however, possible to compare the RDA of one prophy paste to another paste to determine which paste might be the most appropriate one to use. A recent entry to the market is NUPRO Shimmer. Perlite is also available. This may be a place for a discussion about gluten. Change your practice in a positive and impactful way with this new treatment option. The task is easier for you and more comfortable for them. However, studies on hydroxyapatite powders and bioactive glass show improved enamel and improved root surfaces. Air slurry is quick and easy for your patients and makes it easy to keep the enamel and root surface intact. An early study showed root damage on teeth polished with sodium bicarbonate at 20 seconds, a long time in air polishing for a single location. Many view polishing as the most important part of the appointment. An increase in either can leave more distinctive marks on the enamel. There is an available bioactive glass powder (Velopex's Sylc). Those on a sodium-restricted diet are also restricted from using sodium bicarbonate air polishing powder. Most contemporary handpieces feature swivel mechanisms that function with either a fingertip-activated swivel or a hose-end rotating coupler. The potential damage to the dentin on exposed root surfaces is much greater than that of enamel. While this procedure does not have outstanding long-term therapeutic benefits, most patients want their teeth polished, especially those who have personal habits that create stained teeth. Could 10% carbamide peroxide be considered an adjunctive therapy for risk management of COVID-19? Just swapping cups is really all that is necessary. The majority of prophy pastes are pumice-based products. Here are several considerations for what is increasing the risk for both patients and clinicians, and how RDHs are helping patients. Many feel that it is a time-saver to use a coarse polish to remove stains. Susan Wingrove, BS, RDH, has been researching the long-term effects of overhead lights, loupe lights, lasers, curing lights, lighted handpieces, and other visual technology on the eyes. Yes, coarse pastes remove stain faster but they also have a greater potential to cause damage, especially to the root structure. Evaluating a new dry mouth product system: Valuable insider experiences.
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