Posted in Company on April 21, 2021

Spring is a time of new beginnings; days last longer, flowers start to bloom, and the leaves on the trees begin turning green. This new season also springs into action cleaning – referred to as Spring Cleaning.

 

“It is traditional to clean the house thoroughly either right before or during the first week of Great Lent, referred to as Clean Week. April 1st also corresponds with the Julian New Year.” (Source: https://en.wikipedia.org/wiki/Spring_cleaning)

 

Dental practices perform spring cleaning of the operatories every day no matter the season; thoroughly cleaning surfaces, instruments, and equipment. Primarily since the pandemic, stricter infection control protocols and guidelines have been implemented.

 

But what about the suction lines? Are they part of your cleaning and disinfecting procedures? If you haven’t implemented a daily cleaning routine for the evacuation lines, you may experience low suction, resulting in lower aerosol removal. Dental aerosols are generated when dental instruments are used during treatment, i.e., turbines or ultrasonic scalers. They can spread up to 6.6 feet and remain in the air for hours. These aerosols can contain harmful pathogens and could put you and your patients at risk. Using HVEs with a large opening, like Air Techniques HVE Air Protect XL Plus, remove 98% of aerosols1. However, for your HVE to effectively mitigate aerosols, the evacuation lines must be free of debris and build-up.

 

To ensure optimal suction performance and aerosol mitigation with your HVE, “spring clean” your evacuation lines with Monarch CleanStream. When CleanStream is used in tandem with the CleanStream Dispenser, integrated Vortex technology creates a mixture of air and liquid—atomizing the solution through the lines and cleaning the entire inner tubing walls. Atomizing the cleaning solution through the lines means less stress on the vacuum pump leading to a longer life than using a bucket. When holding the hoses into a bucket, the cleaner shoots through the lines with a speed of 30-40 mph, hitting the impeller of the vacuum, which could cause premature failure of your equipment.

 

It’s time, to begin with, a new cleaning routine for your suction lines, and as a reward, we’re offering a $10 Starbuck gift card for every $200 in CleanStream purchases until June 30th, 2021. Click here for details.

 

1 “Aerosol Reduction by means of an intraoral spray mist suction – first findings from an experimental pilot study”; Dr. Martin Koch, Duerr Dental

Posted in Company on February 26, 2021

by Michelle Strange, MSDH, RDH

With so many dental devices on the market, it is challenging to know what is right for your practice. It can be hard to determine the most important features and whether you want something reusable or disposable. Here are some factors to take into consideration when deciding what will work best for your practice.

 

Reusable tools

There is no question, dental professionals must have instruments clean, sterilized, and ready to go.^[1] We are all busy providing the best patient care, but we cannot compromise safety. To keep things clean and meet the required infection prevention standards, practices should have well-documented standard operating procedures (SOPs) in place for sterilization, especially if reusable items are used in the clinic. Depending on your practice, maintaining these standards for reusable instruments could become an issue since they require following proper instructions for cleaning/sterilization, ensuring they are not accidentally thrown in the trash, and confirming each team member is on board. A breakdown in the sterilization process could have catastrophic consequences for the patient and the practice.

Single-use tools

Although single-use instruments may appear wasteful on the surface, they could be safer. No two patients will use the same tool, eliminating most of the worry about cross-contamination. The CDC suggests that single-use items are the best for treating patients to avoid infection transmission.^[2]

 

Your team needs to know if a product is single or multiple-use because with reusable tools the risk for cross-contamination is slightly higher than with disposable. ^[3]

Environmental drawbacks

When it comes to single-use anything, there is a direct threat to the environment. Disposing of dental waste may seem small, but it does add up in the long run.^[4] Using disposable tools increases your footprint, not only because of the item you use on the patient, but also the packaging it comes in, the shipping to get it to the distributor and eventually to you.

 

The pro and con breakdown

Reusables reduce the amount of waste accumulated over time. They do not require replacement often, ensuring you have them on hand at all times. Costs can decrease with reusable products because reordering is less frequent, and single-use item’s expenses could fluctuate.

 

When people attend a healthcare practice, they want to leave infection-free. With reusable tools, the risk for cross-contamination is slightly higher than with disposable. For reusables to work, employees must receive proper training and closely follow the instructions for use for the reusable tools.

 

Whichever you decide to use in your practice, ensure that the necessary precautions, SOPs, and training are in place to reach the highest possible infection control standards, protecting your patients, employees, and your practice.

 

^[1] “Sterilisation in Dentistry: A Review of the Literature – NCBI.” 15 Jan. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350571/. Accessed 8 Sep. 2020.

^[2] “Single-Use (Disposable) Devices | FAQs | Infection Control ….” https://www.cdc.gov/oralhealth/infectioncontrol/faqs/single-use-devices.html. Accessed 8 Sep. 2020.

^[3] “SINGLE-USE (DISPOSABLE) DEVICES | Registered Dental ….” 1 Jul. 2012, https://www.rdhmag.com/infection-control/disinfection/article/16405788/singleuse-disposable-devices. Accessed 8 Sep. 2020.

^[4] “The environmental impact of dentistry – ResearchGate.” https://www.researchgate.net/publication/6509267_The_environmental_impact_of_dentistry. Accessed 8 Sep. 2020.

Posted in Company on January 19, 2021

by Michelle Strange, MSDH, RDH

Recommendations on How to Maintain Your Vacuum System

Follow these steps to ensure your vacuum system is well maintained:

• Regularly change the traps in each unit
• Run the proper vacuum cleaner daily
• If you are doing surgical procedures or intense non-surgical procedures that may have more blood that is suctioned from the mouth, you may want to clean the lines after the procedure

The Monarch CleanStream Evacuation System Cleaner from Air Techniques has a unique formulation designed specifically for daily cleaning. It penetrates and removes line buildup while maintaining vacuum performance and suction.

 

Some Devices Require Special Care

Amalgam separators have become an essential tool in dental practices, required by the EPA in order to reduce the discharge of mercury into publicly owned treatment works to prevent seepage into rivers and oceans. However, when a new amalgam separator is installed, it can fill up quickly affecting the system’s functioning, possibly rendering them non-compliant with the new EPA rules. If the practice doesn’t follow a daily cleaning routine of the evacuation system lines, debris accumulates and build-ups in the lines over time. With a new amalgam separator installation, the buildup can be disrupted and clog up the system. You will need to do a deep clean of your evacuation lines a few weeks before installing a new amalgam separator. This will help prevent clogging and premature filling of the system. Inspect the separator regularly to see if a filter change is necessary.
It may be tempting to come into your office, flip on all the switches, and start seeing patients as soon as possible. However, the treatment that you can offer is only as good as the tools at your disposal, and it is vital to understand the maintenance that your equipment needs. We all know how important a reliable HVE system is in reducing aerosols in the dental office.

The current pandemic is the perfect time to give these vacuum systems, and all the other equipment in the ‘mechanical room’, the care and maintenance needed. The wellbeing of our team members and patients is the priority, making it essential to keep your tools in working order by checking and following the advice from the manufacturers of each system. If you have an Air Techniques vacuum system, you can find maintenance information on our website.

Posted in Company on October 15, 2020

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by: Michelle Strange, MSDH, RDH

Different dental procedures require varying tools just as a contractor would not hammer a screw when building a home—it might do a similar job, but it is nowhere as effective. The same applies to the comparison between high-volume evacuators (HVE) and saliva ejectors. Saliva ejectors tend to be used during routine and straightforward procedures where fluid needs to be removed from the patient’s mouth, whereas HVEs are necessary during more extensive dental work because of their ability to quickly remove build-up of liquids and larger solids that the saliva ejector can’t evacuate. With the added benefit that HVEs can also reduce aerosol production by 90-98%. Understanding the appropriate and proper use of both tools is vital.

 

Flow Rate and Suction Volume 

Performing dental procedures can be challenging if a practice’s vacuum system/HVE is inadequate. Without a proper vacuum system, dental professionals could be making efforts to prevent aerosol contamination, without correctly judging the airflow level that produces adequate suction for clinical purposes. Many dental team members have walked into the office, flipped the switch on to the vacuum, compressor, and water without thinking about the system being fully capable. Most practices however do not have the ability to monitor or check air flow from the HVEs. This requires specific instruments which are only recently available through some manufacturers (such as Air Techniques). So, most practices would not be able to check this themselves or even through their dealers unless they had an AT Sales Rep or Technician do a special on-site visit. This has become even more important during the current pandemic. There is more to understand regarding the use of this great engineering control that is meant to reduce the risk of spreading aerosols including the required minimum airflow levels for producing adequate suction.

 

HVEs and Saliva ejectors perform two different functions

Saliva Ejectors are for removing saliva and pooling water during patient care, HVE’s are meant for specific uses during a procedure like crown preparation, extractions, and to help reduce the spatter and spray during dental hygiene procedures.
Although saliva ejectors are useful during routine dental procedures, they do not have the power needed to limit the spread of aerosols. After all, aerosols can remain in the air and travel throughout the dental practice, posing a risk to all staff, even after the infected patient has left the building. The use of a high-volume evacuator dramatically reduces the risk of these aerosols escaping from the patient’s mouth. Keep in mind this requires the dentist or hygienist to use their free hand always with the HVE, or it requires a second assistant to hold a free HVE specifically for this purpose.

 

HVE Tips without High-Performance Vacuum Systems 

Yes, we will need a saliva ejector to help the pooling of fluid in the patient’s mouth, but an HVE will be what is needed for most of our procedures in dentistry.  We create spatter, spray, and aerosols for most of what we do so becoming accustomed to using our HVE is incredibly important. However, we have to think past the HVE tip and consider the vacuum system that is really the workhorse in this situation.

 

To help eliminate infectious aerosols spreading throughout dental offices, the Mojave Dry Vacuum can “provide the highest operational performance” required. The higher-flow vacuum is consistent and provides an exceptional level of suction without the noise levels of older models. It can adjust speed to accommodate the number of users online without the performance suffering.

 

The system will always provide the right speed, suction, and flow to ensure a safe and reliable dental procedure for both the patient and the staff. With low maintenance and offering 85% energy savings compared to other systems, the Mojave can save dentists money.

 

HVE’s are amazing engineering controls and should be the choice for aerosol reduction during dental procedures.  We just have to remember they only work when we use them and only as good as the vacuum system to support their performance.

Posted in Company on September 24, 2020

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by: Michelle Strange, MSDH, RDH

When we think about controlling exposures to occupational hazards in dentistry, the first thing that comes to our mind is often PPE (Personal Protective Equipment). Although the role of PPE is crucial in a dental practice, we should recognize that it only serves as the last control when all other measures fail to protect against possible contaminations.

 

To optimally protect any workplace, a hierarchy of controls needs to be determined. The concept behind this hierarchy is that the control methods at the top are the priority as they are much more effective than those at the bottom. By following this hierarchy, the risk of contamination, illness, or injury reduces substantially.

 

1. Elimination and Substitution

 

Elimination and substitution are the most effective strategies to reduce any risk in the workplace. Clearly, when we remove the original source of hazard, the accompanying risk will practically disappear or substantially be reduced. Unfortunately, these measurements are often the most difficult ones to establish. A dental practice is limited in the flexibility of its workplace, and some equipment or actions are just inevitable.

 

Examples

• Calling patient before they arrive at their appointment to confirm their health
• Asking employees who are feeling unwell or potentially contagious to stay home
• Choosing to handscale versus using an ultrasonic device on a patient with a contagious disease
• Using silver diamine fluoride on a patient with caries lesions instead of utilizing a dental handpiece

 

2. Engineering Controls

 

Less effective than elimination or substitution as engineering controls do not totally remove the risk from the workplace. However, thanks to smart engineering solutions, they try to remove the hazard at the source. The initial cost can be higher than administrative controls or PPE, but are more effective and in the long term could be more cost-effective.

 

Examples

• High Volume Evacuation to reduce spatter, spray, or aerosols to reach the clinician
• Sharps containers at point-of-use to reduce percutaneous injuries
• Instrument cassettes to hold dental instruments and prevent injuries when transporting
• Ultrasonic baths to remove bioburden during the cleaning process vs. hand scrubbing

 

3. Administrative Controls and PPE

 

As a last resort, administration controls and PPE protect when all other controls fail or where taking other measurements is not possible. Their protective role is still beneficial, particularly during a pandemic, but it is crucial to realize its priority on the hierarchy of controls.

 

Examples

• Not eating or drinking in clinical areas
• Using the engineering controls like the HVE for all aerosol generating procedures (AGP)
• Wearing utility gloves during instrument and operatory reprocessing
• Wearing protective eyewear when there is potential for chemical or infectious hazards

 

In dentistry, eliminating the source is not always possible. Engineering and work practice controls then become the highest priority. Therefore, training personnel with the correct safety procedures is essential.

 

Providing your dental practice with high-quality devices such as good HVE to reduce the aerosols during patient care can be essential to protect against infections too. Air Techniques Mojave Dry Vacuum System delivers more flow and the highest suction power of any dry vacuum system available resulting in effective aerosol capture with your HVE use. Administrative controls cover processes and standard operating procedures (SOPs) to reduce risk further.

 

Implementing a hierarchy of controls diminishes the risk of possible hazards in the workplace. However, although the controls at the top of the pyramid get the highest priority, it is the smart implementation of the right combination that will truly have the greatest impact.

Posted in Company on May 27, 2020

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by Michelle Strange, MSDH, RDH

 

A healthcare environment is a stressful place. Years and years of medical school and training, long work days, time constraints, emotional stressors, negative patient outcomes, rapidly developing diseases, and high-pressure emergency situations make being a medical professional one of the most challenging jobs. In the wake of a pandemic, it seems anxiety has reached a new level. It’s no wonder that the stress of being a dental professional tends to have negative impacts on both their personal and professional lives.

 

You can define professional burnout as “a special type of work-related stress, or a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity.” 

 

Unfortunately, dental workers are more prone to professional burnout, anxiety and depression because of the nature of their practice.1 These feelings can cause employees to experience lethargy and lowers their attention to detail, which can result in imperfect dental infection control and cause safety lapses for both clinicians and patients.

 

The problem with dental burnout is that it can harm patient safety. Health care professionals who feel emotionally exhausted raise the odds of unsafe care, unprofessional behavior, and low patient satisfaction. In fact, the odds for poor patient care double, and patients are three times more likely to give low satisfaction ratings when visiting healthcare professionals who suffer from burnout. 

 

Although this is a common issue that healthcare professionals have to deal with, there are solutions to make sure that your office is not compromised and that you are providing the safest dentist visits possible. Dentistry after COVID-19 may have dental professionals second-guessing their infection control procedures coupled with the anxiety of contracting this novel virus or any future ones. Establishing stress management programs would be advantageous to help dental professionals cope with any fears that are compounding with the already established burnout.  All dental offices should have stress management programs and do their best to accommodate the needs of their workers. Doing your best to promote the positive mental health of your dental staff is one of the best ways to ensure better health and safety for everyone. Though stress management programs may seem like fluff, in this systematic review of the literature, “courses based on mindfulness showed to be effective in improving healthcare workers’ well-being, increasing their quality of life and the productivity outcomes”.  After all, when you feel your best, you can be your best for your patients while adapting to new concerns that may arise!

 

1.  “Stress and Professional Burnout Among Newly Graduated Dentists.” Nov.-Dec. 2016.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5184387/. Accessed 5 Mar. 2020.
2.  “Job Burnout: How to Spot It and Take Action” https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642. Accessed 5 Mar. 2020.
3.  “How Does Provider Burnout Impact Patient Care Quality, Care Access?” 6 Sep. 2018. https://patientengagementhit.com/news/how-does-provider-burnout-impact-patient-care-quality-care-access. Accessed 5 Mar. 2020
4.  “Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction”. 4 Sep. 2018 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2698144. Accessed 5 Mar. 2020
5.  “Work stress and occupational burnout among dental staff in a medical center”. Sep. 2019.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739458/. Accessed 5 Mar. 2020
6. “Stress management interventions among healthcare workers ….” 30 Jun. 2018, https://sensesandsciences.com/index.php/Senses/article/view/138. Accessed 13 Apr. 2020

Posted in Company on May 14, 2020

 

by Michelle Strange, MSDH, RDH

In any profession, it is not unusual to hear things like “I have done this for 17 years, and I haven’t had any problems. Why change now?” While relatable, it’s not a good mindset to have in the dental profession. Dentistry is always evolving, which means that we must also if we wish to offer patients the best care possible. 

In dentistry, infection control practices are not about us, but about the people who enter our facilities and sit in our chairs. Patient health must be the utmost concern, as it only takes one person catching an infection to put our practices and licenses at risk, nevermind the person’s suffering because of our mistake. 

The biggest dangers come from healthcare-associated infection, medication errors, and unsafe surgery. As documented in many studies, numerous infectious outbreaks are due to a lack of compliance with established guidelines for disinfection and sterilization. When incidents happen, patients can be affected by minor to life-threatening ways ranging from temporary to permanent injuries or even death. Patients often advocate for themselves, but at the end of the day, it’s still on us, the healthcare professionals to properly care for our patients. 

To improve the system and help prevent dental-related infections you can:12 

1. Develop relationships with your patients and embrace the importance of human connection. 
2. Avoid blaming when mistakes occur. Instead, question why the error happened and aim never to let it happen again.
3. Remember that Infection control isn’t about you or what you want to do. Do for your patients what you would want them to do for you if the roles were reversed.

Employ these strategies to improve the quality of your service and infection control to keep you, your practice, and your patients safer. 

 

1 “World Health Organization: Patient Safety” https://www.who.int/patientsafety/education/curriculum/course1_handout.pdf. Accessed 5 Mar. 2020.

2 “Disinfection and Sterilization” https://disinfectionandsterilization.org. Accessed 5 Mar. 2020.

Posted in Company on April 29, 2020

by Michelle Strange, MSDH, RDH

After working in one place for a long time, there is a human tendency to become somewhat complacent and move into an almost automated working process. However, as relaxing as this comfort is, it can cause problems because it means that you develop a particular set of responses that prevent you from being the most productive worker. Comfortable workers tend to be perceived as lazy, lack enthusiasm/passion, and settle for the bare minimum instead of going above and beyond. In the field of dentistry, this comfort can result in putting your patients’ well-being in danger.

 

One reason that people tend to become too comfortable in their working lives is because of a lack of accountability. Without accountability, unproductive behaviors are formed and can result in an environment where mistakes are the accepted norm rather than the exception.

 

In dental offices, professional mistakes often revolve around patient safety and can be something like forgetting to sterilize certain pieces of equipment. Errors like this can cause delays that upset patient satisfaction, but more seriously, they can be an indicator of lax safety rules. Many dental infection control safety guides have comprehensive directions to ensure as much as possible a reduction in healthcare-associated infections. If dental professionals lack accountability, it is all too easy for these tasks to get overlooked or done with complacency that fails to protect patients.

 

So, what can we do? Every dental practice needs to instill a sense of responsibility in their teams. The best way to increase accountability is to follow purposeful hiring practices, provide employees with clear deadlines, open clear lines of communication, have regular evaluations, and work tirelessly to have definitive expectations with clearly defined results. Accountability is the best way to build a high functioning team and limit the effects of accepted mediocrity because our patients deserve more than “just ok” when it comes to their care.

 

 

1 “4 Signs You’re Too Comfortable in Your Job”. https://www.themuse.com/advice/4-signs-youre-too-comfortable-in-your-job. Accessed 5 Mar. 2020.

2 “Accountability for your actions: Building a dental team culture that matures from its mistakes”. 1 May 2017. https://www.rdhmag.com/career-profession/personal-wellness/article/16409866/accountability-for-your-actions-building-a-dental-team-culture-that-matures-from-its-mistakes. Accessed 5 Mar. 2020.

 3 “Environmental Infection Prevention: Guidance for Continuously Maintaining a Safe Patient Care and Survey-Ready Environment” https://store.jcrinc.com/assets/1/7/nexclean_environinfectionprevention_%28002%29.pdf. Accessed 5 Mar. 2020.

4 “3 Ways to Hold Your Dental Team Accountable”. 21 Feb. 2019. https://www.dentistryiq.com/practice-management/staffing/article/16363712/3-ways-to-hold-your-dental-team-accountable. Accessed 5 Mar. 2020.

Posted in Company on April 16, 2020

by Michelle Strange, MSDH, RDH

 

Reading could be one of the most valuable skills that we develop in school. Yet, the older we get, the easier it becomes to “forget to read ” because we figure that we already know everything there is to know. However, that couldn’t be farther from the truth. In dentistry and infection control, it is imperative to read the labels. Not all disinfectant products are the same, and if not used correctly, the products can become useless. The only way to know how to use a product properly is to read the labels and instructions. 

 

In dentistry, there are different levels of cleaning, disinfection, and sterilization required. Cleaning is a first step, followed by disinfection. Many people might think these terms are synonymous, or that the products for each process are interchangeable, but they aren’t. Some products only require 1-step, but you have to confirm by reading the instructions. 

 

Failure to use these different products properly can create extra costs and safety hazards.1,2 According to the CDC, dental offices should only use disinfectant wipes that are approved for use in healthcare settings and follow the manufacturer recommendations. Even then, some products require multiple steps, and it’s crucial to follow the label to know how much is needed or if it needs dilution, how long it must make contact with the surface, how to use it safely, and also how to dispose of the cleaning products. 

 

Reading a label only takes a few extra moments, but not reading it can cause a whole host of long-term problems for both your practice and your patients. So, the choice is clear: make sure you read and follow all instructions to make sure that you are doing your part to prevent infection and provide a safer, cleaner dental environment for everyone.

1 “Disinfection and Sterilization in Dentistry”. https://tdaperks.com/disinfectionsterilization/. Accessed 5 Mar 2020.
2 “FAQ-  Disinfection” 2018. https://www.osap.org/page/FAQDISIN20184?&hhsearchterms=%22instructions+and+use%22. Accessed 5 Mar. 2020.

Posted in Company on April 2, 2020

 

by Patti DiGangi, RDH, BS

In the time of the COVID-19 crisis, our patients will need even more assurance when they come back to see us that everything is safe. Though they may not realize the risk contaminated waterlines can create, we know and it is our duty to keep them safe. When we are protecting our patients, we are protecting ourselves and our businesses.

Is COVID-19 Growing in the Lines?

Dental unit waterlines (DUWLs) are used daily in dental practices. The importance of proper infection control to maintain the safety of both patients and healthcare professionals is apparent because DUWLs is a breeding ground for infection-causing biofilm.

The microorganisms that colonize in DUWLs can include bacteria, fungi, and protozoans, including Legionella, Pseudomonas aeruginosa, Candida albicans, and nontuberculous mycobacteria (NTM), and can increase in number to cause illness and infection. We must assume they contain COVID-19.

The CDC and the EPA regulatory standards call for < 500 CFU/ml of heterotrophic bacteria in DUWL. Heterotrophs are a group of microorganisms like yeast, molds & bacteria that use organic carbon as food as opposed to autotrophs like algae that use sunlight and are found in every type of water. Research shows microbial counts can reach 400,000 CFU/ml within 5 days after the installation of a new DUWL. That is 400x the recommended level. We know that COVID-19 grows quickly and is readily spread.

Keeping Lines Safe

Although flushing DUWLs was once recognized as an efficient way to control the microbial presence and decrease the planktonic bacteria in water, there are other strategies to control the presence of biofilm. Inside the tubing, water flows in a laminar fashion, meaning in parallel layers with no disruption in those layers. As a result, biofilm adheres to the sides of the narrow dental water line tubing and remains relatively stagnant, allowing continued growth. Biofilm can multiply rapidly and grow in an established, well-protected shell without treatment, so healthcare professionals must use effective methods to maintain water lines for the safety of themselves and their patients.

The product you choose must be an effective biofilm disruptor with rapid kill times. At the same time, it needs to be gentle on equipment and have no effect on restorative materials. Time is money so it needs to be time-efficient as well as sustainable with no harsh chemicals or leave a residue.

This means we must be picky when selecting products. For example, Monarch Lines Cleaner is a powerful formula that helps attack accumulated deposits in tubing lines without the use of harsh or aggressive chemicals.

Protecting Our Patients and Protecting Ourselves

Not only will patients have concerns coming back into the office; so will healthcare providers. With the COVID-19 Crisis, we have seen the importance of personal protective equipment (PPE). Every professional will be taking infection protection seriously more so in the future. We must take care of ourselves in order to take care of others.

Though waterlines may not have been subject to discussion with patients in the past, it can and should be. You can assure your patients you are doing everything possible to keep them safe.

Posted in Company on March 25, 2020

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by Patti DiGangi,RDH, BS

So here we are all sitting in our homes. Some of us are already bored; how many episodes can we binge in a row has reached new heights.

We are hopefully all keeping safe by practicing excellent hand hygiene in our homes. We know hand hygiene is one of the most important ways to prevent the spread of infection. Which song are you singing so it’s long enough? I got bored with Happy birthday and loved the suggestion of the Glory Gaynor’s song I Will Survive. This song has the dual purpose of helping us wash long enough while also reminding how long pathogens can survive. That’s why I want to kick the pathogens a bit farther by using Monarchs Hydrating Instant Hand Sanitizer. Following that with Monarch Revitalizing Hand Lotion leaves my hands to feel smooth silky and protected.

Now that I can feel confident with protecting myself, there is still the issue of boredom as well as the worry of no patients which means no income to the office. There are so many unknowns happening for practice owners. Great news here, you can see your patients connecting through teledentistry.

Teledentistry is a disruptive innovation and a rising trend. The long-held model and shared assumption for oral health care is Dentists’ Office are the System. Oral health can and should be addressed in many places and in different ways by a variety of health providers. Teledentistry expands the traditional dental practice.

The ADA is providing help in our current crisis. They created a Covid-19 Coding and Billing Interim Guidance that discusses not only how teledentistry can be used; it also talks about the billing and coding aspects of this treatment. This is important so patients with oral health emergencies do not end up in already overburdened hospital emergency rooms.

Teledentistry is also a great option for follow-up with our patients already in treatment, connections with medical providers, staying in touch with all of our patients and making a connection to new patients.
Like me, you have probably gotten notes from your bank, your internet carrier, your credit card and most everyone about how they are caring for you during this crisis. This is also a great opportunity for dental practices to stay connected with your patients. Let them know you are available for emergencies and urgencies.

You can also follow-up on patients already in treatment. You can look into everyone you have seen over the past 2 months and instigate a follow-up with them.

The ADA recommends that you offer assistance to new patients also. This can be a terrific form of referrals and practice building for a dental practice.

This is not simply a matter of having a FaceTime conversation. Facetime is a wonderful way to stay connected to our friends and family. I know I enjoyed seeing my granddaughter recently on Facetime. Yet it is not appropriate to connect with patients using any of the public-facing technologies such as Facetime, Facebook Live, Twitch, or Tik Tok. We need to leave those for personal use.

This a huge subject that can’t be covered in a single blog post. The important messages here are: Stay Safe and consider adding teledentistry as part of your procedure mix. Not just for the current crisis; teledentistry expands the traditional dental practice.

 

 

Author Bio: Patti DiGangi’s specialty is medically necessary coding. Her efforts have assisted thousands of professionals to code more accurately and efficiently. She teaches the why behind the codes. In fact, the American Dental Association recognized her expertise by inviting her to write a chapter in its CDT 2017 Companion book and again for CDT 2018 Companion. Patti holds publishing and speaking licenses with ADA for Current Dental Ter­minology©2020. The Chapter Patti wrote in CDT 2018 Companion included the Teledentistry codes. Patti is the co-author with Cindy Purdy RDH, BS of the workbook Teledentistry Pathway to Prosperity Critical Choices. https://shop.dentalcodeology.com/. I have been on this bandwagon for a while co-writing the only workbook on the subject: Teledentistry Pathway to Prosperity Critical Choices that we are offering at ½ price through this crisis.

Posted in Company on March 19, 2020

By: Patti DiGangi, RDH, BS

The World Health Organization (WHO) declares the coronavirus outbreak a pandemic screams the headlines. Covid-19 puts into sharp focus the importance of standard precautions and infection prevention. With fear running rampant, as dental professionals, we can know that our standard precautions training and education will keep us as safe as possible…if we follow them consistently.

 

The Organization for Safety, Asepsis, and Prevention (OSAP) talks about creating a Culture of Safety. It involves a commitment to the safety of patients and personnel by everyone in the organization (office/institution), including management. OSAP’s Summary of Infection Prevention Practices in Dental Settings Basic Expectations for Safe Care is a concise document that outlines the steps that must be taken by all practice personnel when turning over a room between patients. This includes dental unit water lines and vacuum systems.

 

The mode of transmission of the Covid-19 virus is still not completely clear. Water quality safety has never been more important. The narrow gauge of the dental unit waterline makes them a breeding ground for biofilm growth and the potential spread of infection. Bacteria and other microorganisms form a biofilm, which adheres to the inside of the tubing that supplies water to the dental instruments. As water moves through the tubing or waterline, microorganisms slough off into the water, thus contaminating it. Spraying water can spread viruses and infections.

 

The guidelines calls for flushing dental water lines for a minimum of 20 to 30 seconds after each patient, from any device connected to the dental water system that enters the patient’s mouth (for example, handpieces, ultrasonic scalers, and air/water syringes) as well as at the beginning and end of the patient day. This step is often skipped in a desire to stay on schedule.

 

The same is true for our evacuation system. Suction lines should be cleaned every day with an evacuation system cleaner to remove blood and debris, and a disinfectant that is compatible with the evacuation system should be run through the tubing. Monarch CleanStream has a unique formulation designed for daily cleaning. It penetrates and helps remove line buildup while maintaining vacuum performance and suction.

 

These important steps from OSAP could save a life, maybe even yours.

Posted in Company on March 11, 2020

Your practice is depended on a reliable supply of Dental Compressed Air. A good working definition of Dental Compressed Air is “Dental quality compressed air completely free of oil, ultra-dry and contains as few microbes as feasible.” 

 

 

Air is not just air. Quality air is combined with freed contaminants such as industrial exhausts, particles of soot from vehicle exhaust systems, and microorganisms that can cause disease. Natural and human-made risks are invisible and lurk in the air around us. We are hardly aware of just how many ways compressed air plays a vital role in dentistry. It drives a complete series of appliances and components – from the turbine in the handpiece to pressure-molding devices to actuating precision cutters in the laboratory. Dental air is also used for cleaning dental models and for drying directly inside the mouths of patients.

 

 

So how does oil affect air quality?

 

Oil in the compressed air stream is a contaminant. Even with filtering systems, it is impossible to remove all oil from the air stream of an oil-lubricated compressor. Bacteria laden air flows into the patient’s mouth and subsequently throughout the operatory environment. Oil aerosol acts much like bad cholesterol in the body; components will become clogged or damaged. This oil vapor can negatively impact health, dental instruments, and restorations. The oil-free air compressor eliminates all of these problems. Recognizing the significant advantages inherent in oil-free compressor design, Air Techniques voluntarily discontinued its oil-lubricated compressor line some years ago.

 

Why is oil-free air healthier and necessary for Dentistry?

 

The combination of warm air, humidity, and oil in the closed environment of the compressor storage tank creates an ideal growing medium for microorganisms. This unhealthy air flows through the piping, dental unit airlines, and handpieces into the patient’s mouth and subsequently throughout the operatory environment. The oil will also compromise the bond strength of restorations.

 

AirStar is specially designed for dentistry and produces clean, ultra-dry, oil-free dental compressed air 100% of the time. The problems of moisture, oil, and microbes are purposefully engineered out. No oil whatsoever is used. Further, the exclusive patented Humidistat continually monitors the moisture content of the air stream and automatically initiates a regeneration cycle should extra moisture removal from the air ever be required.

 

Oil-free engineering and stringent moisture control ensure that every AirStar storage tank remains dry and not conducive to microbial growth. Every AirStar storage tank is SME certified, your assurance of safety, and code compliance.

Posted in Company on March 4, 2020

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Do you start your day off with a cup of coffee? If so, you’re not alone; on average, Americans consume 400 million cups of coffee per day¹, and 2.25 billion cups are drunk daily worldwide².  That’s “mocha” beans!

 

Caffeine, the most commonly used drug in the world, is a natural stimulant providing health benefits like:

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• Improved Energy Levels
• Increases Fiber intake
• May Lower the Risk of Type 2 Diabetes
• Boosts Fat Burning & Metabolic Rate
• May Fight Depression
• May Lower Your Risk of Alzheimer’s Disease
• Lower Your Risk of Dental Caries

 

So how can your average cup of black coffee help to lower your risk of dental caries? According to a recent study, coffee without additives hinder caries causing bacteria from adhering to your tooth’s surface. Only about 35% of coffee consumers drink it black, while the remaining 65% prefer it sweetened or with some form of cream⁵.

 

Roasted coffee shows the highest benefit to dental health. Medium-roasted coffee has the maximum level of antioxidant activity as well as antibacterial activity, even preventing the caries-causing bacteria Streptococcus mutants from clinging to your teeth. When coffee is roasting, compounds such as Melanoidins Polymer will form at high temperatures in food that wouldn’t have developed otherwise. People who regularly drink coffee have less risk of caries because of the antibacterial properties as well as having whiter teeth than those who don’t. But with all those benefits, there are, of course, a few forewarnings.

 

Coffee provides the most benefits consumed with no additives for the antioxidant and antibacterial properties to be maintained. Milk alone doesn’t impact the antibacterial and antioxidant properties of coffee but, combined with sugar or artificial sweeteners, minimize those properties. By adding sugar or sweetener, you’re impeding the benefits of coffee and increasing the possibility of tooth decay.

 

The maximum daily intake of caffeine recommended by the Food and Drug Administration (FDA) is 400 mg. In most cases, caffeine is beneficial in moderation but like most things, too much can cause some potentially harmful effects.

 

Which country drinks the most coffee? Finland is ranked top coffee drinker while the United States is ranked 25th for most coffee consumed⁶. Colombia is the United States’ largest coffee importer, averaging 1.24 billion bags⁶.

 

Are you worried that your coffee consumption will lead to stained teeth? Contrary to what you might think, drinking coffee regularly is actually good for your teeth! While there’s some risk of staining when you have a cup of coffee, it’s similar to having wine and other drinks or food that could also cause staining. The key is proper oral hygiene.

 

Encourage your patients to rinse with water 30 minutes after their cup of coffee. Utilize an intraoral camera to show your patients any staining that may need more attention or further treatment.

 

Adding black coffee to your diet won’t guarantee you’ll be cavity-free. Still, it significantly lowers your risk of developing cavities when coupled with good oral hygiene and regular dental checkups. Like everything, coffee should be consumed in moderation, talk with your healthcare provider to see if you are at any risk for implementing black coffee into your diet.

 

 

Sources:

1. http://www.e-importz.com/coffee-statistics.php
2. https://www.statista.com/statistics/292595/global-coffee-consumption/
3. https://www.caffeineinformer.com/7-good-reasons-to-drink-coffee
4. https://www.healthline.com/nutrition/top-13-evidence-based-health-benefits-of-coffee
5. http://www.e-importz.com/coffee-statistics.php
6. https://myfriendscoffee.com/usa-coffee-statistics/

Posted in Company on February 26, 2020

The environment is a topic at the forefront, thanks to the upcoming US Presidential Elections and the recent global phenomenon of Greta Thunberg. No matter what your stance is on global warming and the world’s carbon footprint, you are impacted by new regulations and rulings that affect the way you dispose and handle the waste.

 

According to the EPA, there are approximately 5.1 tons of mercury and 5.3 tons of other metals being discharged by dentists yearly to POTWs¹. Would it surprise you to know that most of this mercury is subsequently released into the environment? Dental offices are the single largest source of mercury at sewage treatment plants².

 

What happens to the amalgam waste that becomes part of the POTW’s sewage sludge? It’s disposed of in one of three ways²:

• In landfills.  If the amalgam waste is sent to a landfill, the mercury may be released into the groundwater or air.

• Through incineration.  If the mercury is incinerated, mercury may be emitted to the air from the incinerator stacks.

• By applying the sludge to agricultural land as fertilizer. If mercury-contaminated sludge is used as an agricultural fertilizer, some of the mercury used as fertilizer may also evaporate into the atmosphere.

 

After knowing these facts, the recent final ruling on amalgam separators by the EPA may make more sense to you. The compliance date for existing dental practices and businesses is July 14, 2020. The EPA estimates that approximately 103,000 USA dental offices use or remove amalgam¹.

 

Amalgam is considered safe for its treatment purposes by the ADA and the EPA. It’s been used in dentistry for more than 150 years, and gold is the only material that has been used longer for dental purposes.

 

How will the use of an Amalgam Separator benefit the environment? The key is keeping as much amalgam and waste out of the POTW’s sewage sludge as possible. Amalgam Separators offer an efficient way to separate and collect dental amalgam, mercury, teeth fragments, and other dental waste. Designed to capture amalgam particles from dental office wastewater through sedimentation, filtration, centrifugation, or a combination of these mechanisms.³

 

What are the facts you need to identify when choosing an Amalgam Separator to meet compliance? First, know the requirements that the system needs to meet set in the EPA ruling. ⁴Chart

•Ensure the removal of dental amalgam solids from all amalgam process wastewater via amalgam separator(s) or equivalent device(s) that achieve at least a 95% removal efficiency and meet EPA standards set by the final rule 441.40.

•Implementation of two best management practices. See 441.30(b) for an existing source and § 441.40 for a new source.

•Comply with reporting requirements. See 441.50(a).

•Maintain and make available for individual inspection records documenting compliance. See § 441.50(b).

 

When choosing an Amalgam Separator for your practice, do your research online, speak with your colleagues, and your trusted dealer rep. Become familiar with your state or local requirements as those might be sterner than those in the rule. Learn about installation requirements set by your municipality. Lastly, be ready to commit to a recycling program. The collection containers must be recycled appropriately to comply. Many manufacturers, including Air Techniques, offer a recycling program. This is often part of the collection container purchase, resulting in a seamless process for dental facilities.

 

Sources:

1.     https://www.epa.gov/eg/dental-effluent-guidelines

2.     https://www.epa.gov/mercury/mercury-dental-amalgam

3.     Chou HN, Anglen J. An evaluation of amalgam separators. J Am Dent Assoc 2012;143(8):920-21.

4.     https://www.epa.gov/sites/production/files/2017-12/documents/dental-office-category_frequent-questions_nov-2017.pdf

Posted in Company on February 18, 2020

Two in the series “A Better Understanding of Your Dental Utility Equipment and its Importance,” from the Sales Experts and Product Management teams at Air Techniques – The North American Leader in Dental Air & Vac systems.  

Have you ever wondered if one system could be affecting the other? Machines are self-contained right, so how could one be disturbing the other? The simple answer is yes; your oil-based vacuum can be impairing the function of your air compressor.

 

Many factors contribute to the oil-based vacuum harming the air compressor. These include how close the two systems are placed beside one another, the plumbing slope, and the seal of the vacuum joints.

 

The mechanical room of most private practices is usually a small closet or other contained room. Often these rooms are not climate controlled, and so it is recommended to have a heating/air conditioning duct installed within this space.

 

These confined rooms leave little room to space your air and vacuum systems adequately apart. Compressors compress approximately 12 cubic feet of air for every one cubic foot. This requires them to take-in plenty of ambient air. What’s the harm here? The oil-base vacuum could be expelling oil and oil vapor that you may not see but could be dangerous to your compressor. The oil and oil vapor is sucked directly into the desiccant tower and renders the drying system ineffective.

 

What are signs that your vacuum is ejecting oil? The most common symptom is oil on the floor near the oil-based system. Other signs to look for include leakage through castings, water in the oil, and the drip rate is not as specified by the manufacturer.

 

The oil that is then sucked into the desiccant tower will turn the normally chalky white alumina beads to an off-white color similar to that of a weak coffee — contaminating the desiccant beads with the “oil-based vacuum” lubricant.

 

Activated alumina is a porous adsorbent that works by trapping water molecules within a lattice-like surface. Hitting the desiccant beads with oil is like covering a sponge in plastic wrap, neither will hold water.

 

What can you do to prevent this contamination of your air compressor and protect the health and safety of your patients, staff, and handpieces? Removing the risk of contaminating the air is the biggest win. Non-lubricated vacuums are a cleaner choice and ultimately provide a healthier alternative than those oil-base models.

Posted in Company on February 13, 2020

One in the series “A Better Understanding of Your Dental Utility Equipment and its Importance,” from the Sales Experts and Product Management teams at Air Techniques – The North American Leader in Dental Air & Vac systems.  

 

It might be easy to wonder why choosing a dental compressor with membrane dryer matters. If all air dryers perform the same essential function, then why is it necessary to select a specific one? Won’t any dental compressor dryer get the job done?

 

Yes, and no. Any dental air compressor dryer will most likely remove the water vapor from your compressed air for some time, but there may be side effects that will differ depending on the sizing and duty cycle.

 

Choosing an inefficient dental compressor dryer could lead to equipment failure, which will, in turn, lead to potentially expensive repairs. You also might lose time and see an increase in dental materials failing or preps becoming contaminated.

 

Having the correct dental compressor air dryer will reduce the risk of equipment failure and expensive repairs. You can help your practice avoid these costly types of delays and expenses by gaining a better understanding of the compressor air dryers. Knowing the differences, available form, each manufacturer will enable you to choose the dental air compressor that best fits your treatment needs.

 

The cleaner the air your compressor creates and uses will, in turn, be safer for your patients. The risk of exposure to bacteria, microorganisms, and pathogens is as you know high in a dental office. Your equipment could be the culprit of creating a breeding ground for these dangers if its producing poor0quality air, or generating a moist environment in your handpieces.

 

Assuming you’ve spent some time learning about the various types of dental compressor air dryers out there, it’s time to start shopping — and there’s no better place to do that than Air Techniques (Air Star Compressors). Our compressors are quadruple filtered, providing the driest, cleanest air possible.

 

Don’t feel alone in your search for the right air compressor. Speak with your local rep and tap into their knowledge and industry experience after all the air compressor is the heart of your practice.

 

Stay tuned for the next installment in this series – A Better Understanding of Your Dental Utility Equipment and its Importance.

Posted in Company on February 5, 2020

If you didn’t already know, February is National Children’s Dental Month (NCDHM). This month-long observance of promoting the benefits of good oral health to children and their guardians is sponsored by the American Dental Association (ADA).

 

Celebrating NSDHM in February makes more sense than you think. February is a transitional month and the real first breath of fresh air post the holiday season. Being only the second month of the year, it supports starting the year with healthy habits for good oral hygiene. The meaning of February stems from the Latin word ebruarius, from Latin februare meaning to “purify” or “expiate.” A perfect correlation between the month and the observance of NCDHM.

 

Cleveland, Ohio, is credited with starting this cause back in 1941 as a one-day event1. In 1949, the ADA took over sponsorship and held the first national observance of the day. The program grew to a weeklong event in 1955 and later to a monthly celebration in 1981.

 

So what does this mean for today’s dental professionals? Use this month to not only educate your young patients on maintaining proper oral hygiene but educate yourself and staff on the best workflows and treatment options currently available for adolescent patients.

 

Besides learning what tech is out there for best practice, talk with your patients and their guardians to get an inside understanding of how their experience is and how you can make it even better. Treating young patients comes with its own set of responsibilities, not only are you keeping them on track for maintaining their oral health, but you are also forging their attitudes toward future dental habits. No pressure there, right?

 

Providing young patients with a positive experience in the dental chair today will help provide a solid foundation for sustaining good oral health as an adult. This point could be validated when you take a look at the top five states that rank highest in the percentage of children with the healthiest teeth. In order, they are New Hampshire, Connecticut, Rhode Island. South Dakota, and Vermont2. Then cross-reference with these states that rank the highest in adult oral health, and the list is pretty identical3.

 

Utilize the ADA’s website that has free resources to help dental offices celebrate and bring awareness of NCDHM to their patients. Learn about current tech that is designed specifically for smaller mouths as well as omits lower radiation exposures. Check out PSP technology, such as ScanX, that utilizes PSP that are 30x thinner than traditional sensors. That thinness makes a massive difference for your young patients.

 

The bottom line, this NCDHM be conscious of taking a higher mind to focus on the entire picture of children’s dental health. Their oral habits, office experience, and what you and your practice can invest in to ensure you are providing specialized treatment. These essential attributes will all collate into a positive experience for your patient’s oral health today, tomorrow, and future care.

 

 

1. https://www.ada.org/en/public-programs/national-childrens-dental-health-month
2. https://www.dentistrytoday.com/news/industrynews/item/4698-report-ranks-the-best-and-worst-states-for-children-s-oral-health
3. https://www.dentistrytoday.com/news/industrynews/item/4356-wisconsin-tops-list-of-states-with-the-best-oral-health

Posted in Company on January 29, 2020

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By Amber Auger RDH, MPH

As of January 26, 2020, there have been 56 confirmed deaths due to the Coronaviruses throughout China.¹ There have been three confirmed cases in the United States.¹ When evaluating the virus; some patients experience the same symptoms as a common cold. In contrast, others experience a more severe strain of the virus known as the Middle East Respiratory Syndrome (MERS-CoV). A third strain has also developed but remains unnamed. The more advanced strains of the virus are potentially lethal human respiratory infections. ²

After many cases of pneumonia were on the rise without being able to identify their etiology, Doctors began to test the virus further. The new strain of the Coronavirus was first detected in China. Within days there were cases identified in Thailand, Japan, and South Korea. The CDC believes that symptoms include fever, cough, and shortness of breath occur between 2 to 14 days after the exposure of the virus. ²

The World Health Organization says the best way to prevent the spread of the Coronavirus is to wash your hands with soap and water frequently, use alcohol-based hand sanitizers, and personal protection equipment.² My personal favorite hand sanitizer is the Monarch Hydrating Instant Hand Sanitizer from Air Techniques with 66.5% ethyl alcohol. The formula meets the CDC guidelines and hydrates while decreasing the bacteria on the skin.

As healthcare professionals, it is essential to discuss this outbreak briefly with patients. We can empower the patient with common tools to break the chain of infection, such as washing hands often, covering the mouth properly with the arm when sneezing, and identifying proper hand sanitizers to use. We have the opportunity to work together to keep one another safe during this outbreak!

 

1. New York Times. Coronavirus. Available at: https://www.nytimes.com/2020/01/26/world/china-coronavirus.html. Accessed January 26, 2020.
2. World Health Organization. Coronavirus. Available at: https://www.cdc.gov/coronavirus/2019-ncov/about/symptoms.html. Accessed January 26, 2020.

Posted in Company on January 22, 2020

The first X-rays were discovered in 1895 by German physicist Wilhelm Röntgen. He tried to coin the name Röntgen rays, but the name x-ray stuck. Just 14 days after Röntgen announced his discovery, Friedrich Otto Walkhoff and Wilhelm Konig took the first dental radiograph (1).

They wrapped an ordinary photographic glass plate in a rubber dam, Walkhoff held it in his mouth for a 25 min exposure and Walkhoff’s molars were the first dental radiographic produced.

 

Since then, dental radiography has jumped leaps and bounds and now plays a regular role in patient exams and treatment plans. The radiographic achieved in current density provides practitioners with a view of their patient’s hard tissues, teeth, and bones. Radiographs also allow the detection of other potential health issues such as caries, jaw bone diseases, periodontal disease, tumors, and infections under gums.

 

There are many things to consider today when choosing your X-ray source. Consider not only the tech of the system but the flexibility of its program offering, dose reduction options, ease of operation, and space requirements.

 

The value added to your patients are:

• Increased Diagnostic Accuracy
• Best Possible Imagery
• Less Radiation Exposure

 

Today, your patients have more options than ever when it comes to choosing a dental practice. What makes your practice stand out above the rest? Sure, some new tech could come across as gimmicky, and why change something that has been working? Because to attract and keep patients, dental professionals need to be up on new tech and, more importantly, know how to utilize it to provide improved treatment to their patients. Ultimately leading to a better experience and office visit for your patients.

 

Providing the best care possible to your patients is no longer as simple as taking a standard X-ray. Patients are more aware of the level of care they are or not receiving. Maximize your diagnostic capabilities by upgrading to a new 2D, 3D imaging system. Better yet, a hybrid system that enables you to produce both.

 

There are a plethora of systems available on the market today. Air Techniques teamed up with Durr Dental to provide the ProVecta 3D Prime. Together, with 50 years of X-ray technology knowledge, we developed the ProVecta 3D Prime to offer a hybrid system of 2D and 3D imaging. The hybrid options create diagnostic flexibility for you, along with ease of use and lower radiation dose. It provides 17 X-ray programs, including four pediatric-specific programs. To learn more about PorVecta 3D Prime, click here.

 

We encourage you to speak with your local rep to learn how upgrading your imaging system can not only improve your diagnostic capabilities but increase your treatment plans and provide a higher standard of care to your patients.

 

1. Gensman LI. A brief history of endodontics.Jô Endod 1982;8:S38 [Google Scholar]