Category: Dental FAQ

Studies have shown that cross-contamination between patients can result from the backflow of bacteria dislodged from dental suction unit. A PubMed study revealed that the majority of the bacteria isolated from backflow samples were staphylococci, micrococci, and non-fermenting Gram-negative rods. Infectious agents such as Pseudomonas aeruginosa and Staphylococcus aureus were also isolated from backflow fluids.

Here are six things you can do to avoid backflow episodes:

1.Never create a vacuum by sealing your lips around the saliva ejector

2.Never suck on the saliva ejector

3.Ask your dental professional if they use a backflow prevention mechanism

4.Ask your dental professional how often they flush the vacuum lines. (Ideally, they do it after every patient.(Click here to buy contra-angle speed-increasing handpiece)

5.Ask your dental professional about single-use evacuation options

6.Tell your dental professional that you value their attention to equipment cleanliness

Although the risk of cross-contamination due to backflow is considered to be low, infection control should always be a top priority. Disposable and single-use evacuation products are available to lessen the risk of patient-to-patient contamination.

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As clinicians, we use dental magnifying loupes to enable us to see better, but what about our patients? We try to explain what we see or try to show them in a hand mirror. But can they really see what we see? Usually the patient doesn’t see the same things we see; they may just trust but not fully understand or visualize what we are trying to explain. I have had many patients to whom I have tried to educate and explain the need for periodontal therapy and the significant amount of calculus present, only to have the patient request a “regular cleaning.”

Once I show the patient a large-screen photo of their bleeding gingiva and inflammation in addition to the calculus present, they are suddenly more interested in their oral condition and usually are more responsive to treatment recommendations. Many patients are then able to grasp an understanding of the condition and are often willing to complete the recommended treatment.

As a proponent for patient education, I always like to explain the reasoning behind any treatment recommendations that are made in the practice. By using intraoral camera with screen, I am able to show as well as tell the patient what I see. How many times have patients put off what they can’t see because it is not hurting at the time? With the use of intraoral imaging, the patient sees the broken filling or recurrent decay on the computer screen, and most do not want that in their mouths. Due to the increased use of intraoral cameras over the years, I have seen case acceptance for treatment increase greatly. I even have patients ask me to take an image so they are able to see the problem as well. I used to rarely use the intraoral camera while explaining an oral condition, but then discovered that imaging and education complemented each other in the dental practice.

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The dental profession, however, says otherwise. Annual preventive X-rays, called bitewings, for healthy dental patients are not necessary.

Of course, for adults whose dental health is not as ideal, listening to your professional’s advice makes a great deal of sense. Adults prone to cavities, for instance, should have bitewings done every year-and-a-half, states the ADA, depending on the individual’s overall dental picture.

Reducing exposure to radiation also can be a consideration as to whether or not have annual X-rays. Without being alarmist, and without demonstrating absolute certainty, studies focusing on radiation accumulation have pointed to avoiding low-level exposure. And with its own recommendations, the ADA concurs.

“Even though radiation exposure from dental radiographs is low,” citing from the report, titled, Dental Radiographic Examinations: Recommendations For Patient Selection and Limiting Radiation Exposure, “once a decision to obtain radiographs is made it is the dentist’s responsibility to follow the ALARA Principle (As Low as Reasonably Achievable) to minimize the patient’s exposure.”

Finally, x ray taken by portable dental x ray unit reveal more than what your dentist can see when s/he peers into your mouth, and for some people the possibility exists that tooth decay, once it starts, can spread quickly. So if you’re the type who tends to operate with an abundance of caution – and possibly, an unnecessary abundance – then accept your dentist’s offer for annual X-rays.

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Access to high quality images and a streamlined digital workflow improve the speed and accuracy of case diagnosis, producing more predictable outcomes for dentists and their patients.

Compatibility

Purchasing compatible components from one supplier ensures no integration issues and simplifies training and maintenance, ensuring there is no buck-passing between different suppliers.

Where to start

If you are starting out you will likely require an portable dental x ray unit and either phosphor plate scanner or digital sensor for fast access to X-ray images. If you require more detail including panoramic, CBCT or 3D images you will want an extraoral imaging unit.

Image quality

The top of the list for anyone contemplating purchasing digital imaging products is image quality using the latest technology such as CMOS digital sensors and Automatically Controlled Exposure (ACE), which ensures sharp images with up to 50% lower radiation emissions.

X-ray unit & Sensor

Automatic Controlled Exposure (ACE), has built in filters to reduce artefacts from metals. User preferences such as contrast settings are automatically saved so all images are processed uniformly to reveal the required detail in either hard or soft tissue. The combination of the X-Mind X-ray and Sopix2 digital sensor yields sharp image quality and a ‘real time’ view which is important in endodontic treatment and implant placement.

Phosphor plate unit

A less expensive alternative is the PSPIX phosphor plate unit, which has the added advantage of different size phosphor plates suitable for smaller and younger patients. The PSPIX is the fastest and most compact phosphor plate scanner available, processing images in just 12 seconds and being fully networkable throughout the practice.

Panoramic and 3D units

The ‘Rolls Royce’ of digital diagnostic units is the latest extraoral imaging device, X-Mind Trium from Acteon – available from A-dec dealers around Australia. X-Mind Trium offers the highest possible image quality, four fields of view enabling you to select the scanning area for examination and to minimise radiation exposure to patients.

Imaging software

The all important imaging software will harness the power of all your digital imaging equipment, making images available to view, store and manipulate.

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PAIN OR SENSITIVITY
If one of your teeth hurts when you chew, or if you have a constant toothache, you may have a cavity.
A tooth has three layers: enamel, dentin, and pulp (where the roots and nerves are located). As the protective layer of enamel decays, the nerves in your tooth have one less layer protecting them. When a cavity forms, chewing can be incredibly painful. If the decay reaches the pulp, your tooth can become infected and result in a consistent, throbbing pain.

BAD BREATH
As a tooth decays, bacteria continue to multiply if the decay isn’t treated. Bacterial growth can lead to bad breath. If you’ve developed bad breath while continuing a good dental routine, you may have a cavity.

NOTICEABLE HOLES, PITS, OR DARK SPOTS
One of the most accurate ways to determine whether you have a cavity is to examine your teeth. If you see any dark spots, pits, or holes in your teeth, you probably have a cavity.
Because you use your back teeth for the majority of your chewing, you’re most likely to develop a cavity there.

When you find these signs, the most important thing that you need to do is to make an appointment with a dentist to examine your teeth. The dental office you choose should have a portable dental X-ray machine to ensure that your condition is detected, such as cavities.

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In a study published in the journal of dental education in 1998, Fifty-two third-year students were randomly assigned to experimental (magnification) or control (no magnification) groups. Members of the experimental group used magnification in their daily work in the pediatric dentistry clinic. No significant differences between the groups’ preparations or evaluations of standard preparations were found (Donaldson, Knight, and Guenzel, 1998).

In a separate, more recent study; the performance of first-year dental students was assessed during an Advanced Simulation Course using virtual reality-based technology training. The test group consisted of 116 dental students using magnification loupes, while students not using them served as the control. The study found that students using dental loupes completed more preparations, worked faster per procedure, therefore displaying greater overall performance. The survey revealed a high degree of student acceptance of using magnification (Maggio, Villegas, and Blatz, 2011).

There is no definitive answer to this question, there are a large number of dentists which advocate the use of loupes for dental students who argue that, although they are quite a large investment (especially for a students), Loupes help to create and maintain good habits in terms of posture and their increased attention to detail. On the other hand some dentists have said that they can’t work with loupes because it makes them dizzy when alternating between looking at the patients mouth and looking at the instrument tray for example.

The best thing to do is to try them on! A number of Loupes companies/businesses will visit dental schools during conferences, trade fairs and provide students with the opportunity to try on their range of models. Some manufacturers also allow a limited trial period (around 45 days) where you can work with them on clinic and if you are not happy with your by the end of your trial, you return them to the manufacturer and you don’t pay.

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One of the key parts to an effective oral disease prevention plan is practicing daily oral hygiene to remove dental plaque. Both brushing and flossing are necessary for cleaning your teeth of this thin biofilm of bacteria and food particles most responsible for tooth decay and periodontal (gum) disease.

Once formed, calculus can adhere to teeth so tenaciously, it’s impossible to remove it with brushing and flossing. But dentists and hygienists can remove calculus safely with special tools called dental ultrasonic scaler.

And it should be removed or it will continue to foster bacterial growth. This in turn increases the chances for infections that attack the teeth, gums or underlying bone. Keeping it under control will therefore diminish your risk for developing dental disease.

Although there are other factors like heredity that can affect your disease risk, keeping your mouth clean is the number one thing you can do to protect your teeth and gums. A daily hygiene practice and regular dental visits will help ensure plaque and its calcified form calculus won’t be a problem.

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An intra-oral camera is a tiny device approximately the same size as a large pen or toothbrush, with a camera lens at the end. It is covered with a protective plastic sheath that is changed for every patient to ensure the device is entirely hygienic and to prevent any risk of contamination. The video camera is small enough to fit comfortably in your mouth so that we can take pictures of your teeth. Unlike digital dental x-ray images, the images produced by an intra-oral camera are easy to understand and are incredibly clear.

An intraoral camera with screen is an extremely safe piece of equipment. It is specially designed only to be used inside your mouth, and the images are captured comfortably and quickly. In fact, it’s a far more comfortable piece of equipment than a dental mirror which can sometimes trigger a gag reflex. With this tiny camera, we don’t need to poke or probe unnecessarily, as it will scan the inside of your mouth, without making you feel as if you want to gag!

By viewing magnified images inside your mouth, we can make a quicker and more accurate diagnosis. A faster diagnosis is essential if you experience any pain or discomfort in a tooth, and where you need immediate treatment. Additionally, an intra-oral camera is comfortable and non-invasive, which is very important when you are in any pain.

Anyone who feels a little nervous about having dental treatment may find they are more comfortable with this treatment approach. Often just knowing more about what is happening and understanding your dental health can help relieve fear and anxiety.

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Debris

Blow out the handpiece using compressed air to remove loose debris, cleaner, and lubricant before sterilization (a handpiece should never be run without a bur!).

Air Pressure

Excessive air pressure (exceeding 40 PSI) could cause damage to turbine bearings, reducing the performance of the turbine.

When dental handpiece performance is reduced at 35 PSI dental turbine unit should be rebuilt or replaced.

Sterilization

Never exceed 275ºF (135ºC) during the sterilization cycle; use the lowest temperature possible while still achieving proper sterilization of instruments.

Air and Water Supplies

Must remain free of debris.

Filters should be used and checked often.

Compressor oils and carbons must be filtered from the air supply.

Push Button Spindle Maintenance

Push button spindles are made of metal components and require small amounts of lubricant and periodic flushing for an extended life span.

Lube Free or Maintenance Free Turbines (Beware)

Only the bearings are maintenance free!

The bearings are pre-greased at the factory and shielded to help protect them from debris and the removal of lubricants during use.

Other turbine components still need to be maintained; O-rings will dry out without lubricants and push button spindles require lubrication and flushing.

1.Choose the correct magnification and working distance in order to ensure that you work in complete ergonomic harmony with your dental binocular loupes.

2.Look at an object with straight black lines.
The most common signs of poor quality loupes are low resolution, chromatic aberration and spherical aberration. Resolution is defined as an optical system’s ability to form distinguishable images of objects separated by small distances, or to recognize fine detail.

3.Test the magnification.
Choose the lowest comfortable magnification level, as this would provide the widest field of view.

4.Test the working distance.
The working distance refers to the distance between your eyes, and the patient’s mouth. You can measure this while assuming your normal working position, making sure you are comfortable, that your back is straight, and that you are not leaning forward too much.

5.Check the field of view.
A larger field of view is preferred, as there is a larger area visible through the dental surgical loupes, and there is less need to move your head around .

6.Check the depth of field.
A larger depth of field is preferred, as there is a deeper area visible through the loupes. The size of the “depth of field” corresponds directly to the “working distance”.

7.Compare with prescription lenses.
If you use glasses with prescription lenses, it is important that you have the option of fitting your loupes frames with the correct prescription. Otherwise, the loupes will not perform according to specifications.

8.Test the weight of the loupes.
Weight is an important factor when choosing a new loupe. Especially if the loupe is to be used for longer periods of time.