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Motivational Interviewing in Dental Hygiene

What’s your goal as a registered dental hygienist?

 

Is it to create whiter smiles, or something more?

 

Hygienists know their breadth of skills and knowledge extends far beyond simply cleaning teeth. Registered dental hygienists are in a unique position to connect with patients and impart personalized dental advice that can benefit them for years to come.

 

Unfortunately, a dental office operates on a tight schedule, leaving little to no time for hygienists to talk with patients one-on-one.

 

This raises an important question: is it worth spending less time on clinical care to spend more time on counselling?

 

At least one registered dental hygienist says the answer is yes. Writing for Today’s RDH, Michelle Strange explains how she came to see her role as a hygienist differently.

 

two ladies shaking hands

 

Clinical Care vs. Self-Care

Michelle Strange is a practicing hygienist, surgical assistant and educator. She is also a self-proclaimed perfectionist.

 

“I need to know I am doing the best job I can while striving to do it better,” she writes. “Sound familiar?”

In the beginning, Michelle felt she was making the most of her limited time with patients by eradicating every last stain on their teeth. She still took the time to give thorough home care instructions, of course – but if there were a minute to spare, she’d rather have used it to deliver additional clinical care.

 

That all changed when she discovered motivational interviewing.

 

“If I have to choose to spend 5 minutes getting every speck of stain off of a patient’s lingual surfaces or 5 minutes making sure they can use a toothbrush properly, I choose the latter”, writes Michelle.

 

It’s a stark difference, but one that Michelle feels will benefit her patients far more in the long run. And she’s not alone. Motivational interviewing is gaining ground in the dental profession, with an increasing number of dentists and hygienists embracing the view that what patients do at home is just as important as the care they receive in the dental chair.

 

What is Motivational Interviewing in Dental Hygiene?

Pioneered in the world of cognitive therapy, motivational interviewing describes an approach to patient care that puts the clinician in the role of a coach or a counsellor more than an authority figure – someone who guides patients in the right direction instead of lecturing them.

 

In dentistry, this approach can apply to how registered dental hygienists educate people about dental self-care. By asking questions and listening without judgement, clinicians can help patients understand choices that affect oral health and feel empowered to make positive change.

 

For example, rather than simply cleaning the patient’s teeth, a hygienist would take time to help them understand why the stains occur and answer any questions the patient may have about flossing and brushing.

 

As Michelle puts it, “Treatment is only going to last so long. If the patient continues to build calculus in the same place every time we see them, are we performing successful patient care?”

 

When clinicians take a non-judgemental interviewing approach, patients are more comfortable asking questions and speaking honestly about their current dental self-care. The hygienist can then provide personalized recommendations that meet the patient’s level of disease, obstacles to care, and lifestyle.

 

Motivational Interviewing in Practice

With this approach, you may find that patients are more receptive to your advice and motivated to make positive changes. Start by incorporating the four basic motivational interviewing techniques: open-ended questions, affirmations, reflections, and summaries.

  • Ask open-ended questions that invite the patient to elaborate, such as: “What do you find works for you in your current home care routine?” and “What do you find difficult about dental care?”
  • Give affirmations that recognize good choices and encourage patients to continue, such as: “I can tell you’ve been flossing.”
  • Reflect the patient’s answers in a way that gives them meaning. If the patient says they only want a treatment that falls within their insurance coverage, you could say, “We’ll have to keep dental care within your budget.”
  • Summarize the patient’s thoughts to confirm their answers and show you are listening.

Motivational interviewing isn’t the only way to approach patient care, but it is one way to ensure they get more from the appointment than a whiter smile.

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Are Your Patients Protected? 4 Important Points on Athletic Mouth Guards

Helmet? Check. Goggles? Check. You’re ready to hit the ski slopes – almost.

 

What about your mouth guard?

 

Most people think orofacial protectors, better known as mouth guards, are only for contact sports athletes. However, the American Dental Association (ADA) has long encouraged the use of athletic mouth guards for people engaged in all kinds of recreational sports and activities, including non-contact activities like skiing.

 

One of the reasons mouth guards are not more widely used is the many misconceptions surrounding them. Do mouth guards cause gum disease or bad breath? Who really needs to use a mouth guard?

 

Athletic Oral Protection

 

This is an area where dental hygienists and other dental professionals can step in to help. Below, we’ll discuss some of the questions (and misconceptions) you may hear about the subject of athletic mouth guards.

 

1. When to Use a Mouth Guard

Athletic mouth guards are designed to provide cushioning in the event the wearer receives a blow to the face. Though the device only covers the upper teeth, it also helps prevent injuries to the lips, tongue and cheek, since all can be hurt by broken teeth. Mouth guards can also help to prevent injuries to the jaw by reducing the force upon impact.

 

Some sports, like hockey and boxing, carry an inherent risk of these types of injuries. However, dental injuries are also prevalent in non-contact activities and exercises like ice skating and gymnastics. Falls are one of the most common causes of tooth injury. And it isn’t only children who are at risk – numerous surveys show that the risk of dental injuries is present for sports participants of all ages, genders and skill levels.

 

According to the U.S. Centers for Disease Control, sports-related dental injuries account for more than 600,000 emergency room visits each year. Both the ADA’s Council of Scientific Affairs and its Council on Advocacy for Access and Prevention recognize the value of wearing an athletic mouth guard when participating in sports and recreational activities where injuries to the face, head or mouth can occur.

 

2. Mouth Guards and Gum Disease

Some people point to mouth guards as a source of bad breath, gum disease, cavities, and other oral health issues. Although athletic mouth guards are not the cause of these problems, mouth guards can harbour bacteria that contribute (along with poor oral self-care) to oral disease.

 

It is important to care for an athletic mouth guard properly. The device should be rinsed with warm water immediately after use, followed by a light brushing with a toothbrush (toothpaste is not necessary.) Since oral bacteria thrives in moisture, the mouth guard must be allowed to dry completely before storage. The mouth guard and its storage case should also be cleaned with denture cleaner periodically.

 

3. Different Types of Athletic Mouth Guards

There are three main types of athletic mouth guards available:

  1. Custom mouth guards made by a dentist using an impression of the wearer’s mouth.
  2. Over-the-counter mouth-formed or “boil and bite” mouth guards, which can be formed to fit the wearer’s mouth by submerging the device in hot water until it becomes soft and then placing it in the mouth.
  3. Over-the-counter pre-formed stock mouth guards.

The most effective type of mouth guard is one custom-made by a dental professional and tailored to fit the unique shape of the user’s mouth. Not only does this type of mouth guard provide the best protection, it is also the most comfortable, meaning the user is more likely to wear it more often. Custom-made mouthguards can also last longer and be less prone to damage by the wearer.

 

For athletes who cannot afford or access a custom-made mouth guard, a store-bought device is still more effective than forgoing a mouth guard altogether. The ADA recommends that athletes look for over-the-counter mouth guards bearing the ADA Seal of Approval, which have met the organization’s standards for safety and efficacy.

 

4. Mouth Guards and Concussions

One of the classic arguments in favour of wearing a mouth guard is the notion that it helps to protect the wearer from a mild traumatic brain injury. In truth, researchers have yet to confirm this claim.  However, one study found that high school football players who wore a store-bought mouthguard were more than twice as likely to suffer a concussion than players who wore custom-fitted mouthguards.

 

Regardless, there is no question that an athletic mouth guard can protect the wearer from injuries to the teeth, jaw, lips, tongue and gums.

 

Are Your Patients Protected?

Sports-related injuries constitute 12-39% of all dental injuries. Athletic mouth guards may not be mandatory for most recreational activities, but they can make the difference between a simple mishap and a costly dental injury.

 

The next time you see a patient, consider asking whether they plan to put on their ski boots and ice skates this winter. If the answer is yes, remind them of the benefits of wearing a mouth guard.

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Checklist: 6 Vital Questions to Ask on Your Next Dental Visit

Communication is the cornerstone of a successful practitioner-patient relationship. Dentists and registered dental hygienists hear this principle repeated throughout their education.

 

However, in most dental appointments, the practitioner does most of the talking.

 

Vital questions for your dentist

 

If you’re a patient, these are vital questions to ask on your next dental visit. If you’re a practitioner, this list should help open the door to more productive communication with people for whom you care.

 

1. How Does Dentistry Impact My Overall Health?

There is a strong connection between a person’s oral health and the state of their health overall. Not only does the mouth offer clues to what’s going on in the rest of the body, but it can affect the body in ways patients often find surprising.

 

By examining teeth and gums, dentists can see early evidence of nutritional deficiencies, general infections, and even systemic diseases like diabetes. Studies also suggest that oral bacteria and inflammation plays a role in certain diseases, including cardiovascular disease.

 

2. What is the Condition of my Gums, Teeth and Smile?

Given the connection between oral health and overall health, it is vital patients know where they stand. The appointment should not focus solely on the most pressing problems. Take time to discuss the state of the patient’s oral health as a whole.

 

3. How Does Your Oral Health Impact Your Everyday Life?

Patients in the dentist’s chair should never be shy about what’s bothering them. Even minor concerns can point to bigger oral health issues that should be addressed. Be sure to bring up everyday issues like swollen or bleeding gums, bad breath, loose teeth, and snoring.

 

This discussion should include cosmetic concerns. Studies recognize the link between how someone perceives their dental aesthetics and their social and psychological wellbeing. The appearance of teeth and gums certainly has an affect on a patient’s day-to-day life.

 

4. How Will a Proposed Treatment Solution Benefit Me?

Part of a dental practitioner’s job is to ensure patients have the facts they need to make well-informed decisions about their oral healthcare.

 

Some treatments are necessary, while others are beneficial but optional, or purely cosmetic. It’s important that patients understand the urgency of a procedure and the possible consequences (if any) of not moving forward.

 

5. Is This the Right Practice to do this Work?

Many dentists are generalists, but some specialize in a particular area of dentistry. For certain treatments, patients may benefit from a referral to a specialist in areas like endodontics, orthodontics, or periodontics.

 

A dental specialist in the United States is a member of a Dental Specialist Organization recognized by the American Dental Association; in Canada, a specialist has completed specific postgraduate training and passed a Royal College of Dentists exam.

 

6. Is This the Right Time to Proceed with Dental Treatment?

Assuming the problem is not an urgent one, it may be better to postpone treatment until a later date. Many people have a limit on the total cost of dental care their insurance covers each year; performing different steps of treatment over a longer period can help the patient maximize their dental benefits.

 

The Importance of Practitioner-Patient Communication

We write about communication between patients and dental practitioners on this blog often. In this post, we aimed to help facilitate the process with questions every patient should ask (and which dentists and hygienists should encourage).

 

Check out the Sable Industries blog for more information on dental equipment and resources for practitioners.

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Assissting Stroke Patients with Oral Hygiene Care

The occurrence of a cerebrovascular accident (CVA), commonly known as stroke, has a significant impact on a patient’s oral health. Dental hygienists can provide valuable support in the maintenance of oral hygiene as survivors recover and adjust to life after a stroke.

 

Oral Hygiene

 

This article provides an overview of the role of hygienists in assisting stroke patients with oral hygiene care.

 

Stroke and Oral Hygiene

Cerebrovascular accident (CVA), commonly known as stroke, affects millions of people each year. It is the fifth leading cause of death for Americans and the third for Canadians. In some cases (particularly in elderly patients) stroke causes severe and lasting disability.

 

Patients typically undergo extensive rehabilitation, including occupational therapy. Traditionally, it was physical therapists that helped patients regain oral hygiene skills following the incidence of a stroke.

 

However, cuts to healthcare benefits have resulted in many patients receiving less rehabilitation and little to no assistance in overcoming the challenges stroke can present in brushing, flossing and general oral self-care:

  • Loss of coordination (apraxia) can make brushing and flossing difficult or impossible;
  • Difficulty swallowing (dysphagia) can increase the time food spends in contact with the teeth;
  • Facial paralysis (hemiplegia) can cause food debris to accumulate in the affected cheek without the patient’s knowledge;
  • Difficulty articulating (dysarthria) hinders communication between the patient and dental professionals.

Additionally, many of the medications used to treat stroke survivors present side effects that further complicate their dental care:

Each cerebrovascular accident case is unique; not all patients who are recovering from stroke present the same conditions or follow the same path in recovery. However, dental hygienists who wish to support these patients must be knowledgeable of the many ways stroke can impact the state of a person’s dental health and the ongoing care they require.

 

Assisting Stroke Patients with Oral Hygiene Care

Oral hygiene is an important part of a stroke survivor’s care and recovery. Regaining the ability to care for one’s teeth and gums gives patients a sense independence and control over their health.

 

For patients with lasting disabilities, dental hygienists can help empower the patient’s caregivers to provide quality dental care.

 

In most cases, patients are advised to wait at least six months after a stroke to receive non-urgent dental care, and to receive a post-CVA consultation with the patient’s physician. These are some of ways that dental hygienists can assist stroke patients with oral hygiene care:

  1. If the patient uses oral hygiene aids at home, have the patient bring the products to the appointment and demonstrate their use. Hygienists can advise on the usage of these products to achieve the best possible results.
  2. Hygienists can suggest products and methods that can help patients compensate for the loss of dexterity or cognitive impairment, such as floss holders, floss piks, electric toothbrushes, and brushes with a two-minute timer.
  3. Patients who suffer from xerostomia as a side effect of medications can be given products and tips to help relieve dry mouth
  4. For patients with cognitive impairment or memory loss, hygienists can assist by providing all oral hygiene instruction in both oral and written form and including the patient’s caregiver in all appropriate discussions.

 

Celebrating Dental Hygienists

October is National Dental Hygiene Month: an initiative to celebrate the hardworking, compassionate dental hygienists who contribute to the cause of improving oral health care. Sable Industries is proud to support your work.

 

We look forward to assisting you.

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Treating the 4 Common Dental Problems During Pregnancy

If you asked the average parent to name the roster of a prenatal healthcare team, they are bound to mention a few key players: the family doctor, obstetrician/gynecologist, sonographer, and perhaps the midwife.

What about the dental hygienist?

 

commin dental problems during pregnancy

Parents and healthcare providers often overlook the importance of oral health during pregnancy. However, multiple studies have indicated a link between poor oral health and adverse outcomes in pregnancy.

A comprehensive overview of research on this subject demonstrated that associations exist between periodontitis during pregnancy and pre-term birth, low birth weight babies, and preeclampsia.

Common Dental Problems During Pregnancy

In particular, there are four oral health conditions that become more prevalent during pregnancy:

  1. Gingivitis
  2. Dental caries/cavities
  3. Pyogenic granuloma
  4. Dental erosion

We’ve provided an overview of these four common dental problems during pregnancy, along with how dentists and dental hygienists can play a greater role in providing care to pregnant patients.

1. Pregnancy Gingivitis

During pregnancy, the body’s response to gingivitis-causing bacteria in the periodontal tissue changes. Some studies speculate the change is triggered by hormonal fluctuations, such as increased salivary estrogen levels during the second and third trimesters.

As a result, patients who had periodontitis before pregnancy may find that inflammation increases throughout the pregnancy. Those with no prior history of gum disease may develop periodontitis or notice increased bleeding and gingival crevicular fluid flow.

2. Dental Caries in Pregnancy

The risk of developing dental caries or cavities often increases during pregnancy. Patients may be affected by one or more contributing factors:

  • Decrease in salivary pH due to changes in diet;
  • Increase in acidity in the mouth due to vomiting;
  • Dry mouth; or
  • Poor oral hygiene care due to nausea and vomiting.

3. Oral Pyogenic Granuloma

Pyogenic granuloma appears as a small tissue overgrowth on the gums that can be smooth or lobulated and red or pink. These lesions are sometimes called ‘pregnancy tumours’ because they are more common in pregnant patients; however, pyogenic granuloma is not cancerous and often disappears without treatment.

Though not harmful, a pyogenic granuloma can be painful and unsightly.

4. Dental Erosion During Pregnancy

Patients who experience morning sickness or gastroesophageal reflux disease (GERD) in pregnancy may develop greater erosion of dental enamel. Although there is no way to reverse dental erosion that has already occurred, dental professionals can assist in preventing and reducing its effects.

Assisting Patients with Common Dental Problems During Pregnancy

Pregnancy can be a critical time for a patient’s oral health. Not only does it increase the risk of these common dental problems, but poor oral health care is linked to outcomes like preterm birth, low birth weight, and preeclampsia.

There are many ways in which dental hygienists can help contribute to positive outcomes through good oral health care at all stages of pregnancy:

  1. Encourage patients to have regular dental checkups during pregnancy, even if they are accustomed to seeing the dentist only once or twice a year. Emphasize the added importance of oral health care during this time in their lives.
  2. Be non-judgemental about new concerns the patient may have about dental treatment during their pregnancy. Many people have heightened concerns about medications, fluoride treatment, and dental x-rays during this time; answer their questions with patience.
  3. Reinforce the benefits of good oral hygiene care: twice-daily brushing for two minutes at a time, once-daily flossing, and using toothpaste with fluoride.
  4. Ask about any new medications or supplements the patient may be taking during pregnancy.

Celebrating Hygiene Month

We all have dental hygienists to thank for being a part of our healthcare team throughout different stages of our lives, including the journey towards parenthood.  This is the second in a series of articles we’ve published on this important role during Hygiene Month: a month to recognize hygienists and emphasize the importance of good oral hygiene.

Sable Industries is proud to produce quality dental tools used by registered dental hygienists and dentists across North America. Contact us today to learn how we can assist your dental practice.

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What You Should Know About the EPA’s Rule on Dental Amalgam Separation

The dental profession has long acknowledged the impact of dental amalgam on the environment. In the year 2014, the American Dental Association adopted nine principles on keeping amalgam particles out of dental office wastewater. Then, following consultation between the ADA and the Environmental Protection Agency, the EPA finally issued a final rule on amalgam separation on June 9, 2017; now, most dentists have until July of 2020 to comply.

 

EPA rules for Dental Wastewater

 

The final rule sets guidelines on everything from how to dispose of amalgam waste to minimum efficiency standards for amalgam separators (right down to the decimal point.) Though they may appear daunting, these regulations are not far from the existing APA best practices, and practitioners who start now should have no trouble meeting their obligations by 2020.

 

Dental Economics magazine has published a helpful summary of the rule. These are the main takeaways for dentists and other dental professionals looking to incorporate amalgam separation into their practices.

 

Who Needs to Use an Amalgam Separator?

Most dental offices in the United States are subject to the EPA’s rule on amalgam separation. In most cases, even those practitioners who do not place amalgam fillings must begin using amalgam separators. However, there are notable exceptions.

  • Certain dental specialists may be exempt from the rule, including practices that specialize in oral pathology, oral and maxillofacial radiology, orthodontics, periodontics or prosthodontics.
  • The rule does not apply to mobile units.
  • Dental practices that neither place nor remove amalgam except in limited circumstances (which the rule defines as fewer than 5% of procedures or nine cases per year) may not have to use an amalgam separator.

If your practice falls into one of these categories, it is possible you may not have to start using an amalgam separator. However, certain localities have dental amalgam pre-treatment requirements, and many states have rules that exist alongside the EPA’s new guidelines.

 

How Does the EPA’s Final Rule Differ from ADA Best Practices?

Although the American Dental Association worked with the EPA to develop the requirements, the result does differ from the ADA’s best practices in several important ways. The most significant differences are:

  • Amalgam separator efficiency requirement. The ADA recommended that dental offices use a system that removes at least 95% of amalgam particles from wastewater, in line with 2008 ISO 11143 standards. The EPA requires an amalgam separator to be 2008 ISO 11143–certified and remove 99% of amalgam particles.
  • Frequent inspections. The EPA imposes onerous inspection requirements on all dental offices that use an amalgam separator. Dental professionals must inspect the equipment as per Manufacturer Instructions and generate a visual inspection log that details who conducted the inspection, the results of examining each device, and a summary of any follow-up actions. 

Most amalgam separators manufactured and sold in the United States and Canada claim to operate at 99% efficiency. However, dentists who have already invested in the equipment should confirm that their system meets the EPA requirements before 2020.

 

How Can Dentists Demonstrate Compliance?

The rule requires that dental practitioners report compliance annually to their respective state Control Authority.

 

The Control Authority differs state-to-state, but it is typically an EPA regional office, a local wastewater utility, or a state environmental agency. Dentists in Alabama, Connecticut, Mississippi, Nebraska and Vermont should report to their state environmental agency; dentists in all other states can contact their regional EPA office to find out who acts as the Control Authority in their state.

 

You can read more about the importance of dental amalgam separation and tips for compliance on our blog.

 

 Please visit www.dds-epa.org for FREE record keeping software and more information.

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Dental Handpiece Innovation: Meet Sable’s 6 Newest Handpieces

The dental handpiece is almost as old as the practice of dentistry itself.

 

Most of its history involves incremental improvement. Handpiece innovation didn’t kick into high speed until recently, with the invention of the first belt-driven electric instrument at the turn of the 20th century and the air-driven handpiece 50 years later.

 

Today, manufacturers and dental professionals are constantly working together to achieve higher speeds, smoother cuts, greater control, and enhanced comfort for practitioners and patients alike.

 

E-Type Prophy package

 

That has always been our goal at Sable Industries: to continuously refine and innovate our offerings based on the insight of dental practitioners like you.

 

Celebrating 20 Years of Handpiece Innovation

Over the past 20 years, we’ve had the opportunity to speak with thousands of dentists, specialists and registered dental hygienists who use our dental handpieces every day. Their feedback has helped us develop the precise, powerful handpieces and components that have carved out our place in the industry.

 

For our anniversary we were excited to release six innovative dental handpieces into the market:

  1. E-Type 1:1 & 4:1 One Piece Contra Angle, an ultralight aluminum slow speed handpiece
  2. Access Pro Series, a high speed, fiber optic titanium finished handpiece with a compact head for optimum accessibility and visibility
  3. Rotamax Pro Series, a high speed, fiber optic titanium finished handpiece designed for maximum torque

Plus, for the duration of our anniversary sale, each of these new handpieces is buy-three-get-one-free.

 

E-Type 1:1 & 4:1 One Piece Contra Angle

We designed every facet of this E-Type handpiece to make your job easier, from cutting and polishing to cleaning and maintenance.

 

The lightweight aluminum body is sculpted to fit comfortably in the practitioner’s hand, and the contra-angle shaft gives access to those hardest-to-reach parts of the oral cavity.

A one-piece design was chosen to enable efficient cleaning and field repair.

 

As for maintenance, the E-Type 1:1 and 4:1 one piece contra angles include internal lubrication channels for faster lubrication and sterilization. This design ensures that the handpiece will remain properly lubricated and extend the life of the handpiece. You can purchase Sable’s prophy button to convert the screw-in prophy head to a snap-on prophy head.
 

Access and Rotamax Pro Series KL & NL

Our new high-speed Access & Rotamax Pro Series models feature:

  • State-of-the-art fiber-optics
  • Quadruple water spray for more efficient surface cooling
  • Innovative teardrop-shaped head design for greater visibility
  • Improved turbine and suspension system for a smoother, quieter operation.
  • Compatibility with KaVo style or NSK style couplers
  • Two-year warranty

The Access & Rotamax Pro Series KL/NL

The Rotamax Pro Series provides additional torque to handle removal of Zirconic crowns. Its sleek, titanium finish is durable and 40 percent lighter than stainless steel – putting more power in the practitioner’s hand while reducing physical demand.

 

The Access Pro Series features a mini-head design and optimum accessibility to all parts of the mouth.

 

Buy Three New Handpieces and Get One Free

The year 2018 marks our 20th anniversary as a Canadian manufacturer of high-quality high and slow speed dental handpieces. We felt it was the perfect time to release six new tools into the marketplace – and for a limited time, we’re offering a free dental handpiece with the purchase of any three of our latest offerings.

(free goods will be equal to or less than the lowest priced item).

 

Get in touch to learn more or claim this offer today!

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Importance of Dental Amalgam Separation

Dental amalgam has long been recognized as a safe and affordable material for fillings. However, the American Dental Association (ADA) acknowledges that amalgam waste from dental offices in the United States contribute 29.7 tons of mercury pollution to wastewater systems each year. This statistic prompted the Environmental Protection Agency (EPA) to finalize regulation on the use of amalgam separators in 2017.

Copyright: 123RF Stock Photo

 

This article provides an overview of the use of amalgam separation in the dental office, including the ADA’s best practices on amalgam separators.

 

Dental Amalgam and Mercury Pollution

Dental amalgam consists of approximately 40 to 50% mercury, 25% silver, and 25 to 35% mixture of copper, zinc and tin. These materials are bound together as a hard, stable substance.

 

Amalgam has been subject to numerous studies and reviews that demonstrate it is safe and effective for use in dental fillings. The problem with amalgam is not its effect on dental patients, but rather the difficulty of disposing of dental amalgam safely.

 

When dentists place new amalgam fillings or remove old ones, water containing amalgam particles is flushed into chair-side drains. These mercury-containing particles then enter the wastewater disposal system and water treatment plants. From there, the amalgam particles may be incinerated, land-filled, or made into fertilizer pellets for lawns or gardens. In each case, mercury from amalgam fillings is discharged into the environment, where it may bioaccumulate in fish and contaminate the food chain.

 

To summarize, dental offices that work with amalgam fillings (including “mercury-free” practices that only remove them) flush amalgam particles containing mercury down the drain and into the wastewater system. These particles ultimately become environmental pollutants.

 

One survey found that dental amalgam is the greatest contributor of mercury pollution in the wastewaters of California, Minnesota, Ohio, and Maine; numerous studies have also identified the dental industry as the top source of mercury in sewers in Canada and Europe.

 

Regulating the Use of Amalgam

The EPA’s National Pollution Discharge Elimination System (NPDES) mandates the reduction of mercury and other contaminants to ensure the discharge does not negatively affect water quality or people’s health. On July 14, 2017, the agency finalized regulation specifically targeting the use of dental amalgam.

 

The regulation applies to most dental practices that discharge waste into a public sewer or wastewater system. The basic requirements are:

  • Using amalgam separators (or equivalent devices) to remove dental amalgam solids from all amalgam process wastewater;
  • Implementing best management practices;
  • Complying with reporting requirements; and
  • Maintaining certain records documenting compliance.

Practices have until July 2020 to comply.

 

What Are Amalgam Separators?

An amalgam separator is a device installed on a dental vacuum line to filter out mercury and other particles from water waste before they enter the sewer system. The captured mercury can then be recycled to industry or safely disposed of.

 

Traditionally, dental practices used chair-side traps and vacuum filters to capture amalgam waste; however, the ADA estimates that 6.5 tons of mercury bypass these filters annually.

 

Amalgam separation is proven to reduce the impact of amalgam on environmental pollution. In Toronto, the amount of mercury in wastewater sludge decreased by 58% after regulation requiring the use of amalgam separators in dental offices took effect.

In addition to reducing environmental pollution, using an amalgam separator can help to extend the life of vacuum pumps by preventing solid particles from entering and damaging the pump.

 

To comply with EPA regulation, an amalgam separator must be ISO 11143:2008-certified to remove greater than 95% of solids by weight. Most amalgam separators on the North American market meet this standard.

 

Amalgam Separation Best Practices

To assist in complying with the new regulation, the ADA has published best practices for the use of amalgam separators. These practices recommend that dental practitioners:

  • Use chair-side traps, vacuum pump filters, and amalgam separators to capture and recycle amalgam particles.
  • Use pre-capulated mercury alloys instead of bulk mercury in amalgam fillings.
  • Salvage, store and recycle scrap amalgam whenever possible, including amalgam pieces from restorations and used disposable amalgam capsules.
  • Recycle teeth that contain amalgam restorations (ask your recycler whether these teeth must be disinfected first).
  • Never dispose of amalgam waste in biohazard containers, regular garbage, or down the drain.
  • Flush wastewater lines with line cleaners that minimize dissolution of amalgam (like BioPure Evacuation System Cleaner) instead of bleach or chlorine cleaners.

By implementing these practices and following the EPA regulation, dental practitioners, specialists, and registered dental hygienists can work towards reducing their impact on the environment.

 

Contact us to learn more about line cleaners that minimize amalgam dissolution. We look forward to assisting in building a more sustainable dental practice.

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The Importance of Pet Dental Care

Your pet’s oral health is important. Although it might not be something you think about often, dental care is a critical part of maintaining your cat or dog’s overall health.

 

Bacteria and plaque can harden on your pet’s teeth and form tartar. This can lead to gingivitis, receding gums, pain and tooth loss. Dental problems not only affect your pet’s teeth and oral health but can easily spread to other vital organs such as the heart and kidneys.

 

 

Recognizing the importance of pet dental care is an important step in giving them long, healthy lives.

 

Dental Care Helps to Avoid Pain

Annual oral examinations, dental X-rays and cleanings ensure that your pet’s dental health is in check. Oral pain can be frustrating for your pet and is often expensive to treat. Avoid this unnecessary problem by keeping a close eye on your pet’s dental health and incorporating your dental vet’s recommendations into your regular caring routine.

 

Preventative Care Avoids Added Expenses

Dental procedures can be expensive. That’s why it’s vital that you monitor your pet’s oral health frequently. Although basic treatments are usually included on a pet insurance plan, larger procedures are not. These treatments and surgeries range anywhere from a couple hundred to thousands of dollars. That’s why you must take care of things before they get serious.

 

Tooth Brushing is Important for Pets, Too

Like humans, pets need a dental routine in place. Although brushing your pet’s teeth is not as easy as brushing your own, it’s crucial for overall oral health.

 

Regular brushing is the first step in preventing tartar build-up and gum disease. Use a toothbrush and pet toothpaste. You can also use a finger brush or wrap gauze around your finger. If the process of brushing teeth is introduced gently and gradually, pets will usually tolerate cleaning.

 

Brush your pets’ teeth at least a few times a week. This will help maintain healthy teeth and gums. Pets can become agitated, so make sure they’re feeling calm or tired.

 

Recognize the Signs of Oral Disease

Check your pet’s mouth a few times a month to ensure their oral health is in check. Make sure gums are pink, not white or red, and teeth are clean without signs of brown tartar. Vomiting, loss of appetite, excessive drinking or urinating and bad breath are also signs of dental disease.

 

Other Techniques to Maintain Oral Health

There are many products that promote dental health in pets including textured toys, teeth-cleaning kibble and gels. However, your pet’s diet must contain at least 75% dental food for it to be effective. Look for products approved by the Veterinary Oral Health Council, and never use human tooth pastes with your pet.

 

Of course, having your pet’s teeth checked and cleaned by a professional is the best way to monitor their oral health and ensure they’re getting the best care possible.

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It’s Time to End These 6 Persistent Veterinary Dental Myths

Veterinary dentists and pet owners alike want what is best for their animals. Unfortunately, the subject of pet dental care is plagued with harmful misconceptions.

 

 

Is “dog breath” normal? Should dogs chew bones? Is it safe for groomers to use dental equipment? These are among the persistent veterinary dental myths we want to address in this article.

 

1. Bad Breath Is Normal in Dogs

Myth: Even healthy pups can have foul-smelling “dog breath”; it’s just one of those things that come with owning a dog.

 

Fact: In dogs and other pets, halitosis is a clear sign of gingivitis or oral infection.

 

The idea that “dog breath” is normal is a common misconception. The truth is that dogs with halitosis almost always suffer from significant to severe periodontal disease.  

 

Halitosis occurs when anaerobic bacteria in the mouth certain amino acids. Although it can result from gingivitis alone, oral infection is by far the most common cause.

 

Chronic bad breath is a clear sign that a pet needs veterinary attention.

 

2. It is Safe for Dogs to Chew Bones

Myth: A canine’s powerful teeth and jaws are built to chew through hard materials like bone.

 

Fact: Chewing bones poses numerous health hazards to dogs.

 

Much as dogs love to gnaw on a good bone, it’s not necessarily good for them. While it’s true that dogs benefit from having something to chomp on, there are many reasons why hard materials like bone, antlers and chicken’s feet are not a safe choice:

  • A dog’s teeth are susceptible to fractures, which are immensely painful and may require surgical treatment.
  • Bones and other firm materials can splinter into sharp pieces, causing gum or tongue lacerations, or becoming embedded under the gum line.
  • Bones are a serious choking hazard.
  • Since bones are not digestible, they can cause stomach and intestinal problems if swallowed.

Dr. Fraser Hale, a veterinary dental specialist, recommends owners use the “kneecap rule” to decide whether a toy is suitable for a dog. The rule goes like this: if you wouldn’t want someone to hit you in the kneecap with it, your dog shouldn’t be chewing on it. 
 

3. Dental Chews and Dental Formula Food Will Improve a Pet’s Oral Health

Myth: Using products marketed as ‘dental chews’ or ‘dental formula food’ can help improve an animal’s teeth and gums.

Fact: Not all pet dental products are effective.

It isn’t difficult to find chew toys, treats, and pet food that carriers the ‘dentist-approved’ label. Well-meaning pet owners collectively spend millions of dollars on these products each year.

However, not all ‘dental formulas’ are beneficial for an animal’s teeth (not more than the average bag of kibble, at least.)

Veterinary dental specialists recommend that pet owners look for the Veterinary Oral Health Council (VOHC) seal of approval before purchasing a product that purports to promote good oral health. The Council’s work is approved by the American Veterinary Dental College.

 

4. Dental Scaling by a Groomer Can Prevent Oral Health Issues

Myth: Dental scaling services offered by pet groomers are a good way to keep a pet’s teeth clean and healthy.

 

Fact: Non-professional dental scaling is cosmetic only and does not prevent or treat oral disease.

 

It is illegal in many places for pet groomers to offer non-professional dental scaling (NPDS). However, in some regions, the myth persists that this service can help pets stay healthy.

 

Dental scaling involves using dental equipment to scrape debris from the surface of an animal’s teeth. Some groomers purchase these tools and offer scaling services to clients at a lower cost than a professional dental cleaning performed by a vet.

 

Unfortunately, this non-professional dental scaling is merely cosmetic. Groomers lack the knowledge to identify oral health treatments, nor the ability to prescribe treatment. Without anaesthetic, they cannot remove disease-causing bacteria below the gumline.

 

Veterinary dental specialists recommend pet owners avoid these services, as they do nothing improve oral health.

 

5. You Can Judge A Pet’s Oral Health by Its Appetite

Myth: If an animal is still eating, it must not have dental issues.

 

Fact: Many pets will eat despite severe oral pain.

 

It’s true: loss of appetite and difficulty chewing are tell-tale signs of periodontal disease. However, these are far from the only signs, and many dogs, cats and other pets will not stop eating just because they’re in pain.

 

When an animal is in pain, they will often instinctively try to conceal it. It’s typical for an animal with serious oral health issues to clean their bowl as usual.

 

This is one reason why it’s important for owners to stay vigilant about their pet’s oral health and be aware of other warning signs, such as:

  • Red or bleeding gums
  • Pawing at the mouth
  • Loose or missing teeth
  • Facial swelling
  • Nasal discharge
  • Gum recession

Pet owners should also take steps to prevent these issues at home; which leads to the final veterinary dental myth that must be quashed.

 

6. Dogs Don’t Need to Have Their Teeth Brushed

Myth: Dogs clean their teeth naturally by gnawing on bones and chew toys, so they don’t need to have their teeth brushed.

 

Fact: Daily brushing is the best way to prevent oral health issues in dogs.

 

By the age of 3, over 85% of dogs have some degree of periodontal disease.

 

It begins when bacteria form plaque on the teeth, gradually working their way under the gums. Over time, oral bacteria damage the supportive tissue around the teeth. In serious cases, periodontal disease can destroy the gum, bone and ligaments holding teeth in place and even infect the bloodstream.

 

Fortunately, there is a simple way to deter this prevalent problem: regular brushing.

 

As demonstrated by this video, the process is no different from how we humans brush. Dog toothpaste is available in appealing flavours like chicken and seafood. Eventually, the routine can become as natural as brushing our own teeth.

 

Vets and veterinary dentists should encourage this practice among every owner they advise.

 

Dental Equipment and Supplies for Veterinary Specialists

Sable Industries is a premiere supplier of quality dental handpiece parts, dental equipment, and other dental supplies. We strive to provide the best tools of the trade to dentists, registered dental hygienists, and veterinary dental specialists across North America.

 

Contact us to inquire about our solutions for veterinary dental specialists.

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