Bruxism, or teeth grinding, impacts anywhere from 8% to 31% of the general population. Mild bruxism does not always require treatment, but it can cause teeth to become chipped, broken, or worn. Severe bruxism can also affect the jaw and gums.
Some patients gnash, grind, and clench their teeth while they're awake, but others do it while they're sleeping ‒ conditions known as awake bruxism and sleep bruxism, respectively. Sleep bruxism is considered a sleep-related movement disorder, and people with it are more likely to have other sleep disorders such as snoring or sleep apnea. Patients might not even be aware of it.
After the damage has been done, a dentist can restore eroded teeth and treat them to stop further damage. Treatment options for worn down teeth include composite bonding, cosmetic veneers, crowns, and (in severe cases) orthognathic surgery.
Veneers are thin porcelain or composite resin shells attached to the front part of the teeth. Porcelain veneers are generally viewed as the superior option, since they’re stronger and less likely to colour or stain. Porcelain veneers require at least two dental visits to apply, whereas composite resin only requires one appointment.
Composite resin veneers require a mild chemical to be applied to the front surface of the tooth. This will establish some roughness, allowing the composite resin to adhere to the tooth's enamel. You want a resin that matches the color of your patient's teeth, so it can blend in. When the resin's final layer hardens, the tooth is shaped and polished so it looks smooth.
Local anesthesia is usually required for porcelain veneers because a thin layer of enamel is removed from the patient's teeth to make room for the veneers. Temporary veneers are often necessary to replace the part of the tooth that was removed, and they are used until the permanent ones are ready. Temporary veneers need to be handled with care while eating and cleaning because they come loose easily.
When the patient returns for their next visit, the temporary veneers are removed, and a mild chemical is applied to the teeth to give them a rough texture. This allows the veneers to adhere better to the teeth. The veneers are then glued to the individual teeth with composite resin cement.
Caring for Dental Veneers
Patients should brush (with soft bristles) twice per day and floss once daily. They should avoid toothpastes that contain abrasive chemicals. Regular dental checkups are also a must. Coffee, tea, tobacco, and other things that will stain teeth should also be avoided.
For patients with sleep bruxism, a mouthguard can protect the veneers from the wear that damaged their natural teeth.
Bruxism and Composite Bonding
Bonding, also called bonded restoration, fixes minor breaks in teeth using a tooth-coloured composite resin. The procedure is painless, and multiple teeth can be bonded during a single visit to your practice.
The bonding resin can be matched to the teeth, shaped to fill in a gap or chip, build up teeth, or fill space between them. On top of that, it can be used to fix a broken tooth.
A protective film is first positioned between the damaged tooth and neighboring tooth. Then, a mild chemical is placed on the tooth to roughen it up and ensure the composite resin sticks. The composite resin is then layered onto the tooth, to be shaped and polished after the last application hardens so the finished tooth is smooth.
In a recent article for DentalTown called Reversing the Grind, Dr. Terry Shaw demonstrates this technique, restoring a patient’s maxillary teeth and lower incisors worn by bruxism.
Caring for Bonded Restorations
Patients should brush twice a day and floss once daily. Avoiding hard food, coffee, tobacco, and nail-biting will help. As with veneers, a mouthguard may be necessary to protect the newly bonded teeth from sleep bruxism.
Dentists and hygienists are so focused on their patients that they tend to forget about themselves.
However, even the most dedicated dental professional knows they must care for their own physical and mental health in order to provide optimal care.
Because their work is physically and mentally stressful, dentists and hygienists are more susceptible to musculoskeletal injuries and disorders (MSD’s). Dental professionals frequently suffer from back and neck pain caused by the awkward, forward hunching posture that is necessary to examine a patient's mouth.
With that in mind, it’s clear that ergonomic magnification loupes are a must-have in any dental practice.
Not All Loupes are Created Equal
Finding an ergonomic loupe may seem like an easy thing, but unfortunately, some loupes aren't ergonomic even though they claim to be.
To start, there are plenty of sub-par products on the dental equipment market. Many manufacturers sacrifice quality and standards in the name of low prices, and ergonomic magnification loupes are no exception.
Some salespeople claim that all loupes are the same, but that’s just not true.
To determine whether or not a loupe is ergonomic, you have to be 100% sure of its declination angle. This angle determines how steeply your view drops through magnification oculars. If the declination angle doesn't hold your head upright, it increases the risk of chronic neck pain.
Here's what you need to remember about ergonomic loupes:
For an ergonomic working distance and declination angle, there must be a forward head of less than 20 degrees. This is your first line of defence for staving off chronic neck pain.
A forward tilt of 20 degrees or greater will first cause you substantial discomfort and can contribute towards permanent MSD.
Neck Pain Shouldn’t Be “Part of the Job”
There is something of a toxic trend in our profession when it comes to musculoskeletal disorders.
It's believed by many dental professionals that physical discomfort (e.g., neck pain) comes with the job. Don't be fooled. Pain won't only cause your body to break down and fail you; it can also wreak havoc on your mental health too.
Recently, Dee Humphrey, RDH, BHSc wrote to DentalTown describing how using non-ergonomic loupes can shorten careers. Her own tenure as a dentist was prematurely ended due to a previous neck injury that grew worse because of a faulty product.
Humphrey offers dentists and hygienists the following advice on choosing ergonomic loupes:
Have a colleague help you assess your work posture while using a loupe. This will help ensure your current loupe is giving your neck the support it needs—if it’s not, look into another option.
Keep in mind that snazzy-looking loupes aren't a priority. Do your due diligence when it comes to ergonomic products. Ignore salespeople who focus only on aesthetics.
Don't take salespeople or marketing collateral at face value. You need to fact-check all their ergonomics claims.
Finally, be proactive in learning about ideal ergonomic posture and what it looks like. Ask someone to take a photo as you work—or take a video. This can help you make necessary postural corrections.
Humphreys urges hygienists and dentists to listen to their bodies, not salespeople or colleagues. Neck pain shouldn’t be ignored. It could be a sign you need a new loupe.
There’s no substitute for the two pillars of oral health: brushing and flossing.
But the more layers of defence against plaque, tartar, and gingivitis, the better. Mouthwash or mouth rinses can help patients to get even more out of regular brushing and flossing.
You might even call mouthwash the third pillar of oral health!
Adding mouthwash to an already-robust oral health regime has long-term benefits. It can be a crucial step in the battle against cavities, bad breath, gum disease, and dry mouth symptoms.
With that said, let’s take a deeper look at the many types of mouthwash that could help your patients achieve better oral health.
Cosmetic Mouthwash vs. Therapeutic Mouthwash: What’s the Difference?
As the term suggests, cosmetic mouthwash functions as a one-dimensional ‘band-aid’ for halitosis, or bad breath. Cosmetic mouthwash tastes pleasant enough and keeps your patients’ mouths feeling fresh for a brief time.
However, beyond temporarily freshening breath, cosmetic mouthwash has no chemical or biological function.Typically, cosmetic mouthwash does nothing to kill bacteria or address the root causes of halitosis.
Conversely, therapeutic mouthwash eats away at bacteria that cause bad breath, gingivitis, plaque, and cavities.
Therapeutic mouthwash contains active ingredients such as cetylpyridinium chloride, chlorhexidine, essential oils, fluoride, and peroxide. Cetylpyridinium chloride actively reduces bad breath, while chlorhexidine and essential oils control plaque and gingivitis. Fluoride prevents tooth decay, while peroxide is prevalent in whitening mouthwash.
Therapeutic mouthwash is available over-the-counter as well as by prescription. However, the chlorhexidine-based products can only be obtained with a prescription.
Common Clinical Applications for Therapeutic Mouthwash
Dry socket: also known as alveolar osteitis, commonly occurs after dental extraction procedures, especially extraction of the third molar. This results from a fibrin clotting that forms once a tooth is dislodged. Using chlorhexidine without antibiotics has proven effective against dry socket.
Halitosis: caused by volatile sulphur compounds that arise due to food breakdown, dental plaque, etc., can be controlled using mouthwash that contains antimicrobials. The active ingredients in antimicrobial mouthwash may include chlorhexidine, chlorine dioxide, cetylpyridinium chloride, and essential oils.
Plaque and gingivitis: when combined with daily brushing and flossing, antimicrobial mouthwash reduces plaque and gingivitis.
Tooth decay: fluoride ions cultivate remineralization and are available in some mouthwash.
Topical pain relief: local anesthetics are found in some pain-relieving mouthwash. Such anesthetics may include lidocaine, benzocaine/butamin/tetracaine hydrochloride, dyclonine hydrochloride, or phenol.
Whitening: extrinsic stain reduction can be achieved through the use of carbamide peroxide or hydrogen peroxide in mouthwash. Using 1.5-2% hydrogen peroxide-based mouthwash for 12 weeks provided similar whitening results to using 10% carbamide peroxide whitening gel for two weeks.
Dry mouth: mouthwash with fluoride helps prevent caries that stem from xerostomia, or a lack of saliva. Alcohol-free mouthwash is preferable since alcohol is a drying agent. Patients with dry mouth should use a mouthwash containing enzymes, cellulose derivatives, or animal mucins.
The Most Effective Way to Use Mouthwash
First and foremost, patients should brush before using your mouthwash, waiting longer between brushing and mouthwash if they use toothpaste containing fluoride.
It is best to use three to five teaspoons of mouthwash, which should be the volume of the mouthwash's bottle-cap or cup.
Swish, don’t swallow! Instruct your patients to swish, gargle, and rinse for 30 seconds. And voila! It's time to spit it out.
While mouthwash is best used after brushing, it can be used as a quick fix for bad breath at any point of the day.
But we live in a world with coffee, curry, tomato sauce, and other delicious foods and beverages that make the dream of a pristine smile difficult.
When brushing and flossing can’t undo discolouration, patients often request more powerful means of teeth whitening. Treatments involving hydrogen peroxide or carbamide peroxide are commonly relied upon to achieve the desired results.
Regardless of the approach, your patients’ safety should be the topmost priority. Here, we’ll explore the risks associated with some teeth whitening procedures and discuss the steps you can take as a dental hygienist to ensure your patients are safe.
Review of Common Teeth Whitening Procedures
Whitening toothpaste contains abrasives and detergents to combat surface stains. There’s no bleach in whitening toothpaste, but products may contain a small amount of carbamide peroxide or hydrogen peroxide that help lighten tooth colour. A whitening toothpaste can lighten teeth by 1-2 shades, but it cannot change the natural colour of the teeth or eliminate stains that go below the tooth's surface.
Over-the-counter whitening strips are thin, plastic trips with a thin layer of peroxide gel, shaped to fit onto the buccal surfaces of the teeth. Peroxide-based gel can also be applied directly to the surface of the teeth. With either method, it is usually recommended to apply twice daily for two weeks. Gels and strips can provide a 1-2 tooth shade improvement after treatment.
Whitening rinses contain hydrogen peroxide and other oxygen sources, reacting with the chromogens within the dentine to lighten the body colour of the teeth. Whitening rinses are meant to be used two times a day, where the patient rinses for a minute each time. Patients can expect a 1-2 tooth shade improvement in about three months.
Tray-based teeth whiteners are available over the counter or by prescription. The apparatus consists of a fitted tray with carbamide peroxide bleaching gel. Patients wear the gel between two and four hours a day or overnight. Teeth whitening trays can yield an improvement between 1 and 2 shades in just a few days.
In-office whitening procedures offer more immediate and noticeable results than over-the-counter alternatives, with higher concentrations of peroxide and the aid of UV light. Patients will notice an improvement in tooth shade after 30 minutes to one hour of treatment, and after several treatments, they will see more significant results.
What Are the Risks Associated with Whitening Procedures?
The two most common issues affecting people who use whitening treatments are tooth sensitivity and slight gingival irritation. The primary factors that impact the intensity of these side effects are:
Concentration of the peroxide bleach component;
Duration of treatment; and
Product’s non-bleach composition.
Usually, any tooth sensitivity starts during the treatment and persists for a couple of days. Irritation from the gingival tissues will last about as long, but often appears within 24 hours of the treatment.
Other reported risks associated with whitening procedures include:
Tooth mineral degradation
Increased susceptibility to demineralization
One of the best ways to protect your patients is to provide them with sound advice for their at-home whitening routines. This begins with directing them on how to apply the gel. Moderation is key. Your patients shouldn’t go too heavy on teeth whitening gels.
Your patients should also steer clear of teeth whitening procedures by unqualified individuals. Like most things related to oral health, any treatments are best left in the hands of professionals, and the equipment or compounds being used should be approved by the relevant authoritative bodies.
What’s more, not all patients are ideal candidates for teeth whitening procedures. Patients who suffer tooth decay should have that problem treated before beginning in-office whitening. The same applies to patients with cracked or broken teeth, since the gel could seep into a cavity and cause an array of issues, and with an abundance of amalgam restoration.
When it comes to treating your patient in-office, remember the advice about moderation. If more gel is applied after the initial treatment, it should be used on an as-needed basis only.
It is important to use precisely-fitted whitening trays to protect the gums and reduce the risk of spillage. Although you might worry about a patient's pain threshold, avoid using local anesthetic gels to numb the area so the patient can tell if gel is seeping into their gums.
Now, You’re Ready to Help Your Patients Get the Smile They’ve Always Wanted.
A beautiful smile is a powerful thing. However, oral health and safety are much more important. By keeping those precautions in mind, you can confidently help whiten your patients' teeth and give them the smile they've always wanted!
You probably hear the words, "virtual dental conference" and think that it couldn't be anywhere close to the real thing.
Granted, when an event is forced to go virtual, there will always be some things you miss out on. It’s hard to replicate the tactile sensation of gripping a new dental handpiece through video conferencing ‒ and you’ll miss out on the unique energy of interacting with your peers in-person.
But don’t be fooled into thinking that virtual dental conferences are a bust. Far from it.
In fact, at a time when we’ve been forced to rethink all aspects of patient care, clinical delivery, and infection control, the knowledge you pick up through these events is more important than ever.
So, while virtual dental conferences might not be what you’re used to, they are very much the “real thing” ‒ and these tips will help you make the most of them.
Plan Ahead to Get Some Variety
It’s easy to feel underwhelmed with a virtual trade show or conference when you’re watching a parade of monotonous, lecture-style webinars.
Instead of spending the whole time with the same type of content, try to fill your conference days with a variety of different formats: keynote addresses, thought leadership, panels, Q&A’s, and so on. This “mix-it-up” approach will help you stay engaged and retain information.
Of course, as a conference attendant, you only have so much power over the content you’re presented. What you can do, however, is plan ahead and find virtual conferences that offer some variety, then plan your time accordingly.
Branch Out Beyond Webinars
One of the biggest draws of a traditional dental trade show is the opportunity to get your hands on new and innovative products ‒ and we mean that literally. No amount of product literature can equal the experience of a real, hands-on demo.
But how do you do that without being there in person?
Well, in 2021, there are ways to make it happen.
Today, many online trade shows offer a sort of virtual Exhibition Hall, complete with virtual “booths” where vendors offer up-close video demonstrations of their products. Some of these take place live, allowing attendants to ask questions or request a specific kind of demonstration in real time.
Make time to visit these virtual exhibitions and be sure to ask questions. While you might not be able to see and touch a product in real time, this is an excellent opportunity to connect with a sales representative. You could even request a real-world sample for your business or practice!
Make an Effort to Engage
Remember that initial awkwardness of hopping on Zoom the first few times? Unfortunately, you might find yourself reliving that experience at your first virtual dental conference meet-and-greet.
Networking has always been the cornerstone of any dental industry event. Their new, virtual counterparts are no exception. And like any endeavour involving career development, the value of these virtual events is contingent on the effort you put in.
Many video conference technologies that run webinars and similar events also have chat functions and features. This way, you aren't only sitting there and listening but gaining an opportunity to reach out to your peers and harness network connections.
Whether you're talking to fellow dentists, hygienists, consultants, or equipment dealers, you have much to gain by reaching out. Plus, like most chat functions, there's a chance your questions can be answered by the webinar or event host.
Breaking out into these chats gives you those similar interactions you’d have in person, nearly emulating those benefits.
Yes, networking on Zoom or a live chat is awkward at first. But you owe it to yourself to put yourself out there to make connections and immerse yourself in the activities. The more detached you are from everything, the less enriching the experience will be.
If you already have experience presenting at a dental conference in-person, consider volunteering to host a webinar this year instead. This could have two-pronged benefits in that you’ll be more invested in the process while also establishing your professional reputation.
That said, if you’re hesitant to prepare an entire virtual presentation on your own, you could also offer to help moderate an event.
Are Virtual Conferences and Trade Shows a Pandora’s Box?
Once everything is “back to normal,” so to speak, in-person conferences and tradeshows will once again be part of the dental industry.
However, many professionals in the space will realize how convenient and effective virtualizing these events can be. Busy dentists and hygienists will appreciate being able to make connections and acquire knowledge without commuting and dealing with logistics.
As such, expect more of a balance between in-person and virtual events as the years go by!
For various reasons, it’s been deeply ingrained in many of us to think we must all aspire to, “be our own boss.”
Who hasn’t fantasized about calling the shots and captaining the ship? We idolize entrepreneurs and worship the hustle. The dental profession is no exception.
However, there's a world of difference between the fantasy and reality of owning your own dental practice.
The truth is that many dentists, young and old, are perfectly happy working Monday to Friday, 8 to 5 as part of a DSO ‒ and many who thought they wanted to own a dental practice later find that it’s not what they bargained for.
Before deciding to own your own practice, you must ask, “is ownership for me?” And if the answer is “no,” know that there is nothing stopping you from having a fulfilling, successful career.
Here are a few of the top reasons why ownership isn’t for everyone in this profession.
1. Managing Staff is Incredibly Challenging
As a practice owner, you can expect to have your attention wrenched away from the dental chair multiple times a day.
Because managing your staff can take as much, if not more, time and energy.
Chances are, you entered this field to help people improve their health, not to direct employees. You aren't a formally-trained manager, president, or CEO ‒ yet you’ll be expected to take on all of these roles and the unique skills they require.
Working as an associate at someone else's practice, on the other hand, is far less complicated. You can spend your days doing what you love ‒ helping people ‒ and shine in your role without the stress of calling all the shots.
To put it simply, when you don’t own your practice, you can focus less on your coworkers and more on your patients!
2. Owning a Practice Can Make You Feel Stuck
Once you start or purchase a dental practice, you're very much tethered to that business for the foreseeable future.
Should you realize it’s not for you, pivoting comes with an array of headaches and hassles. You’re now stuck trying to sell, close, or move your practice. This can be exceptionally costly and drag out for a long time.
When you’re a dental associate working at someone else’s practice, you have far more freedom.
So what if the role or the workplace culture doesn’t vibe with your personality? You’re an associate, untethered by ownership. You can search for a role at a practice that better suits your values.
What’s more, you have the freedom to move onto higher-paying work at another practice when you're a dental associate. As an owner, your earnings are based on what you can afford to pay yourself ‒ which can be a curse as well as a blessing.
3. As an Owner, Practice Management Gets in the Way
Your patients' well-being is always your top priority, whether you're a practice owner or associate.
But that doesn’t always mean enjoy dealing with people beyond the scope of giving them the best possible treatment.
When you own a practice, you’re not only helping patients improve their health. You might also be hounding them for payments, handling their complaints, and facing the other ugly facets of customer service.
Not to mention all the rest of your practice management responsibilities, which include equipment management, finances, marketing, and advertising.
Don’t get us wrong. Some people thrive in the role of a practice manager, even when it’s outside their “comfort zone.”
Regardless, that’s a lot of responsibility piled onto your already-vital role as a dentist.
Is Being an Owner for You?
After reading this article, you might still feel like you’re up to the challenge of ownership. And more power to you if that’s the case! You’re probably the perfect fit for this role and will thrive accordingly.
All the same, there's absolutely nothing wrong with deciding that you'd make a better associate than an owner. Choosing this path will likely benefit you over the long haul because you decided on what was correct for your personality and skill set.
As Howard Farran, DDS, MBA writes in a recent DentalTown editorial, “If you come out of dental school and you just want to join a DSO or a group practice and live happily, go for it!”
It goes without saying that COVID-19 has caused widespread fear and uncertainty. As such, it’s not surprising that misinformation has run rampant across all facets of life impacted by the pandemic, and oral health is no exception.
One claim that has surfaced recently surrounds the link between mask-wearing and oral health. Specifically, there is growing concern that regularly wearing a mask can cause an influx of plaque and tartar buildup, causing bad breath, gum disease, cavities, or tooth decay.
The claim has become so prevalent that there’s even a common name for this supposed condition: ‘mask mouth.’
In truth, there is little to no evidence to suggest that ‘mask mouth’ is real ‒ at least not in the sense that mask-wearing directly causes oral health issues.
However, as dental associations and professionals point out, this phenomenon could point to other, real concerns surrounding COVID-19 and oral health.
Let’s separate fact from fiction and take a closer look at mask mouth, including the real impact of mask-wearing on oral health and ways to stay fresh while wearing a mask.
A Closer Look at Mask Mouth
Lesli Hapak, the president of the Ontario Dental Association (ODA), defines mask mouth as such: “Very simply put, mask mouth is the bad smelly breath underneath your mask.”
Many dentists, like Dr. Robert Jaffe, note that mask mouth could simply be a result of people being more aware of halitosis during the pandemic. With your nose and mouth covered, there’s no escaping the odour of bad breath.
Plus, as Dr. Jaffe and others point out, masks are conducive to dry mouth. Dentists and other healthcare practitioners can attest that it’s harder to stay hydrated when you’re wearing a mask for hours on end.
Another possible explanation? Lockdown diets. Research suggests that the pandemic has led to increased snacking, decreased consumption of fresh food, and increased consumption of sweets, biscuits and cakes.
Together, these factors are a recipe for plaque, tartar, and cavities ‒ and the unpleasant odours that come with them.
But that’s not all.
Stress Could Be Causing Adverse Dental Outcomes
Bruxism, or teeth grinding, is a condition known to be associated with anxiety and anxiety. With stress and anxiety on the rise, it stands to reason that bruxism is a growing concern in this pandemic as well.
While bruxism doesn’t cause serious complications in most cases, it can cause damage to the jaw, teeth, restorations, crowns ‒ which one could mistakenly associate with mask-wearing.
In fact, when asked about concerns regarding mask mouth, Dr. Jordan Hottenstein points out that most of his patients aren’t dealing with tooth decay from plaque or tartar buildup. Instead, the bulk of the work at his practice stems from broken teeth, previous fillings, and stress-related fractures.
For this problem, dentists like Dr.Hottenstein can prescribe night guards to patients. After all, clenching and grinding can’t be prevented with flossing and brushing. Both actions are often involuntarily triggered by stress.
How to Prevent Mask Mouth
We’ve already highlighted how staying hydrated (i.e., drinking lots of water) will prevent your mouth from becoming overly dry while wearing a mask. Beyond that, good oral healthcare could be the key to keeping mask mouth at bay:
Brush twice daily
Use an electric toothbrush with fluoride toothpaste
Try to see a dental hygienist twice per year
Stimulate saliva flow by chewing gum
Rinse with fluoride-based mouthwash once per day
Masks should be cleaned regularly
Avoid sugary snacks and drinks
Brush after meals
Dispelling Mask Myths for Your Patients
As a dental professional, your patients rely on you to be an accurate source of information for their oral health (and overall well-being). When they ask questions about masks, make yourself as knowledgeable as possible about the myths and truths.
Here’s a helpful resource to clarify and mask-related questions. With this vital information, you can better guide your patients through this challenging time.
You know how you tell your patients to brush and floss multiple times per day?
The same principle applies to how you should treat your dental handpiece.
Just as brushing and flossing helps to keep teeth and gums healthy between visits, there’s plenty that you can do – whether daily or weekly – to keep your handpiece performing at its best for as long as possible.
The longer you extend the life of your dental handpiece, the better the return on investment. After all, a quality handpiece doesn’t come cheap!
With that said, the quality of the product isn't the only thing that affects its longevity. If you’re not careful, certain mistakes could drastically shorten the lifespan of your handpiece. Not only will you and your colleagues be stuck without one of your most vital pieces of equipment, but your patients could miss out on a quality experience as well!
It might seem like increasing air pressure will enhance your handpiece's performance. However, this couldn't be further from the truth. Once you go past the manufacturers recommended air pressure there are no improvements to the RPMs /Torque. In fact, this could damage the turbine and hinder the equipment’s functionality!
2. Autoclaving the Bur
First and foremost, the bur of your handpiece must always be 100% secured before you operate the handpiece. However, you must also ensure that you remove it when you’re autoclaving the handpiece, nosecone, or latch head.
Failing to remove the bur before autoclaving can cause a corrosive reaction with various metallic surfaces, which leads to unnecessary wear and tear.
3. Jumping from Hot to Cold
While we’re on the topic of autoclaving, don’t rush to use your handpiece or its components after you’ve removed it from the autoclave. Instead, before using it, ensure that it’s returned to ambient room temperature.
It is not recommended to cool handpieces under running water or in cold water. Always allow the handpiece to cool naturally, and never use it before it has been allowed to cool!
4. Skipping Pre- and Post-Autoclave Care
Don’t let autoclaving stand on its own! Follow proper cleaning and maintenance processes before and after to help ensure optimal function. Remember to clean and flush the handpiece before autoclaving, and lube and flush the equipment afterward.
While there’s no such thing as over-lubricating your handpiece, under-lubricating will definitely give you problems! Daily lubrication is necessary to keep the turbine, air motor, shank and head in good working order.
If cost is a concern, there are affordable handpiece lubricants on the market. Sable Industries has developed an extremely high-viscosity handpiece lubricant that offers cost savings of 20-30% over other top lubricant brands. Sable EZ Lube even comes in the different and proper 'delivery' containers for the varying requirements applicable to different types of equipment!
6. Using Counterfeit or Low-Quality Replacement Parts
What goes into your handpiece matters! Just because the cheaper parts ‘fit’ doesn’t mean they’ll do the job as well. Worse, substandard or counterfeit parts can damage the rest of the handpiece ‒ and since they wear out faster than genuine parts, you’ll spend more to replace cheaper parts in the end.
Most handpiece failures aren’t due to a single mistake – rather, they’re the result of a lifetime of poor maintenance. As powerful as it is, your dental handpiece is still a delicate instrument! Maintenance is the key to ensuring that your handpiece doesn’t fail before its time.
Dental aerosols are a top concern in the era of COVID-19. Even with reduced capacity, a busy dental practice is a community hub ‒ meaning that if someone gets infected, whether you, a colleague, or a patient, there's an increased chance of super-spreading.
Dental aerosols are tiny microdroplets (under 50μm in diameter) caused when ultrasonic power scalers, air polishers, and other dental equipment are used on patients. Generally, ultrasonic scalers are the worst offenders.
The two main sources of dental aerosols are dental unit waterlines (DUWL) and patients.
Whenever high-speed equipment makes contact with a patient’s saliva, blood, or plaque, it is bound to create microdroplets. That’s a given.
However, the water used to cool the scaler’s ultrasonic tip could also contain bacteria which can then become aerosolized. This risk tends to be exacerbated when you connect the scaler to an older style water source that's poorly maintained.
Why Are Aerosols a Risk?
While not all dental aerosols are harmful, they may contain harmful bacteria and viruses. These pathogens, including viruses like COVID-19, can linger in the atmosphere or settle on surfaces for long after the patient has left.
It's yet to be 100% determined that aerosols generated during dental procedures carry a large enough viral load to spread infection. All the same, proceeding with caution wins the day, and industry professionals are doing everything possible to control droplets.
Controlling Dental Aerosols With, or Without, an Assistant
All the best intentions in the world mean nothing if you aren't following the consensus best practices to mitigate aerosol generation risks.
Right away, we'll point out that solely relying on a saliva ejector won't adequately control aerosols and splatter. You need a more robust control system to optimize everybody's safety.
Below are proven techniques to offset aerosol and splatter production. Better yet, these techniques will work even if you don't have an assistant to help out.
1. Use High Volume Evacuation (HVE) Devices
High-volume evacuation devices control aerosols much more successfully than saliva ejectors, according to multiple studies.
More specifically, the Journal of Dental Hygiene published a study citing how HVE devices reduced 89.7% to 90.8% of aerosols. Yes, operating these devices while using a scaler or polisher without an assistant presents challenges. But there are ways you can do it.
The following suggestions can help make your HVE device more useful without relying on an assistant.
2. Rinse Before Every Procedure
An antiseptic rinse before the procedure lessens the bacterial bioburden and viral presence in your patients' mouths. A 1992 study in the Journal of Periodontology found a 94.1% reduction in aerosols after a 30-second preprocedural antiseptic rinse (Listerine).
Although the study referenced measured applied 30-seconds of rinsing, use a 60-second rinse-time for your patients after they're seated. Repeat this process once you've taken your patient history and performed every other pretreatment task.
Moreover, the patient should rinse multiple times throughout the entire treatment. This is due to how quickly the bacteria and viruses re-develop in one's mouth.
Ensuring the rinsing process is repeated reduces potentially infectious bacteria at the source. Thus, your HVE will be more effective since there will be less harmful pathogens to manage.
3. Leverage Isolation and Suction Devices
Nowadays, there's a diverse array of isolation and suction devices on the market. The HVE ports connect to a hose where these devices can connect.
Isolation is provided with these isolation and suction devices. Furthermore, they keep your patient's mouth open while providing high-volume suction.
4. Use a Microbial and Enzymatic Evacuation System Cleaner
Years of sludge and debris can build up and clog your suction lines. This prevents your vacuum suction from performing at full pump capacity, limiting your ability to control dental aerosols via evacuation.
Flushing the system with an all natural, enzymatic cleaner like Bio-Pure can improve suction performance. Bio-Pure contains naturally occurring, non-pathogenic microorganisms that digest organic waste (ex. blood, saliva and mucus) that would normally build up inside the system. What cannot be digested is loosened and flushed through!
Bio-Pure maintenance comes in 3 different formulas: an end of day powder, end of day liquid, and between patient flush. You can easily adopt it as part of your existing maintenance routine to help your vacuum suction perform at peak capacity and enhance your ability to control dental aerosols.
Keeping Staff, Patients, and Your Community Protected
In the new normal, infection prevention has never been more of a priority. On top of that, the dental industry – given the equipment being used – is associated with many viral risks. Your community relies on you to follow the safest possible practices. By adhering to the above suggestions, you'll be doing your part!
A high-quality handpiece is key to giving your patients the best possible results! And since dental handpieces are a considerable investment, you’ll want to extend their life for as long as possible. Fortunately, there’s a surefire way to ensure you get the most out of these important instruments: dental handpiece maintenance.
Maintaining your dental handpiece isn’t rocket science by any means. However, it’s a fairly intensive process, requiring some extra effort and diligence on your part.
You could write entire volumes on all the ins and outs of maintenance for various handpieces; however, there are key points that apply universally to virtually all of them. Follow this 10-point checklist as a starting point to optimize your dental handpiece maintenance process!
1. Manage Pressure Levels
The manual that comes with your dental handpiece should include air pressure specifications. These aren’t mere suggestions -- they're integral to properly maintaining your handpiece!
Landing upon the ideal levels requires a perfect balance, as is highlighted in the manufacturer’s specifications. Ignoring these instructions will leave this critical piece of dental equipment open to severe turbine damage, whether the handpiece is low or high-speed.
2. Use The Right Tools For The Job
A high-quality dental handpiece is a sensitive device, often requiring manufacturer-approved tools for even the most minor maintenance or repairs. You might be tempted to reach for your household pliers to handle a nagging yet small repair -- as much as it might go against your proactive nature, don’t do it! It will likely cause more damage.
If you don’t have the skills or tools to get the job done right, contact the manufacturer or a trustworthy handpiece service company.
When it comes to handpiece repairs, you should ensure that your instruments receive only premium quality handpiece parts. Poor-quality aftermarket parts might seem cost-effective upfront, but you run the risk of damaging your handpiece and voiding its warranty.
Wiping down the handpiece is, of course, necessary both for hygiene and maintenance. Cleanliness is essential to extending the life of all your dental tools.
However, there is a caveat: this process should generally be kept simple. Rely on warm water, potentially with a mild detergent, to wipe down the handpiece before lubrication and sterilization. Nothing more, unless specified by the manufacturer.
Using strong chemicals is both unnecessary and problematic. Such chemicals can cause harmful interactions during the Autoclaving process.
Lastly, unless the manual tells you otherwise, avoid submerging the handpiece in any liquid.
4. Keep Your Eyes on the Bur
Thorough lubrication helps the handpiece's internal components entirely purge all harmful bacteria. Removing the bur before lubricating and purging your handpiece allows for the most effective lubricating.
5. Pay Extra Attention to Your Port
The smaller of the two larger holes in your handpiece is called the drive air port, which should be your vessel for lubricant application. There are other openings found on the equipment, but don't use those! It’s through the drive air port that your lubricant gains direct access to the turbine.
6. Be Generous with Your Oil...
Being stingy with oil might seem to make sense initially, as it would help avoid creating too much internal residue. Still, not being generous enough with your lubricant means it won't do its intended job.
You should ensure that the lubricating oil is visible in the head before you stop applying it.
7. ...But Don’t Go Overboard!
As was discussed in the previous section, just enough oil is a good thing. But too much of it will risk clogging your handpiece’s bearings.
Upon lubricating your instrument, attach it to the delivery unit tubing. From there, turn on the handpiece for half a minute. Alternatively, you could use an air flush station.
Note that excess oil might be discolored. Repeat the above process until the oil is 100% clear, so you know the handpiece is thoroughly cleaned.
8. Don't Get Lost in the Darkness
Your fiber optics will become dim and dark when too much debris builds because it adversely impacts light transmission.
To combat this, clean all fiber optic surfaces with a cotton swab and alcohol. Remember not to use any sharp instruments to clean because they can do more harm than good.
9. Let Your Handpiece Relax
When your springs and levers compress during heating, they tend to weaken over time. This drastically hinders your handpiece’s shelf-life.
Release that tension by removing the bur and releasing the chuck levers before sterilizing your handpiece.
10. Always Remember Your Chuck
Chucks necessitate their own unique care, separate to the rest of your dental handpiece. Most frequently, applying lubricant provides the necessary attention for optimal function. You’ll want to perform this maintenance task at least once a week.
This can be done manually or through various dental equipment care systems.
Extract the Most Value from Your Dental Handpiece
Dental tools that don’t optimally function make for a substandard patient experience while hampering your ability to provide quality care.
Your handpiece is one of the most integral pieces of equipment you’ll have in your practice, and it must be well maintained! Learn more about premium quality parts, lubricants, and cleaners for your air driven dental handpiece.