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8 Fun Dental History Facts You Didn't Learn in Hygiene School

 

Dentistry is as noble a profession as it gets, filled with some of the most caring people on earth. Still...it’s always taken a special kind of human to look someone in the eye, tell them to open wide and then courageously yank their teeth out! 

 

Visiting the dentist is no longer something most people lose sleep over...however, the same cannot be said of decades gone by. The age-old practice of the tooth has changed so much thanks to modern medicine and state of the art machinery. Dentistry has not always been so painless!

 

Let’s dig in to the long, rich and occasionally painful history of dentistry, including a few fun facts you probably didn’t learn in hygiene school.

 

1. Barbers Used to Double as Dentists

These gentlemen were known as barber-surgeons. It may seem quite barbaric to have the local barber extracting teeth and bloodletting, but it made sense in the medieval times, since it left more doctors available to attend to the war wounded.

 

Nothing quite like getting your wisdom teeth carved out with the same blade you were just shaved with!

 

2. Ornamenting Teeth Was All the Rage

The ancient Mayans used to bejewel their teeth by chipping at them and embedding small gemstones with glue. Although the outcome would be a dazzling and mesmerizing smile, the process was certainly not for the faint of heart.

 

In the industry today, this ancient practice by the Mayans isn’t too far from the modern practice of bejeweling your teeth...without the gruesome chipping part, of course. Nowadays, they’re called tooth gems, which some people use to give an extra shine to their smile.

 

3. Ever Wondered Where Toothbrushes Came From?

The need to maintain dental hygiene is not a 21st century phenomenon. In ancient times, people would snap a supple twig and chew the edges to spread out the fibers. Even today, some people prefer the twig toothbrush over the conventional toothbrush.

 

The Europeans used a rag and salt or soot for brushing their teeth until the English inventor William Addis invented toothbrush. This was in 1780 but by 1498, Chinese artisans had invented the toothbrush as we know it by using animal hair as bristles.

 

If you’re feeling naturally inclined to use a twig toothbrush, then you can consider trying a twig from the toothbrush tree.

 

4. Anesthesia Was Gross and Ineffective

Archigenes was a tooth doctor back in 15 A.D Rome. His idea of anesthesia for dental works was ointment made from hair-raising ingredients including roasted earthworms, spikenard and spider's crushed eggs. He would drill into your tooth then apply the ointment to relieve pain.

 

It’s hard to imagine that ointment would actually reduce pain, yet it was widely used ‒ maybe the sheer shock of having dead spider babies smeared on your gums was enough to kill the pain?

 

5. The Electric Chair and Teeth Have a Lot in Common

What does an electric chair have to do with teeth? Well, luckily not much...other than the fact that the inventor of the electric chair was also a dentist by profession and a professor who taught dental medicine at the then-University of Buffalo School of dental medicine in New York. 

 

The good news is that he invented the electric chair in the mid 1800s specifically for the purpose of execution and not dentistry. It’s a mild relief knowing that Southwick had no intention of experimenting the efficacy of electric current on tooth cavities.

 

6. Dentist Power Drills Were Powered By Feet

You might know that the dentist attending to the first president of the United States, George Washington, invented a foot engine to power his dentist's drill.

 

What you might not have known is that he used his mother’s spinning wheel making it into a torque to power the drill!

 

7. Dentistry Was a Lonely Profession

Until the year 1960, dentists were expected to do everything while attending to their patients. They would handle every procedure and tool on their own with no assistance! The result was weary and lonely dentists. 

 

This continued until four-handed dentistry was introduced, providing two extra hands (and a lot of camaraderie!) to help.

 

8. Tooth Decay Was Caused By Worms!

...Just kidding! Of course that was never true. But for a time, that’s what people really believed. 

 

After all, worms drill holes, and tooth decay is characterized by holes in teeth. This was a logical conclusion at the time. This old explanation for tooth decay was so believable it carried on in many cultures until the 1900s.

 

Today, we’re thankful for miracles like Novacaine and other tools and treatments that make your life (and the lives of your patients) easier. But we should also be thankful reflecting back on the dentists of old. Though they may have been misguided at times, they’re the ones who made it possible for us to offer the quality of care we can today!

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Treating Patients with Thyroid Disease as a Dental Hygienist

Thyroid conditions present oral and systemic manifestations that can challenge even the most seasoned dental professionals. Up to 15% of the general population has some form of thyroid abnormality, and many people have never been properly diagnosed - which makes treating them all the more complicated.

 

As a registered dental hygienist, there are ways you can help to identify and manage the oral manifestations of thyroid diseases. Here, we’ll discuss two of the most common thyroid diseases you’ll see in your practice: hypothyroidism and hyperthyroidism.

 

Oral Manifestations of Hypothyroidism

 

Hypothyroidism, also called underactive or low thyroid, is a decrease in the hormone production and functioning of the thyroid gland. Hypothyroidism most often affects women from middle age onward, but it can occur in people of any age.

 

Many people who have hypothyroidism present only a few or very mild symptoms. However, those with severe hypothyroidism can experience numerous symptoms including slow metabolism, weight gain, lethargy, sensitivity to cold, and puffiness of the face.

 

When treating a dental patient with hypothyroidism, you may notice one or more of the following common oral manifestations:

  • Salivary gland enlargement
  • Compromised periodontal health
  • Glossitis, or inflammation of the tongue marked by soreness, swelling and change in colour

People who experience severe hypothyroidism as a child may present long-term dental and craniofacial manifestations in adulthood, such as:

  • Enamel hypoplasia
  • Micrognathia, or undersized jaw
  • Mouth breathing
  • Thick lips
  • Macroglossia, or oversized tongue

Oral Manifestations of Hyperthyroidism 

 

Hyperthyroidism, also called overactive thyroid, is the unregulated production of thyroid hormones. It is most often called by an immune system disorder called Grave’s Disease and usually affects women under 40, but it can occur in people of all ages.

 

Many of the symptoms of hyperthyroidism mirror hypothyroidism in reverse - sensitivity to heat, weight loss, increased cardiac output are common. It can also cause emotional instability, tremors, abnormal heart rate and hypertension.

 

A dental patient who has hyperthyroidism may present the following oral manifestations:

  • Increased susceptibility to periodontal disease and dental caries
  • Enlarged extraglandular thyroid tissue (mainly in the lateral posterior tongue)
  • Burning mouth syndrome
  • Xerostomia or dry mouth caused by Sjogren's syndrome

Treating Dental Patients Who Have a Thyroid Disease

 

As a registered dental hygienist, it is important to understand how thyroid dysfunction could affect your patient care.

 

First, you are well-positioned to notice the symptoms of hypo- or hyperthyroidism and aid in early diagnosis. Your keen eye could be what points a patient in the right direction to receiving treatment for their condition.

 

For patients who have confirmed thyroid disease, it’s also important that you and your colleagues deliver care that will help, not harm. Complications can occur from improperly treating dental patients with thyroid disorders.

 

Rebecca Marie Friend, BS, RDH demonstrates this perfectly in a recent column for Today’s RDH. When an elderly patient came in presenting with hypothyroidism, Rebecca took the time to carefully review the patient’s health history and discuss the patient’s medications, including over-the-counter remedies. Not only did this discussion reveal an important oversight by the patient’s doctor, but Rebecca was able to provide the patient with a better understanding of the condition.

 

Rebecca also provides the following recommendations to hygienists and other dental professionals in treating dental patients who present with thyroid disorders.

 

  1. Establish communication with the patient’s endocrinologist and other healthcare providers. This will ensure that you are kept up to date with the patient’s medications and the rest of the healthcare team is aware of the patient’s oral manifestations.
  2. Plan treatment in a way that limits stress and infection. Patients with hypothyroidism are at greater risk of infection due to increased bleeding and delayed wound healing.
  3. Treat the oral manifestations of hypothyroidism and hyperthyroidism as needed, including periodontal disease, caries and xerostomia.
  4. Conduct an extraoral head and neck examination at each appointment. This will help you detect changes to the patient’s thyroid region.
  5. Be sure to always use a thyroid collar when taking patient X-rays. The thyroid gland is very sensitive to radiation, and excessive exposure is a known risk factor for thyroid conditions.
  6. Help the patient feel comfortable in the chair. People who have hypothyroidism could use a blanket to help keep their legs warm, while those with hyperthyroidism might appreciate you turning the thermostat down a few extra degrees.
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Struggling with a Difficult Patient? Here’s How to Manage 4 Difficult Dental Patients

In any business, there are customers that we like and customers that test our patience. The same goes for the patients that visit the dentist’s office.

 

And sometimes, it’s hard to handle them so that they have the best experience and you can do your job.

 

Here are 4 types of patients that can be difficult and how to manage them.

 

 

1. The Google Expert 

 

We all know that one patient.

 

They know all the latest and greatest medical news and can’t wait to share with the dental hygienist. Instead of giving them a cleaning, we’re bombarded with questions that have taken four years of dentistry school to learn.

 

“Why didn’t you use this treatment?’

 

“Shouldn’t you be doing this?”

 

It can be exhausting.

 

It’s wonderful that the patient is enthusiastic about getting involved with the process, but it can hinder dental hygienists’ trying to do their job and sometimes even be harmful to the patient.

 

So, what’s the best course of action?

 

Be firm with the patient and confident in your own education. It’s important to make sure that they know we have their best interest in mind and that we are a much better resource than anything they can find on the web. 

 

2. The Late Comer

 

It’s 3:50. Their appointment was at 3:30. At this point, we’re assuming they just aren’t coming.

 

That’s when they stroll on in. The only thing more frustrating than that is if it happens on the regular.

 

Lateness has a domino effect. Regardless if all the next patients are on time, there’s no way to get back that 20 minutes. The worst part is making other patients wait just because someone has chronic tardiness. It isn’t good for anyone.

 

The best way to manage lateness is to incorporate a late policy. And stick to it.

 

Anyone that is more than 15-20 minutes late to their appointment, cannot be seen that day and will have to reschedule.

 

Generally, patients will respect the set appointment time and it will reduce the amount of late arrivers.

 

3. The Nervous Patient 

 

Dental anxiety is no joke. Nearly 1 in 5 patients have some degree of dental anxiety.

 

As dental hygienists, no one wants to see a patient cringe and tense as we recline the chair or pull back their cheeks. But no matter what we try to do to calm them, nothing works.

 

Sometimes, their discomfort and tension can radiate onto us, making us nervous too.

 

The best advice is to stay calm yourself. This is much easier said than done but often times what you put out into the world you get back in return.

 

It may be beneficial to open up the floor to a discussion about what is causing the anxiety and how we, as hygienists, can ease that discomfort. By knowing what makes them the most worried, you can avoid or minimize that factor.

 

In extreme cases, the patient may need to consult their doctor for anti-anxiety medication to take before appointments.

 

4. The Chatty Cathy 

 

You love them, but at the same time they can be quite frustrating.

 

These are the types that will get to know you, ask about the kids or about upcoming vacations. They are often the sweetest patients you’ll get!

 

As much as they make the workday go by faster, they can eat into the appointment through their conversations and suddenly we’re behind schedule!

 

It can be challenging when managing a Chatty Cathy because we don’t want to be rude in any way but we also have to get the job done on time. But like any skill, managing chatty patients comes with time and experience.

 

Focus the conversations towards the beginning and end of the appointment as well as during the period of time before the patient is seen by the doctor. These time zones are optimal for conversations because they don’t interrupt your job but also give the patient a chance to socialize.

 

Not only that but it will also build a better relationship with the patient!

 

While these four types of difficult patients can pose a challenge, there’s nothing we, as dental hygienists, can’t handle.

 

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Introducing a Tooth Whitening Program to Your Practice

 

Tooth whitening is big business. Generating over $1 billion in sales every year, professional whitening stands out as the most frequently-requested dental procedure. It’s also major source of revenue for dental practices across North America. 

 

Together, a dentist and their hygiene team can create comprehensive whitening programs that integrate whitening into a long-term oral care plan. That way, whitening can serve to facilitate financial gain to hygiene and other ancillary offerings. 

 

In a recent piece for Hygiene Town, Mary Jane Livingston and Jennifer Vasquez provide insight into the process of creating a professional whitening program at your practice. Here’s what to keep in mind in offering tooth whitening to your patients. 

 

Professional Whitening 101: How the Tooth Whitening Process Works 

There are several reasons why teeth lose their natural whiteness: diet, genes and oral hygiene all play a part. 

 

Darkening can occur both in the tooth’s outer enamel layer and the secondary layer of dentin. Tooth enamel, made of phosphate and hydroxyapatite, can develop surface stains that attach to the biofilm. These so-called extrinsic stains typically stem from the patient’s diet and habits – frequent smokers and red wine drinkers are likely to have enamel stains. 

 

Stains within the dentin, known as intrinsic stains, can result from medications, fluoride exposure, genetic conditions or systemic conditions. It is more difficult to remove stains from dentin than enamel. 

 

Professional whitening gels use hydrogen peroxide (or a compound containing H2O2) to break the bonds of light-absorbing colour molecules on the teeth. These molecules, called chromophores, contribute to the darkened or stained appearance of teeth. Once the peroxide breaks the molecular ‘glue’ that holds the chromophores together, the teeth look whiter and brighter than before. 

 

Tooth whitening is not a one-time solution – the procedure has a cumulative effect of breaking down stains over time. Additionally, since the average person’s teeth become two to three shades darker every ten years, requiring multiple whitening treatments to maintain the results. 

 

Still, the popularity of professional tooth whitening (not to mention sales of whitening strips, tooth whitening strips and other home treatments) speaks for itself. Many patients are more than willing to invest the time and money necessary to improve the appearance of their smile. Dental practitioners can benefit by investing in a tooth whitening program. 

 

Introducing a Whitening Program to Your Dental Practice 

The benefits of a teeth whitening program go beyond offering your patients brighter smiles. 

 

Tooth whitening brings an emotional component to your dental care. It gives people a greater sense of confidence and satisfaction, which in turn boosts their motivation to maintain better oral health overall. A whitening program increases the likelihood of patients returning for hygiene appointments and other treatments. 

 

Consider the following in determining the best teeth whitening system for your patients. 

 

1.      Contact time. Modern whitening systems use a heat-activated mouthpiece to decrease treatment time, which reduces the risk of the bleaching agent causing sensitive teeth. Shorter contact time also means shorter appointments and increased efficiency. 

2.      Concentration. Higher concentrations of hydrogen peroxide (24 to 38%) produce more dramatic results, but also the risk of sensitivity. More concentrated whitening products may not be suitable for all patients. 

3.      Hydrogen peroxide versus carbamide peroxide. Carbamide peroxide provides a lower concentration of hydrogen peroxide and increases contact time, which can increase the risk of tooth and gum line sensitivity. A more concentrated formula with shorter contact time may be preferable for patients who require a shorter contact time. 

4.      Open versus closed environments. Closed-system environments (such as bleaching trays and whitening mouthpieces) result in superior whitening results by keeping the active ingredients in the whitening compound concentrated. 

5.      pH level. Consider the patient’s enamel health and sensitivity when choosing a whitening gel. When mouth pH drops below 5.7, enamel demineralization can occur. 

 

Thinking of introducing a whitening program to your practice? Get the right start with industry-leading instruments. Browse our catalog of dental handpieces, supplies and other dental tools. 

 

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7 Truths About Hygiene School to Remember When It’s Getting the Best of You

 

Late-night study sessions. Lifelong friends. Stress, tears, and anxiety. And, above all, the satisfaction of pouring it all into a hard-earned degree in dental hygiene.

 

When Kara Vavrosky looks back on her time in hygiene school, those are a few of the things that come to mind.

 

Most dental hygienists would concur. Dental hygiene school is a rewarding experience, of course – but at times, it’s also a gruelling one.

 

From the writings of hygienists who’ve been there, here are seven truths about hygiene school to reflect on when you’re feeling the pressure.

 

1. It Pays to Be Organized

By now, you’ve learned that dental hygiene school isn’t like other post-secondary programs. The coursework is dense, the deadlines come fast, and the practical fieldwork leaves no room to play catch-up.

Put simply, procrastination isn’t an option.

 

Kara Varovsky, who wrote about her experience in Today’s RDH, admits she spent more time in her first week at hygiene school staring at the books and assignments than sitting down doing them. To keep up, she had to make a concentrated effort to begin tracking and prioritizing homework and exams.

 

Keeping to-do lists and assignment sheets might just feel like more work at first, but it can save a lot of time and stress in the long run.

 

“If you’re having a really tough time, take it one day at a time until you can handle taking it week by week,” Kara suggests. “Ask yourself, “What do I have to get done by tomorrow?” It makes everything feel achievable when you break it down and don’t look too far ahead.”

 

2. Some Stress is Normal

Few registered dental hygienists would deny there were times that hygiene school pushed their limits, especially in the first year.

 

It’s completely normal to feel overwhelmed in the beginning. But as the weeks and months pass and you gradually find your footing, hygiene school will become far more manageable.

 

Kimberly Rorstrom-Wittig, a hygienist in Prince George, British Columbia, encourages dental hygiene students to keep looking forward. “Keep focused on your goal and remember that you are all reaching for the same endpoint, to become a dental hygienist.”

 

However, it’s important not to ignore the toll stress can take on your mind and body. As Jason Skazyk, an RDH in Winnipeg, writes: “One of the things that I encourage each student to do is to look after your physical, mental, and spiritual self. Dental hygiene can be a demanding career physically, and if we do not look after our bodies, all that scaling can begin to take a toll.”

 

3. Mentors Make Life Easier

Whether it’s a classmate, an upper-level student, an instructor or a graduate, all hygiene students can benefit from the support and advice of a trusted mentor.

 

Don’t hesitate to ask your colleagues for tips and advice. Even students in the same year as you may have hints and strategies you hadn’t considered.

 

Heather Britton, who practices in Carleton Place, Ontario, urges hygiene students to look for mentorship opportunities everywhere – even those outside the hygiene profession.

 

“The dentist can offer you knowledge on procedures that the books can only describe, by showing you the stages of restorations, prosthetics, and extractions,” she writes. “The dental assistant(s) offer a wealth of information on radiographic techniques to open that tough contact, ordering procedures, and lab techniques, to mention a few. The receptionist can also aid in telephone etiquette, computer booking, and filing systems.”

 

4. Trust Your Instructors

Why do we have to fill out pages of classifications and descriptions for every patient in the clinic?

 

Why so many competencies, rules and requirements?

 

Why won’t my instructor just give me a straight answer?

 

If you’ve spent a few weeks in hygiene school, you’ve probably asked a few these questions yourself.

 

At times, hygiene school can feel overly strict, repetitive, or just plain confusing. Frustrating as it may be, it’s all designed to prepare you for practice. Your instructors aren’t just there to teach you practical know-how, but to impart professionalism and critical thinking skills. All three are essential to becoming a registered dental hygienist.

 

Think of it this way: every obscure term you memorize and head-scratching conundrum you solve goes towards making you the best hygienist you can be.

 

5. You’re Not Alone

“My fondest memories from college days were the camaraderie of all of us,” writes Jan Krawchuk, an RDH in Windsor, Ontario. “We had a class of 20, and many of us would get together for study clubs.”

 

There are so many benefits to joining a study group in hygiene school. Not only does it get you to study at regular intervals (instead of cramming the night before a test), but to share and discuss what you have learned beyond the level of memorization.

 

6. Don’t Compare Yourself to Your Classmates

School isn’t a race. Everyone develops different skills at different paces and having a slow start doesn’t mean you cannot excel as a dental hygienist.

 

It is often tempting to compare your progress to that of your classmates. As a recent graduate, Lana MacDonald knows from experience that it’s not a useful exercise.

 

“My advice to dental hygiene students is not to rush the learning process,” she says. “Don't worry about competing with other students. Work at your own pace and learn everything the ‘right way.’ It will make things easier when you go out into practice even if you may feel behind in school.”

 

7. Don’t Forget to Have Fun

Whether you choose an accelerated program or a four-year degree, dental hygiene school is a significant part of your life. Take the opportunity to make friends and create memories you’ll look back on fondly.

 

“Always strive to do the best you are able to do, but remember to enjoy this time in your life,” advises Nancy Mar Hoffos, an RDH in Alberta. “When the opportunity arises to have fun, take it, or when you reflect back, you will have regrets.”

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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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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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Do Dental X-Rays Cause Thyroid Cancer? How to Ease Patient Concerns About Dental X-Rays

Dental x-rays are an important diagnostic tool. They reveal oral health issues that could otherwise go unnoticed: areas of decay, bone loss, abscesses, tumours, and conditions of the root canal. Unfortunately, some people are wary of dental x-rays, dental practitioners aren’t always sure how to ease their concerns.

 

 

These tips can help you educate patients on the significant benefits and minimal risks associated with dental x-rays so they can make a well-informed decision about their care.

 

Do Dental X-Rays Cause Thyroid Cancer?

If you’ve worked as a dentist or dental hygienist in the last few years, you’ve probably heard it before:

 

Are dental x-rays safe? Can they cause thyroid cancer?

 

According to an article in Today’s RDH, much of the fear surrounding dental x-rays originates from a talk show several years ago. The show presented a link between the radiation from dental x-rays and thyroid cancer. Video clips shared widely through email and social media sites, sparking an increase in patients refusing x-rays out of concern for their health.

 

In truth, the link between dental x-rays and thyroid cancer is tenuous, and the show failed to explain how dental x-rays compares to other radiation sources (a dental x-ray is about 0.005 mSv of radiation, equalling less than one day of background radiation exposure.)

 

Regardless, this trend is a challenge to dental practitioners. The public is not well-informed about radiation, and not all practitioners are prepared to address their concerns. The absence of x-ray images can make it difficult to effectively diagnose and treat patients.

 

However, with the right approach and a bit of patience, many dentists and dental hygienists can help patients understand that dental x-rays are safe.

 

1. Have Empathy

For many patients, visiting the dentist is unpleasant to begin with. The added uncertainty surrounding radiation can make the experience more frightening.

 

Your patience and empathy can make a world of difference in this circumstance. As always, it’s crucial to communicate openly with the patient and take time to explain things in a way they understand.

 

2. Respect Different Backgrounds and Beliefs

Understand that dental x-rays are not common everywhere in the world. Newcomers, along with older adults who have little experience with the dentist, may not be familiar with dental x-rays.

 

Acknowledge that you may have to take a different approach with patients of differing cultural backgrounds. It may help to have an interpreter explain the process to them.

 

3. Explain the Precautions Taken

Take time to assure your patients that you and your staff take measures to ensure that dental x-rays are as safe as possible. Explain the purpose of a lead apron, lead thyroid collar, and the ALARA principle for radiation exposure.

 

4. Compare Dental X-Rays to Other Radiation Sources

A 2017 study examined different approaches to informing patients about radiation exposure from x-rays and other imaging tests. According to this research, patients prefer to receive the information in both oral and written formals, along with a table showing how radiation exposure from the test compares to background radiation.

 

The average American receives about 620 mrem of radiation each year, half of which comes from natural background radiation. The radiation ‘dosage’ associated with dental x-rays is just 0.005 mSv, less than a single day’s worth of background exposure.

 

Making this comparison can help patients understand that dental x-rays are not something to fear. However, the information should be delivered with empathy and not to belittle the patient’s concerns.

 

More Resources for Dentists and Dental Hygienists

Sable Industries is a trusted provider of quality dental equipment and supplies to practitioners across North America. Check out our oral health blog for more dental news and resources.

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10 Ways Being Confident Can Boost Patient Satisfaction

There are many ways to boost patient satisfaction in your dental practice. Clear communication, good time management, friendliness, efficiency, and empathy are significant factors in a patient’s overall expectations of their dental experience.  

 

10 Ways Being Confident Can Boost Patient Satisfaction

 

But according to the Canadian Dental Association, one quality stands out above the rest: confidence.  

 

A dental practitioner’s confidence, and the ways in which they demonstrate it, ranks as the #1 influencer on how patients perceive their quality of care, according to the latest Canadian Dental Association survey. 

 

Why? Confident people attract positive attention — no secret there. It’s natural to be attracted to people with high self-esteem, whose confidence shines through their charisma, appearance, speaking, writing, and listening skills. Confidence is a sign of competence, not arrogance, in the dental practice. 

 

To promote and maintain patient satisfaction, professional dental care providers need to keep confidence at an optimum level to ensure ongoing quality of care. Below, we’ll discuss some of the ways to grow and maintain that confidence in your practice. 

 

Ways to Be Confident and Boost Patient Satisfaction 

 

A person’s levels of confidence can swing up and down due to positive or negative experiences, and criticisms. We are most confident when we are performing routine and familiar tasks.

 

Here are ways to show your confidence as a dental practitioner or hygienist: 

 

  1. Be optimistic. Think positively. While it may sound cliché, there are tangible and proven benefits to adopting an air of optimism, and your positive outlook will rub off on your patients. 
  2. Focus on the present. What do you want to accomplish today? Don’t dwell on the past. Once you have acknowledged your mistakes, learn to accept them and move forward. 
  3. Accept compliments graciously. Say thank you. What may seem like minor work to you can have a profoundly positive impact on your patients’ lives, so you should always be open to their praises. 
  4. Face your fears. When you have a busy day ahead, tackle the tasks you like least first. You will face the remainder with the confidence of knowing the worst is over. 
  5. Break down large tasks into smaller sub-tasks. Knowing how to prioritize your to-dos is key to ensuring you accomplish your daily goals. 
  6. Learn and research new skills and technology. The world of dentistry is continuously advancing, and being prepared will help you keep a competitive edge. 
  7. Recognize your strengths and achievements. You have come a long way to get where you are. Remember to celebrate successes. 
  8. Manage stress. Don’t let your own wellness get lost in the daily grind. Develop effective coping strategies, and take moments to just breathe throughout your day. 
  9. Smile. Learn to laugh at yourself. Take pleasure in your daily tasks. 
  10. Believe in yourself and your team. Positive reinforcement will help everyone in the practice grow their confidence and boost patient satisfaction. 

Image: wavebreakmediamicro

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Is Your Dental Practice Using Too Many Chemicals?

With more and more people making an effort to be informed on the chemicals and materials they’re exposed to every day, many dentists are looking to reduce the number of chemicals used in their practices.

Cutting down on chemicals dental practice

 

Proper cleaning and disinfection in a dental office is a legitimate concern. After all, if disinfection isn’t done properly, a patient could be harmed. Everyone in the practice is responsible for ensuring the safety of all patients that walk through its doors.

 

The best way to avoid making a patient sick is to make sure that any sources of infection are properly contained. Unfortunately, it’s all too common to hear that evacuation systems aren’t cleaned daily—or aren’t properly disinfected when they are cleaned.

 

Reasons for the lapse in cleanliness could partly be due to the work involved, but also the perceived dangers of the continuous use of chemicals every time the system is cleaned. Over the past three decades, newer and stronger chemicals have been introduced to keep surfaces, water lines, and evacuation systems clean and sterile. However, the number of chemicals can also create issues, and many are harmful on their own.

 

The alternative is microbiological cleaners. But what are they, and how do they work?

 

Microbiology

 

It was over 150 years ago that doctors figured out washing their hands before surgery drastically reduced the patient’s risk of infection. This jumpstarted the field of microbiology, or the study of microscopic organisms.

 

Once we started looking, we discovered bacteria everywhere.

 

It’s estimated that there are more bacterial cells in a human body than there are cells that make up that whole person. The sheer number of microbial organisms that constantly surround us is staggering, which is why it’s so hard to create sterile environments. We need to use intense stressors like temperature, pressure, or chemicals to eliminate microbial growth.

 

We simply must accept that we are, and always will be, swimming in a sea of bacteria. The good news is, though, that the clear majority of bacteria won’t make you sick. Most bacteria really do not affect us. In fact, there are plenty of microbes that actually keep us healthy. Your gut, for example, is chock full of bacteria that is helping you to remain healthy and digest your food.

 

The good bacteria in your gut also keeps dangerous, harmful bacteria at bay. It’s this same principle that makes microbial disinfection such a good alternative.

 

Microbial Disinfection

 

As an alternative to chemicals, disinfection can be done using microbial cleaning products. These products seed and jumpstart the growth of “good bugs.”

 

These good bugs not only help to kill harmful ones, but they also work to keep the bad bugs away. This is one clear advantage to chemical sterilization—the harmful bacteria is kept at bay for longer.

 

Products like Bio-Pure can keep an evacuation system clean of harmful bacteria on a continuous basis. It does this by introducing a cleaning microbe into the system. Microbial growth is exponential, which means one microbe can quickly become 10,000,000. This army of good bacteria cleans out all other microbes and creates a barrier against bad bugs.

 

Short of cleaning out the system before and after each use, Bio-Pure is the most effective way to keep a system clean and safe at all times. Plus, there’s no need for harmful chemicals.

 

Click here if you want to learn more about Bio-Pure and whether it’s a good fit for your practice!

 

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