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Needleless Local Anesthesia Approved for Commercial Use

 

One of the top fears in the world is the fear of needles. About 10% of the general population suffers from such fears. This can make going to the dentist something to be feared because typical anesthetics are administered using needles. 

 

A needleless anesthesia, called Kovanaze, might be a beneficial practice to ease the anxiety of needles and save patients from injections overall.

 

The History of Needleless Anesthesia

Since the 1940s, the use of Tetracaine (also known as amethocaine) has been used for eyes, nose and throat treatments. It is a local anesthetic, typically applied in liquid form to the desired area. It wasn’t until patients began to inform doctors that when used for nasal treatments, that their upper lip was also numb. This led researchers to look into the compound for dental applications.

 

About a decade ago, a pharmaceutical company called St. Renatus developed Kovanaze which was a combination of 3% Tetracaine and 0.05% Oxymetazoline. On June 29th, 2016 it was approved for dental use by the Food and Drug Administration. It is the first approved nasal anesthia. 

 

What is Kovanaze Anesthesia and How is it Used?

Tetracaine is a very temporary anesthetic, approximately lasting only 15 minutes. This makes it quite difficult to work on a patient in such a tight time limit, especially for intricate dental procedures. With the addition of Oxymetazoline, the duration was increased because it slows the systemic absorption of tetracaine.

 

Using it is extremely simple. Spray into the nostril that corresponds with the side in which the patient is having work on followed by another spray 4-5 minutes later. It is important to wait 10 minutes to ensure the effects are working, if not another spray may be administered for adults only.

 

The nasal spray treats the upper anterior teeth, specifically teeth 4-13 (See image). Initial tests resulted in an 84% success rate for teeth 4-13 and 96% effective for teeth 5-12. The premolars seem to have less success in having a consistent and reliable result using Kovanaze.

 

Additional testing has been conducted since with fantastic results. Out of 186 subjects, only two had any pressor response. This was likely caused by the Oxymetazoline component. A history of Hashimoto’s thyrotoxicosis, a relative contraindication to oxymetazoline, was found in one of the pressor response patients.

 

Kovanaze is unique because it does not anesthetize the lips. Dentists performing anterior restorations could find this to be invaluable. Precision is greatly improved for the placement of veneers and crowns. Additionally, due to the ability to move the lip in a natural way, patients are able to have more aesthetically pleasing results.

 

Drawbacks of Kovanaze Needleless Anesthesia

As with any medical procedure, there are of course risks associated with it.

 

Approximately 10% of patients have identified the following possible temporary side effects:

  • Rhinorrhea
  • Nasal congestion
  • Increased lacrimation
  • Nasal discomfort
  • Oropharyngeal pain

Like all other local anesthetics, there are limitations to who may be administered it. Children under 88 lbs, patients with uncontrolled hypertension, thyroid disease or taking MAOIs (Monoamine Oxidase Inhibitors) should not be given it.

 

Due to the fact that this is a very localized anesthetics, it is limited to only the maxillary and premolar anterior. For any of restorative work outside this region would require an injection to complete. 

 

Kovanaze is limited for hygiene procedures such as scaling and root planing because of unpredictable gingival conditions. Further testing will be conducted to determine if it will be able to produce the desired result.

 

This exciting new development allows for people to now have the choice to have an injection or not. Many people would jump at the chance to avoid it.

 

It is not only good for patients but also practitioners because it can put patients at ease and lowers the fear of the dentist office.

 

As this company continues to develop and improve this product, it’s our hope that new insights will be found that furthers the use for Kovanaze. Many people would prefer this option over an injection so if it can be used for more than just the maxillary and premolars of the anterior, it should be!

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How Ultrasonic Scaling Benefits Patients and Dental Hygienists Alike

 

 

Scaling used to be a dental hygienist’s daily grind. But owing to advancements in ultrasonic scaling, the process has become increasingly efficient and effective. Not only is ultrasonic scaling more convenient to the hygienist than scaling with hand instruments, it has numerous benefits to patients’ oral hygiene as well.

 

What is Ultrasonic Scaling?

An ultrasonic scaler is a power-driven scaling device that utilizes ultrasonic vibration to break up hardened calculus deposits on patients’ teeth. The vibration is driven by a generator converts electricity into ultrasonic waves through piezoelectricity or magnetostriction.

 

Once activated, the tip of an ultrasonic scaler oscillates at incredible speeds up to 35,000 cycles per second. The hygienist guides the tip from the coronal to the apical of a tooth, pulverizing calculus so it can be washed away by a coolant spray.

 

Ultrasonic scalers remove plaque through a dual application of mechanical force and cavitation. The vibration of the tip creates pressure waves in the water dispersed as coolant, causing the formation and implosion of atomized gas bubbles. These shockwaves help to disrupt bacterial biofilm and fracture the calculus deposits as they are pounded by mechanical force.

 

The oscillating tip of an ultrasonic scaler is replaceable, with tips of various shapes and diameter available for different purposes. Thicker tips are generally suitable for use with higher power settings to remove heavier calculus deposits, whereas thin tips are used for light calculus or biofilm removal. In any case, hygienists should read the manufacturer’s directions as to a tip’s proper usage.

 

Benefits to Ultrasonic Scaling

Ultrasonic scaling is highly effective in removing subgingival/supragingival calculus from teeth without damaging roots or gum tissue. Other benefits to ultrasonic scaling include:

  • Using an ultrasonic scaler, hygienists can remove calculus from pockets between teeth and gums at probing depths that are unreachable with hand tools (4mm or greater.)
  • Ultrasonic scalers have replaceable, specially-designed tips that can penetrate difficult nooks and corners.
  • Since there are no sharp cutting edges and no ‘scraping’ sound, many patients find ultrasonic scaling is more comfortable than scaling with hand dental instruments.
  • Scaling using an ultrasonic scaler is faster than hand scaling, allowing more time for the hygienist to speak to and educate the patient at the end of the appointment.
  • Ultrasonic scaling is more ergonomically sound, as its power-driven vibration replaces the need to exert lateral pressure on the instrument to remove plaque.

These benefits have made ultrasonic systems like the Cavitron-Compatible Autoscaler the method of choice for many dental practices, replacing other methods power-driven scaling.

 

However, ultrasonic scalers are not suitable for all patients. Notably, ultrasonic scaling should never be used on or near a person with a cardiac pacemaker. Additionally, some patients are apprehensive of power-driven scalers and prefer that their hygienist provide scaling using hand instruments.  

 

Ultrasonic Scaling Technologies: Magnetostrictive vs. Piezoelectric Scalers

Ultrasonic scalers are driven by one of two types of generators: magnetostrictive or piezoelectric. Both can be effective, but there is a learning curve associated with each.

 

A piezoelectric ultrasonic scaler uses transducers to convert electricity into mechanical energy using materials like quartz crystals. The device sends electrical energy to ‘activate’ the material within the handpiece and vibrate the instrument tip at 28,000 to 35,000 cycles per second. The tip vibrates in a back-and-forth motion and only the lateral sides are active.

 

Magnetostrictive ultrasonic scalers like the Autoscaler generate vibratory motion by transferring electrical energy to metal components in the handpiece. The tip operates in an elliptical motion at 25,000 to 30,000 cycles per second. Unlike piezoelectric scalers, all sides of the tip (lateral, face and back) are active in a magnetostrictive device.

 

Questions? For more information about ultrasonic scaling or Sable’s Cavitron Compatible Autoscaler, contact our team of dental experts. We’re always happy to help!

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Fluoride – What You Should Know

 

Almost everyone concerned about the health of their teeth brushes regularly, but they may not know exactly why toothpaste performs the cleansing magic it does. They may not even know they also receive fluoride every day in their community’s drinking water.

 

There are various cleaning components in toothpaste and one of the primary ones is fluoride. The discovery of fluoride's cleaning abilities was a boon in preserving dental health. Toothpaste and tap water then became convenient fluoride delivery systems to aid in the fight against tooth decay.

 

A Natural Cavity Fighter

 

The discovery of fluoride’s ability to keep our teeth healthy dates back to the early 20th century. A pair of dentists in Colorado discovered that people in the area had teeth unusually resistant to decay. This was due to the high degree of natural fluoride deposits in the area, which had found their way into the local drinking water. Fluoride became a regular part of toothpaste beginning in 1914.

 

In the 1940s, a multi-year study began with the goal of determining whether adding fluoride to drinking water made a notable difference for dental health. The results showed a 60-65% decrease in tooth decay in children born after the experiment began. As a result, a number of states in America began water fluoridation programs to improve their citizens’ oral health.

 

How Flouride Works

 

The enamel of your teeth is the natural coating that helps to protect them. When children’s teeth are first forming, fluoride combines with the enamel to help stave off decay during a time of life when teeth are particularly vulnerable to cavities. Fluoride remains valuable throughout the life of your teeth by helping protect them against the ravages of sugar and plaque.

 

Rare Health Risks

 

As mentioned, almost everyone’s teeth come into regular contact with fluoride through exposure to drinking water and toothpaste. There are additional fluoride supplements in the form of drops or tablets, and it is also an ingredient in mouthwash. The degree of fluoride in the latter is quite high, so do not swallow it.

High doses of fluoride in water can be bad for you, but this would require ingesting a volume of water with fluoride going well beyond what the normal person drinks.

 

Excessive fluoride can cause conditions known as dental fluorosis and skeletal fluorosis. You can only come down with dental fluorosis as a child, as ingesting too much fluoride at a young age can lead to white spots appearing on your permanent teeth. Fortunately, degrees of this condition ranking above very mild are almost non-existent.

 

You can also acquire skeletal fluorosis by taking in too much fluoride. However, you would have to have a very high amount on a daily basis for a very long period. As with dental fluorosis, the odds of contracting this problem are extremely rare.

 

Government oversight helps to ensure the level of fluoride in drinking water does not exceed safe rates. In Ontario, municipalities follow the guidelines laid out in the Safe Drinking Water Act managed by the Ministry of the Environment.

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8 Things You’ll Learn About in Dental School

 

Everyone knows dental hygienists clean teeth. But did you know they also examine patients for signs of disease, provide preventative treatment, and educate people on good oral health? Here’s a sneak peek at some of the amazing things you’ll learn in dental school.

 

Practical Skills

 

Dental hygienists do more than just clean teeth. They examine teeth and gums, chart cavities, place brackets and bands, install arch wires, and take a hands-on role in all kinds of dental procedures. These practical skills are the core of any dental hygienist program.

 

Once you have learned the fundamentals, you’ll begin to apply what you have learned in a mock clinical setting until you’re ready to assist with real patients.

 

Tools of the Trade

 

What's the difference between electric and air-driven handpieces? You’ll know soon. Dental hygienists use a wide range of dental equipment and tools, from simple picks and dental mirrors to high-tech equipment like X-ray machines.

Dental school will teach you to pick the best dental tools for the job.

 

Treating Different Patients

 

No two patients are exactly alike. Different people have different needs when it comes to dental care. In dental school, you’ll learn to provide top-notch treatment to people of all ages and backgrounds. Some schools offer courses focusing on the unique needs of people who are elderly, disabled, or have other barriers to receiving dental treatment.  

 

Human Biology

 

Dental hygienists not only learn the ins and outs of oral anatomy, they also acquire in-depth knowledge of the human body in general. They study various aspects of human biology, right down to the microscopic make-up of tissues and the mechanisms of disease.

 

 

Community Health and Advocacy

 

As members of the dental profession, dental hygienists have a platform to advocate on dental health issues in the community. Many dental schools have a course on public health and advocacy, where you learn how to improve access to dental care and spread the word using marketing and mass media.

 

Nutrition

 

Diet plays a huge role in oral health. To help your patients maintain healthy teeth and gums, you must know the science of nutrition. Dental hygienists learn the function of basic nutrients, vitamins, and minerals in the body, along with the impact of nutrition and nutritional deficiencies on oral health. By the time you’re finished dental school, you’ll know more about healthy eating than a dedicated health nut!

 

Communication Skills

 

Do you have good people skills? If so, you’ll have a leg-up in the dental profession. If not, dental school will help you catch up! Dental hygienists often spend more time speaking with patients than dentists do, and they teach patients to maintain and develop good dental habits. With good communication skills, you can help make the dental office experience more comfortable and beneficial to patients.

 

Yourself

 

Dental school is no walk in the park. Mastering the practical skills takes a great deal of physical strength, endurance, and manual dexterity. Your science courses will demand hours of reading and dedicated studying, testing your ability to analyze problems and think critically. However, at the end of this long road lies a career full of potential! Going through the rigors of dental school will help you discover whether the dental profession is right for you, and if so, what role you want to play within it.

 

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