by Trish Walraven

Did you really want to see that last pair of centrals in crisp detail? I mean, down to every last craze line and coffee stain?

If not, you’re probably one of those people that like shadows, you’ll want to go back down in your burrow and sleep through the next few months. Nothing uncomfortable or awkward for you, thank you. Please leave now – bye! – because the information below will only lead to spending money on things that you don’t care about.

Are they gone yet? Good. Now we can talk about this shadow business. Do you remember when you first started using loupes, how they made you sit up taller, take notice of things you never saw before, and how it is now that you cannot imagine working without them?

About a month ago I hooked a tiny little light onto my loupes in hopes that it would keep my back straighter. I didn’t really expect any more than that. At first it was nice, the light was whiter and just about the same intensity as the incandescent overhead light. Hmm. Then I realized that I had the power turned all the way down on the battery pack. What happened when I began dialing the light up was nothing short of a knee-trembling-Thank-You-Jesus epiphany moment. THE SHADOWS WERE GONE! I didn’t know that there were shadows in people’s mouths before. I didn’t realize that the shadows were extremely annoying in people’s mouths. I didn’t know that you could visualize the distal of tooth numbers 1 and 16 in full spectrum light and see down into that 4 mm pocket that never gets cleaned and scoop out that little yellow goo like a miner panning ankle-deep in a river of gold.

When you have a light attached to your glasses, it always spotlights your focus point exactly. It goes where you go (ouch! just don’t look your patient in the eye through your loupes). It helps you save time because you’re not always reaching up and adjusting the handle of the overhead light. And patients like it when they don’t feel like they’re in an interrogation session. It’s so free and breezy above the chair without all that equipment hanging over their heads.

Now that I’m using a headlamp it really is like a whole new world opened up to my eyes. It’s like the first time I started using loupes all over again. It’s like. Well it’s like something I should have done forever ago. The only two things that were holding me back until now were comfort and cost. I didn’t want to pay over $600 for what is essentially a flashlight. And I didn’t want it to be inconvenient to wear.

After evaluating just about everything offered at the dental meeting booths, one choice has ultimately claimed its place as my new pet: the LumaDent. Don Ton, DDS is the CEO of LumaDent, Inc. and he packs a great story about how his company got started from a DIY project, so I couldn’t resist supporting his business. Okay, I could have resisted if his product was no good, but in my opinion it is the best dental headlight available, for many reasons:

The Price. It is extremely reasonable for a niche market like dentistry. If you find it’s hard to swallow, geez, build it yourself. You’ll still need a battery pack, which you can purchase a la carte from LumaDent.

The Package. Totally turnkey. You get a rechargeable battery pack, a charger, a hip holster, a mount made especially for your type of existing frame, an orange filter, and all sorts of things to help you control your wires. If you have problems along the way, Dr. Don will make it right until you are happy.

The Promise. You hope that it will be comfortable. At 5 grams and a lens no larger than the size of a dime, the LumaDent weighs almost nothing. The headlight is only noticeable because of the wires. If you’re patient and work with the wires to learn how to wear them, they will be no more difficult to put on and take off than a tie. And as I stated before, the quality of the light is exceptional.

If you’re getting the idea that I was somehow coerced into this endorsement with money or discounted product that’s not the case here. I simply love my loupe light, I love juxtapositioning Punxsutawney Phil with shadowless dentistry and I hope to inspire you to see the way you practice in a whole new….

…way. Ha. You thought I was going to say light.

by Trish Walraven

Stanky Moufs, Stanky Moufs, I want to rid the world of Stanky Moufs. When a patient sits down in a chair with a freshly-stanked cigarette mouf, that smell hangs in the operatory longer than their jacket.

Is the American Lung Association with me? NO! Maybe it’s because they’re still getting a part of that $206 billion settlement from Big Tobacco back in 1998. Can’t put their sugar daddy out of bidness.

Well then, is the government with me? Not really. The government wants to tax those stanky moufs for recreational nicotine use, and they want to regulate the patches, gums, and lozenges being sold as medical devices designed for smoking cessation.

How many smoking patients do you have that don’t want to quit? They’re not supposed to admit to you that they really love smoking, now. Especially not to you. But more and more of them are coming into my practice, breaths a-bloomin’, tissues pinkin’, and when I ask them if they quit smoking, they don’t say yes. They say that they’ve switched to e-cigarettes.

RRRrrrRRT ( that record scratch stop noise that’s used too much in media but I can’t help myself). WHAT THE?  WHAT IS AN E-CIGARETTE?

I Gurgled it. Gurgling is kind of like Googling except that you ask your patient an open-ended question while they’ve got a little spit in the back of their throat that they really don’t have but they think they do and they want you to suck it out before they answer the question.

Best answer I got: “Well, everyone in our office either got a supply of E-Cigarettes if they would quit using regular cigarettes, or $200 to use on themselves if they weren’t smokers.” An employer has gone out of their way to get tobacco out of the bodies of their workforce. This sounded BIG.

That’s when the internet got much more handy than Gurgling. Here’s a great description of an E-Cigarette from AlterNet:

The e-cigarette was invented in China in 2004. It’s a cigarette-shaped tube that contains a rechargeable battery, a mini-vaporizer, a small reservoir, sensors and, in most cases, a light on the tip. The sensor notes when you take a drag on the tube and turns on the vaporizer, which more-or-less instantaneously turns the substances in the reservoir into a stream of visible water vapor that mimics the taste and feel of tobacco smoke. The tip glows like the end of a lit cigarette with each drag. It’s infused with the taste of tobacco – or tobacco combined with other flavors for those who are into that sort of thing – and nicotine, in various doses (including none at all). The refill cartridges – which look like the butt of the cigarette–give you about the same number of drags as a pack of cigarettes, but cost around $3 each – a bit more than half the national average and a third of what a pack of smokes go for in places like New York City.

The next question everyone asks is “Is it safer?” (I must stop with the Marathon Man references…this is only my second offense, sorry!). But really. Are e-cigs safer than tobacco? I for one am totally convinced that they will kill you much, much slower than tobacco, and far slower than water (if you’re drowning in it, of course). It’s the combustion that creates the majority of carcinogens found in cigarettes, which is why no real smoke is safe. The vapor ingredients in an e-cigarette – propylene glycol or glycerin – are Generally Recognized As Safe (GRAS) by the Food and Drug Administration. The problem arises when you don’t know what else is being added to the cartridges. Like Cialis. No joke. You can get some Cialis to smoke in an e-cigarette here. What about a dangerous, banned weight loss drug? They’ve got that too.

These extreme additives are all the excuse that e-cigarette opponents need to try to get them banned in the United States. That’s why no one will touch this issue, especially with the FDA coming down hard on new tobacco products in March. The federal courts are leaving it alone for now, but arising is a vast current of e-cigarette fanboys. They call themselves Vapers, and their recreation? Vaping.

What do you prefer? Stank Mouf or vape mouth? If your patients are committed to their cigarettes, it might not be such a bad idea to turn them on to something that may do less harm than their current habit.

I don’t know about you, but my ops are smelling better already. 

The next time your patient makes a yuck face at you with the accusation that the stuff that just hit their tongue has the most awful flavor EVER, you need to be sure and come back to this blog to share your experience so that your offending dental material can be rated accordingly.

For now, you’ll have to settle for this Top Ten, which was created by someone who is so meticulous about isolation that they never (!)  get complaints about the taste of the following products:

The Top Ten Worst-Tasting Dental Materials

10. Air polishing powder

Some people like the taste of baking soda, which is why this is at the high end of the list. Others, you’d think that you’d hit them with the entire Pacific Ocean with the way they wretch from the spray. Young Dental has one of the better products in this category. And most patients actually do prefer it to the grit of pumice prophy paste if an operator is good at managing an air polisher.

9. Impregum Penta impression material

Fortunately the second generation flavor is much better than the first. But what is with the aftertaste? It’s not like you can use a rubber dam when taking a full mouth impression.

8. Vizilite rinse

Sour flavors seem to go over worse than salty ones. And because this cancer-screening pre-rinse is essentially vinegar, you may get a dirty look right before you start checking for the dirty bombs that are cancer cells.

7. Jeltrate Plus

Yum. Unflavored alginate with a splash of antimicrobial quaternary ammonium compounds to give it a little bit of awkward je ne sais quoi.

6. Compounded tricaine topicals

This is like benzocaine on steroids. Because it is not available in a commercial formulation, you’ll have to have a pharmacy compound the gel for you. John Hollis Pharmacy whips up a pretty mean cocktail of lidocaine, prilocaine and tetracaine at a decent price. It tastes pretty bad, but when patients rave about your painless injections afterwards, you’ll want a tube of it in every operatory.

5. Parkell Mucohard relining material

Not only does it taste foul, it gets bonus points for heating up while it’s curing in your patient’s mouth. This PDF from Parkell even cautions against leaving the patient alone for fear of spontaneous combustion.

4. Septocaine

Even a few drops of the local anesthetic inadvertently dripped onto the back of the tongue will make your patient want to chew through the stainless steel of your syringe. Be careful or else you will be switching back to lidocaine.

3. Viscostat hemostasis gel

Great for getting a lot of bleeding under control. Unless that bleeding is on the tongue. Then, not so great. Ultradent has addressed this notoriety by bathing their latest Viscostat with mint flavor ribbons. But I’m sure you can still taste the caustic astringency that would make bleeding to death not seem so bad.

2. The goo under a loose crown that you just removed

Can we all gross out at this one for a moment? And hahahahaha, they can’t blame this flavor on you. Which brings us to:

1. RelyX Unicem cement

Stag-nasty payback for that loose crown you just had to smell. RelyX gives you the ultimate in sourness and bitterness that lasts and lasts (but so does the bond).

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Why more dental product manufacturers don’t try to mask the noxious flavors inherent in their materials is a question that can’t be easily answered with chemistry or economics. If you’re not one to wait on this development, let your patients choose the flavor of their next crown seat or impression tray instead by carefully slipping them a few drops of one of these flavoring agents that are especially created for that purpose.

Pearson Dental Supply Flavorings

Practicon Flavorings for Alginates

Dental A to Z Flavor Set

jazidental Flavor Drops

American Dental Supply Flavor Kit

And when you ask your patient how everything tasted, they can honestly tell you it was just peachy. Or grapey, their choice.

Now it’s your turn. Which materials taste the worst to your patients? Leave a comment below to cast your vote.