by Trish Walraven

Rubber dams, meet silicone simplicity! Awkward assistants, take your cheek retraction and spit-sucking attempts elsewhere. You have both been banned from the operatories where isolation mouthpieces rule supreme.

First brought to market in 2005, Isolite™ Systems originated the idea of combining dryfield illumination and isolation in a patented product called the Isolite, which costs about $1700 per operatory to set up. Whoa, steeeeep. The tubing and LED Smart Stick sure isn’t their loss leader, now, is it? Then you still have to buy a $2.50 mouthpiece for each patient because they’re not sterilizable. All of it together is still easier and less expensive than your assistant.

But what if you want to keep your assistant, even though she kicks you under the chair all those times you say something stupid to a patient or start getting all OCD over a procedure? You’ve already ditched your overhead lamp for loupe-mounted headlights, so maybe you don’t even need the Lite part of the Isolite.

About a year ago, Isolite™ Systems indroduced a non-illuminating version called the IsoDry that runs a little less than half the cost of the original product. Both systems come with extra tubing. Tooobing. Makes me want to laze down the Guadalupe River with a six-pack in a styrofoam cooler. Don’t we have enough tubes and hoses to twist around each other already?

This brings us to the essence, the soul, the very magic of what makes the Isolite System the game-changer that it has become. It’s all about the mouthpiece. This transparent, comfortable, easy-to-insert soft piece of silicone not only attaches to high-speed suction to create a dry field, it replaces bite blocks, throat packs, cotton rolls, drying angles, and everything else that you used to cram in your patient’s mouth to create a perfect restorative environment.

But in order to use the mouthpiece, the rule is, you have to buy an Isolite or an Isodry. You can’t just stick it onto your high-speed suction and use it solo.

Or can you?

Mark Frias, RDH, can hook you up to go commando. Literally. He’s invented a hook-up mod for the Isolite mouthpieces that must have been driven by the frustration of trying to keep a squirmy six year old’s teeth dry for sealants with traditional isolation. You can see the differences between his design and the original Isolite on the left. It’s not sleek and sexy, but from a cost perspective this little adapter is a no-brainer. Mark calls it the Kona Adapter. Why? Is he an Ironman Triathlete from Hawaii? Actually, I think he named it after his dog.

Whatever the case, the ingenuity here is striking at a great moment. Mark is having difficulty keeping Kona Adapters in stock if that’s any indication of its demand.

For those who are concerned about taking business away from Isolite, Mark suggests purchasing a single system for one of your operatories and fitting the rest with Kona Adapters. This will give you the privilege of being an official Isolite customer so that you can be assured that you aren’t buying mouthpieces on the down low.

And everyone really wins here. Isolite could give the system away like Gillette gave away razor handles to sell you the blades for the rest of your life, or use the printer model: sell the hardware cheaply to lock you into high-priced ink refills. It’s not like Isolite Systems is exactly losing money on the mouthpieces. With this new adapter, Isolite can now make money from the dental practices that may have not been able to justify a whole-office use of their product.

So slippery-gripped assistants everywhere: Ding! You are now free to move about the office. Your hands have finally been relieved without a significant lightening of your employers’ bank accounts.

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.