DentalBuzz Staff

Amabrush cleans your teeth in ten seconds

June 27, 2017 By DentalBuzz Staff 21 Comments

What do you get when you start with a silicone sports mouthguard, embed it with hundreds of tiny bristles, and magnetize a rechargable toothpaste ball that vibrates and cleans all of your teeth at the same time? DentalBuzz recently sat down with the inventor of the new Amabrush to find out where this thing came from, where it’s going, and how to get one.

____

DentalBuzz: Hi Marvin. Thanks for joining us here at DentalBuzz. What’s the story? Tell us about yourself and your company, how you got into the business of toothbrushing, where the name Amabrush came from.

Marvin Musialek: Thank you for having me! Well, my name is Marvin and I’m the founder of Amabrush, a completely redefined toothbrush. I came up with this idea 6 years ago. I brush my teeth twice a day, not because I want to, but because I have to, and this is every dentist’s advice.

Six years ago I stood in front of the bathroom-mirror as usual, and asked myself, “Why are we on the edge of self-driving cars, but we all still have to stand in front of the mirror and put a stick with nylon-bristles into our mouth, in order to clean our teeth?” Since then I thought about an autonomous cleaning-robot-thingy everyday. Three years later there was still no product like this on the market, and I simply decided to “do it on my own.” I did a lot of research and put a strong team together from many disciplines: dentists, biomedical engineers, physics engineers, electronic engineers and even a psychologist. We had to clarify even the simplest questions with a scientific approach. Why are we brushing our teeth? How should we do it correctly? How much toothpaste? What angle should the bristles have? And so forth. We have been developing Amabrush for the last 3 years and have also received grants from the Austrian Government and the European Commission. With our own money and these grants we were able to finance the cost-intensive development of numerous different prototypes, test-units, pre-production-devices and expert-consultations. Our redefined toothbrush should be seen as a stable and good friend, who takes over an annoying and time-intensive task (toothbrushing) for everyone. So we decided to call it Amabrush, so people who ask “what’s that?” will get their answer: “I’m a brush.”

DB: Since it doesn’t look like a typical brush, that’s perfect! And endearing. Kind of like the name talks back to you when you say it.

Now, you’re in Austria but also have offices in San Francisco? Before everyone in the United States gets addicted to using your brush, we want to make sure that replacements will be easily available. What percentage of your sales do you see coming to the US once you’re in the retail market?

MM: Yes that’s right. We estimate that 50% of our sales will take place in Europe, especially in German-speaking Europe (Germany/Austria/Switzerland) and the other 50% will take place in North America, especially in the United States. This coincides with our research and as well with our current subscribers, who are also equally distributed between these two regions. Because of that we want to produce Amabrush in these two different regions in the long run.

DB: You have subscribers already? For a product that they can’t even get yet? Okay, so we haven’t even talked about the toothbrush. You’re estimating that its retail price is going to be around $200. While you can’t put a price on good dental health, there have been regular electric toothbrushes in this range for years that have proven not to work any better than the $60 version of the same brand (yes, we’re talking about you, Sonicare). Explain what it is about the Amabrush that puts it far ahead of its competition, and why it is a value at $200.

MM: Yes indeed. We already got 7000 subscribers within a month, which is really, really great. That proves to us that our community is as excited as we are about a toothbrush that takes over the task of toothbrushing. There are many low-priced electric toothbrushes available, but also many high-priced ones. The cost of Amabrush is more to the mid- and high-range, but the brush itself is really high-end. We had to develop everything from scratch, like the micro-pump that foams the toothpaste, the specially formulated toothpaste itself, and the mouthpiece, which was one of the most complicated parts. Not only because we use an uncommon material (anti-bacterial silicone) with a specific toughness, but also because of the integrated, carefully arranged bristles and the micro-channels that deliver the toothpaste directly to the customers’ teeth.

DB: This has the potential to change everything we think we have to do to take care of our teeth. A silicone mouthpiece instead of a handle that you hold as you move a small brush around your mouth, brushing every tooth at the same time, Bass method bristle alignment, self-contained toothpaste, sonic vibrations. If this brush is capable of consistent and thorough plaque removal, then you may have just created the holy grail of preventive dentistry. When and where will customers get the Amabrush once they’re available to the general public?

MM: We have to explain this completely new concept of toothbrushing to people a lot. Amabrush is currently “online-only.” The simplest way for people to inform themselves about Amabrush is over the internet with our online-shop and our website. But in the long run we definitely want to bring Amabrush into grocery stores and drug stores, because the majority of people still buy personal care products “offline.”

DB: Do you see an application for people whose hand dexterity is limited?

MM: Amabrush is definitely also for people with hand disabilities. We developed Amabrush on purpose as a hands-free device, not only that it is as convenient and automatically as possible, but also that there is no barrier in order to use it.

DB: What does it feel like to use?

MM: It feels like if someone else brushes your teeth with a soft bristled toothbrush paired with the feeling of a gingival massage.

DB: So it’s sort of like having your teeth cleaned by a professional? We would imagine that would be pretty effective. What kinds of plaque index scores are you getting; in other words, how well does the Amabrush actually clean compared to manual or other electric toothbrushes?

MM: That’s true, it does a pretty good job at cleaning your teeth! We’ve had plaque index scores calculated by an independent clinical institution and have been pleased with the results. What’s worth knowing is that Amabrush is not necessarily better than a regular manual or electric toothbrush, because common toothbrushes work good enough if they are used properly. The thing is, Amabrush is way more convenient. You can do so many things wrong with a regular toothbrush, as you have to be highly concentrated for at least 120 seconds each time you brush your teeth. And while brushing, you should use different methods like the Bass method paired with the red-white technique. This is not only time-consuming, but also annoying for most people. Because of this, people usually tend to do something else while brushing their teeth. Furthermore, they put too much pressure on the toothbrush which can damage their gum. What’s more, most of the people don’t brush their teeth long enough. Amabrush cleans your teeth the same every time, with the right technique, and does not depend on your concentration.

DB: What it sounds like you’re saying is that the problem with electric toothbrushes is that manual ones are just that – they have to be moved around with your hand, so even if they’re the best at what they do, they’ll still miss areas because the human being attached to the hand doesn’t apply the brush properly. The Amabrush provides hands-free brushing at a fraction of the time? Very novel.

Back to your subscribers, then. How can subscribers order the Amabrush? How can I get one as a consumer? What do I need to do?

MM: Interested customers can subscribe to our newsletter right now on our website. We created a landing-page that explains all relevant information and details about Amabrush and the upcoming Kickstarter campaign. Speaking of which, this will be the first opportunity for our customers to get Amabrush. We will start our crowdfunding-campaign on Kickstarter next week (end of June 2017). Customers have the ability to support our project, and as a return, get Amabrush at a strongly discounted price ($69 instead of $199)!

Regarding your question what the customer needs to do: simply sign up for our newsletter on our website (www.amabrush.com). We will send a reminder with the exact date of our Kickstarter-campaign to all subscribers. When the campaign is live, simply choose a package that suits best for you. All of them are strongly discounted, as this is our way to say “Thank you” to all of our supporters and the community!

DB: Dentists and dental hygienists are particularly interested in finding new ways like yours to pass on to our patients that help them keep their mouths healthy. Do you have anything more you’d like to say to us?

MM: Our pre-production units are already in the making, in order to be shipped around the globe to various dentists. We highly appreciate feedback and input from every professional expert in order to make Amabrush as perfect as it can be. We are really looking forward to the support of our community!

DB: Thanks again, Marvin for sharing your story with us, and we sincerely hope that you get all the attention that this Kickstarter campaign deserves.

MM: We hope that too. Thank you very much for the interview and the great time!

UPDATE 6/28/2017: Amabrush announced today that the launch date for their Kickstarter campaign is next week – July 5, 2017.

UPDATE 7/5/2017: The campaign is now live, with the Amabrush expected to begin shipments in December 2017. This video shows close-up vibrations of the prototype. We imagine that the production version will be even more refined.

UPDATE 8/31/2018: It’s taken quite a bit longer than expected, but today Amabrush announced that they will start to ship brushes very soon. The best part? Their testing suggests that all the hard work means that this is a true 10-second toothbrush and not a gimmick. Here’s what came in the mail:

Many patients took part in our dental studies, which took place on 3 different dates with a minimum interval of 24 hours. The tests were performed and evaluated by independent dentists. Amabrush was tested simultaneously with two different institutions and two different sets of patients.

The TQHPI (Turesky modified Quigley Hein Plaque Index) which we used as the method determines how much plaque was present on the teeth – the lower the value, the less plaque on the teeth.

Test procedure

1.) 24 hours before the test, participants were not allowed to brush their teeth. For the plaque test, the patients chewed plaque disclosing tablets so that the dentist could then determine the initial plaque values (tablet is used to make plaque visible).

2.) Patients had to brush their teeth with a regular manual toothbrush for at least two minutes. The remaining plaque values were determined afterwards.

3.) The same process was repeated for the second appointment one week later, but this time with using the Amabrush instead of the manual toothbrush. Teeth were cleaned for just 10 seconds and the dentist determined the plaque values again.

Results

The plaque index decreased statistically significant and there was no statistically significant difference between Amabrush (with 10 seconds brushing time) compared to a regular manual toothbrush (with roughly 3 minutes brushing time on average).

These results make us truly proud and show us that hard work, clever engineering and patience pays off for all of us. We hope that you also like those results, which we would have never reached without your support, help, and feedback!

Want to know when we post a detailed review of the Amabrush once it’s available and we’ve had a chance to chomp on it? Be sure to subscribe to DentalBuzz by adding your email address and you’ll automatically get notifications each time we add a new article.

Best ways to get numb at the dentist

February 3, 2017 By DentalBuzz Staff 4 Comments

Why “Painless Dentistry” Doesn’t Have to Be An Oxymoron

Dentistry has got a bad reputation!

“No offense doc but I hate dentists.” …said everyone who ever came to see me.
“I was in Vietnam and I’d rather be shot at than come see you.” …said one of my veteran patients.
“My last dentist put his foot on my chest and pulled a tooth out while I wasn’t numb!” …said most people who ever had a tooth extracted.

Why so much hate? In my personal experience, most of the people who hate dentists have had really bad experiences in the past. They’ve got legitimate reasons to be fearful. As a profession, we dentists, especially in years past, haven’t done a great job with pain and anxiety management. Uncontrolled pain and anxiety creates lifelong dental phobics.

So here’s the secret… While dentistry isn’t ever something that will be fun, it doesn’t have to be the traumatic experience that many people expect. Dentists have a huge number of different tools at their disposal to make dentistry as painless and easy as possible. For the most part, all it takes is a willingness to listen to a patient’s fears and address them with whatever tool is most appropriate.

What?!? We have more options than just “Open wide”, “It’ll only pinch a bit” and “Suck it up”? Yes! I’m going to cover all your options here, from techniques that have been around forever, to the latest advances in painless dentistry.

If you’re a dentist who thinks all dental phobics are over-dramatic and that the previous statements are appropriate, this article may not be for you. You should probably go hang up your drill and find a job that doesn’t require contact with the public. I hear dental insurance companies are always looking for cranky dentists to deny claims. Everyone else, let’s get working on ways to make dentistry better for our patients!

Old School

Let’s start with some options that have been around for a long time. Just because these options are technically “old school” doesn’t mean they shouldn’t be used. It’s my opinion they should be used far more often than they currently are today.

Laughing Gas / Nitrous Oxide
Laughing gas is almost synonymous with going to the dentist but somehow many dentists don’t offer this at all. I’ve heard from many that they find it to be too much hassle. I’ve had the exact opposite experience in my practice. The benefits of laughing gas include decreased anxiety, increased pain tolerance, quick acting effects, and an almost perfect safety profile compared to any other type of sedation. The downsides… ummm…. occasionally people don’t like how it feels and we have to stop using it. So why aren’t more dentists using laughing gas? Beats me. It is the absolute easiest and quickest way to make a dental appointment easier. I often give it away free because it makes the appointment easier for me and the patient. Easier for me + Easier for the patient = A good day!

Sedation
Sedation can range from taking an oral medication before a dental appointment (with or without nitrous oxide) all the way up to IV sedation or general anesthesia. Of all the techniques we go over here, this is by far the most challenging to get trained in and implement due to safety and liability issues with sedation. It is also the most effective option for treating patients who are truly terrified of any type of dental experience. If you’re able to offer this safely and effectively, you’ll really set yourself apart. One option for sedation if you don’t want to go through training is to look for a traveling anesthesiologist who comes to your office and does sedation while you do the dental work. This is a fantastic option where you can focus exclusively on treating your patient instead of worrying about anesthesia at the same time. There are more and more anesthesiologists who offer services like this today. If you’re especially lucky, you might even find a dental anesthesiologist who understands the special challenges that come along with sedating a patient for dental work (dental work is essentially an anesthesiologists worst nightmare).

Air Abrasion
Air abrasion uses a high pressured jet of abrasive particles to conservatively remove smaller to medium sized decay in teeth. As it doesn’t generate any vibrations, pressure, or heat most people don’t need any shots of anesthetic (yay!) to have the procedure done. Many people think air abrasion is a new technique in dentistry. It actually has been around over 60 years! Early on, it wasn’t something that was typically used because the bonding materials needed to do minimally invasive dentistry weren’t invented yet. Now that we’ve got all these great bonding techniques, somehow air abrasion still isn’t routinely used. Very few dentists own an air abrasion device and even less use it routinely. It can be especially useful on children as it is far less “scary” than a dental drill and doesn’t require a shot! Kids who have good dental experiences are far less likely to become dental phobics in the future.

This article by Dr. Gordon Christensen goes into a bit more detail about air abrasion and why he thinks it should be used far more often… http://www.dentaleconomics.com/articles/print/volume-100/issue-6/columns/ask-dr-christensen.html

New-Fangled Stuff

Distractions
I spent about $400,000 several years ago to build a brand new office. You know what makes the biggest impression on our patients? It sure isn’t the $50k panoramic machine, several thousand dollar chairs, or amazingly efficient layout. It is the $300 television mounted on the ceiling that they can watch during treatment while wearing a pair of noise canceling headphones. OK, OK so televisions aren’t exactly new to the scene. CHEAP flat screen televisions sure are though. I just saw a 37 inch TV at Best Buy the other day for about $150. This is what most dentists charge for a single filling. Considering the benefits, calling it an affordable investment is an understatement. I’ve found it to be equally effective for both adults and children.

Vibraject™ / DentalVibe™
The Vibraject™ and DentalVibe™ play off our overall distraction theme. These devices vibrate a patient’s lip while the injection is being given in order to distract them from the sensation. They’ve been proven to be quite effective and many dentists say they wouldn’t want to give injections without them anymore. If you’re talented you can pull off this trick yourself without the device. Just vibrate a patient’s cheek quickly while giving the injection. Dentists have used this technique successfully for a long time. That is about the only thing I remember about the dentist from when I was a child.

For more information on these devices visit https://www.physicsforceps.com/vibraJect-comfort-solution or https://www.dentalvibe.com/.

Compounded Topical Anesthetic
Topical anesthetic has been used for a long time to reduce the pain associated with the needle stick. Unfortunately the only topical anesthetic that is widely available is 20% benzocaine. This works OK but there are a lot better options out there. The downside… you have to get them specially compounded at a pharmacy. It’s unbelievable that none of the big dental companies have come up with a better topical anesthetic (OK I do actually know why… The FDA approval process is a bureaucratic nightmare and costs a fortune for approval of a new formulation). If anyone in dental product R&D is reading this, I’D BUY A BETTER TOPICAL IN A HEARTBEAT! Get working on it!

My favorite formulation is a compounded gel with 10% lidocaine, 10% prilocaine, and 4% tetracaine. A SMALL dab of this a couple of minutes before an injection does wonders to almost entirely eliminate the pinch of the needle stick.

There are a good number of other formulations but most are some variation of these anesthetics. Some compounding pharmacies offer to add 2% phenylephrine to the gel to prevent but I do not recommend this. Any of these gels with phenylephrine seems to cause high incidence of tissue sloughing in the area where the gel was applied. I’ve only rarely seen minor tissue sloughing with the plain mixture of anesthetics. Once you use compounded topical you’ll never want to go back to plain benzocaine again!

Buffered Anesthetics
Even if the needle stick during a shot is totally painless, the shot can still hurt. Why is this? Most anesthetics used in dentistry are quite acidic. When they are injected they cause quite a burning sensation. This sensation can be minimized by injecting very slowly but people will still occasionally feel it. A couple of years ago a system known as Onset™ was introduced that buffered the anesthetic with sodium bicarbonate in order to bring it up to a more neutral pH level. Buffering solutions is commonly done in medicine but really hasn’t been used in dentistry up to this point. When anesthetic is injected with a pH close to physiologic levels, the burning sensation is almost entirely eliminated. In addition to reducing the burning it also dramatically increases the speed that the anesthetic takes effect. Mandibular blocks are fully complete within a minute and a half. You don’t even have to leave the room before getting started. There are a couple of other buffering systems that have come out since then but Onset™ remains the standard.

Stanley Malamed (You know, the guy who basically wrote the book on dental anesthesia) is a big fan. You should be too!

For more information on Onset™ visit http://www.orapharma.com/products

The Wand™
The Wand™ is a computerized anesthesia device that injects anesthetic at a controlled rate. As we discussed with buffered anesthetics, the rate at which anesthetic is delivered determines whether that uncomfortable burning sensation is felt. The Wand™ keeps this from happening by injecting at an extremely slow and controlled rate that is controlled by a computer, instead of your hand. Interestingly enough, the slow injection rate also provides higher success rates of getting people numb. One additional benefit to The Wand™ is that it looks far less scary than a typical dental syringe. Perception counts for a lot in how pain is experienced. The Wand simply looks like it will hurt less.

For more information on The Wand™ visit their website at http://www.thewand.com/.

Lasers
Lasers are very slowly making headway into dental offices. They can be used to remove tooth structure, oftentimes without any need for an injection. Due to how the laser pulses it actually induces some analgesia in the nerve of the tooth. It is truly needle free dentistry. There are some major downsides with lasers at this point. They can’t remove all types of materials from a tooth like a dental drill can, there is a huge learning curve, major magnification is required, and lastly the units still are wildly expensive (think $100kish). When the price comes down, I think they’ll start showing up in more dental offices but I don’t expect them to replace dental drills anytime soon.

For more information on dental hard tissue lasers you can visit http://www.Biolase.com, http://www.convergentdental.com/solea/, or https://www.lanap.com/laser-dentistry/periolase-mvp-7/

Kovanaze™
Kovanaze™ is the first needle free anesthetic option that I know of. Kovanaze™ was approved in the summer of 2016 by the FDA for use as a dental anesthetic and became available for purchase towards the end of the year. Kovanaze™ is a combination of the anesthetic tetracaine and oxymetazoline. This solution is sprayed up the nostril and provides anesthesia from the premolars to central incisor on the same side. Second premolars have a success rate around 64% while the first premolar through central incisor have a success rate of 96%. For major anterior work, such as veneers, this is a game changer. I know that I personally hate giving injections for the maxillary anterior teeth due to the sensitivity of the tissues in this area, especially around the centrals. Going from multiple painful injections to several painless nasal sprays makes these procedures far easier and essentially painless for patients.

The big downside at this point is cost. As of the time of this writing it costs approximately $600 for 30 sprays (or 15 doses as each dose requires two sprays). This is cost prohibitive for routine use by most dentists. Hopefully the price will start to come down and it will come into more routine use in practice. This would be a huge win for patients in general. Injections don’t bother me that much and I’d still pay extra just to have this type of anesthesia. My guess is that I’m not the only one.

As cool as needle free anesthesia is, the real story I’d like to hear is how the inventor originally came up with the idea of nasal spray anesthesia. Also, who was the unlucky person to be the original test subject?!?

For more information on Kovanaze™ you can visit their website at http://www.Kovanaze.com

There are so many different options out there for making dental care easier for patients. Not all of them have to be difficult or expensive. I’d highly recommend that you pick just one of these tools to implement well in practice and see what a difference it can make. Even better, pick several that you don’t currently offer and put them in place. I believe that comfortable patients will be happier, trust us more, and follow through with treatment which is ultimately a win-win for everyone.

About the Author:
I’m Dr. M, a regular dentist with aspirations of being a tooth saving superhero. My website, The Healthy Mouth Project is dedicated to educating and equipping patients to take control of their oral health.

A hygienist’s answer to “what do you do?”

March 11, 2015 By DentalBuzz Staff 8 Comments

If you read Dentaltown Magazine, you may have received the edited, paper version of this article today in your snail mail box. But because I don’t have to make room for saliva ejector advertisements in the sidebar (seriously, this article helps sell SALIVA EJECTORS!) you can enjoy the original here in its more raw form.

A hygienist’s answer to “What do you do?”

by Trish Walraven RDH, BS

You’re at a gathering of acquaintances, a general hob-nobbery of casual conversing, one of those social obligations that you love/hate because you’re really more of an outgoing introvert, someone who plays well with others but enjoys their quiet, navel-gazing world too. Sooner or later you know that the question will be asked.

“So, what do you do?”

No hesitation here. You know what your profession is. You have a title, a position, a calling.

Then that inner part of your thinking begins to twitch.

You weren’t asked about your job title, actually. You were asked a direct question: What do you do?

The typical reaction of hearing that you’re a dentist or hygienist involves a full disregard of the art and compassion that you put into your profession. People want to tell you about their bad experiences as a child, or how much they hate you (but don’t take it personally!). They just nod, warily, quietly, at your response and quickly think of a way to change the subject.

Instead of giving away the conversation and letting it slide into other people’s thought bubbles, then, you can steer the dialogue back to the original question, and the feel-good answer you’ve prepared instead.

“I take care of people’s teeth.”

You’re a regular Mother Theresa now, aren’t you? The way you dedicate your life’s work to helping others, it’s so freaking noble. This response elicits a smile of comfort and familiarity from your obligatory small-talk partner. The conversation can move forward now that your profession has been deemed socially acceptable.

An hour later, driving home, you’re blissfully alone with your thoughts, rewinding your earlier social interactivity, musing over the highlights, and you really, deeply, ask yourself in hindsight, “what do I do?”

I can’t speak for dentists, but if you’re a dental hygienist, you do some pretty strange things, actually.

First of all, perfection to you is wave-shaped. It’s the curve of a thin scallop of attached pinkness that anoints each interproximal space with a coral-tipped point of the healthiest gingiva imaginable. Anything less than this in your patients’ mouths is limbo. Chaos is the reason your job exists, but you always hunger for order and balance. To achieve this imagined perfection in a mouth that is not optimal, then, means that you often resort to some diversions along the way. It’s about the journey, not the destination, right?

How do you handle the patient whose lower anterior linguals are piled with a couple of grams of Grade A calcium phosphate? Sure, you could just chunk the calculus off. But sometimes, when you’re feeling a little dastardly, you carve out the top and the bottom of the tartar evenly, so that you’ve left a neat chalky white mustache, complete with curlicues. With artistic satisfaction, you turn your attention back to your duty and politely erase the Banksy-esque dental graffiti from your patient’s teeth.

This is not something you tell people that you do.

You also tell no one that your deepest fear is running into anything artificial while you’re cleaning someone’s teeth. Your ultrasonic scaler turns into a fierce lead pencil in those situations, which means not only that you are wearing down your precious metal antennae into useless nubs, but also that you’re leaving dark lines where there was once only whiteness. Every last bit of old orthodontic cement has now been revealed like a charcoal rubbing, thanks to you. And you would never admit to leaving a grey streak on a brand new porcelain crown. How could you slip like that? You hope like heck that the prophy paste will get that scary line off before anyone notices.

When it comes to things that you enjoy, then, there’s a bit of hesitation about sharing those stories as well. Like hovering around the periapical abcess that’s begging to be relieved? Or when you’re spraying baking soda slurry under a bridge and the patient becomes aware that its odor speaks more than the thousand words that you could ever say about superfloss? To you the stink is like scoring a point. Or why your trophy at the end of a particularly difficult appointment is a 2×2 gauze loaded with something that looks like buckshot, but is really your patient’s carefully extracted calculus? Fun times.

Probably the most difficult part of your career, though, has to do with patient management. Unless you’re regularly disengaging people from their mouths via nitrous oxide, there are forceful tongues, and lip pulls, and saliva ropes, and people who forget that it’s safe to swallow their own spit. Suck. Suck. Suck. Ten times a minute. At least this way they’re remembering to breathe. When they forget to breathe they feel like they are drowning. It’s not the water; they’re just suffocating because you’re blocking any chance of mouth breathing. Never mind that noses are much more optimal for breathing but whatever. Not everyone has learned how to snorkel either. And how do you convince patients that unless they just ate a handful of almonds, brushing immediately before their dental appointment won’t make your task any easier?

Then there are the patients themselves. Not just their mouths, but the whole person. Patients whose embarrassment about their teeth are the reason they haven’t been to a dentist in a while. People who not only open their mouths but open up to you, tell you their secrets, their fears, their wishes and hopes. People who trust you to take care of them, to love them, to nurture them towards health. They see something special in your eyes, and they open wide.

So go ahead and make it known out there in the big world that you’re hygienist. Or a dentist. You scale teeth. You drill teeth. No biggie. That’s what you do.

What really matters, though, are the reasons why.

Trish Walraven RDH, BSDH is a mom and practicing dental hygienist in the suburbs of Dallas, Texas. She is a bit of an an introvert when she’s writing dental articles, but you get her together with her best friend from high school and Irish festival beer and she begins to make faces like this. She also makes faces like this under her mask if her patients aren’t paying attention to her flossing instructions.

I wanna be sedated

July 28, 2014 By DentalBuzz Staff 3 Comments

By Amanda Kaestner

Oh yeah, that’s all we need.

Back in 2006, a research psychiatrist at the National Center for Post-traumatic Stress Disorder, H. Stefan Bracha, M.D., suggested upsetting dental experiences could install PTSD in patients, which might then last their entire lives. Along with another couple of miscreants, Bracha advised that any caption including the word “phobia,” or “anxiety,” wasn’t humorless enough to describe the unfounded fear of our selfless, albeit remarkably remunerative, healing art.

What, then, is it exactly that sends our patients into states comparable with returning warriors who’ve experienced an imminent threat of death on the battlefield?

Thanks Again, Sir Larry

Well, patients who are edging onto the chair for an invasive procedure, obviously enough, are more fearful than those who’re scheduled for a cleaning (though we’ve all seen hygienists who seem determined to even out that particular playing field).

Assuming the dentist is warm and caring, rather than emulating Sir Larry, better known as Laurence Olivier’s character Christian Szell in 1976’s Marathon Man, the single most intimidating factor may well be unconsciousness. When you’re out, you’re unable to inhibit a negative event or experience. It’s not so much that patients expect us to slip ’em a roofie and wreak havoc with their innocence, it’s just that – in all fairness – being utterly helpless is an intimidating event for most animals. It’s lack of control… it’s…

Sedation and Anesthesia

Choose your poison. Of the several methods of dentistry sedation that ensure reciprocity on the recliner, each has its proponents, but most have problems, too.

Local Anesthesia. The injection of local anesthetic directly into the area where the work’s to be carried out; this blocks nerve impulses, thus moderating or eliminating pain signals. But it’s the jab, man. The. Jab. That needle heading inbound at their head is, for many patients, the very image which sets off their trip-hammering heart. Not nice.

Inhalation Sedation. Nitrous oxide/oxygen is a great deal of fun at frat parties, sure. It has its place in our surgeries, also, after the light-headedness and giggles give way to euphoria and sleepiness. Improperly administered, though, adverse effects can range from vertigo and nausea, through active vomiting to hallucinations and unexpected flash-backs (and couldn’t we expect that to bring on driver lawsuits, were the fact widely known).

Intravenous General Anesthesia. Voila! The Cadillac of the comatose. An intravenous (IV) catheter is inserted into a vein and from there, an infinitely-controllable amount of anesthetic happiness is introduced. Just a few good drips and the patient is in a safe state of unconsciousness, allowing the professionals to get to work without any major side effects after all procedures are said and done. To the patient’s benefit, there’s no sensation of pain at all, and no memory exists afterward of the entire time he or she was “under.” More and more practices are looking to this form of sedation as being their one and only form because it’s just that safe, comforting, and effective. For example, Advance Dentistry, a well-known practice in Cincinnati, has found that IV sedation helps the dentist because it reduces the risk of movement, and it provides maximum comfort (or minimal discomfort, I suppose) to the patient no matter how much work he or she may need done. It’s not uncommon to see IV sedation being their primary option for dental anesthesia. Furthermore, recovery from this form of anesthesia is typically swift and complete, with little or no “hangover” effect as one would see in the other forms listed earlier, so the patient’s free access to their credit card is seldom impacted.

We’ve come a long way since the early 19th century where anesthesia wasn’t even a thing in any surgical practices, much less dentistry. But thanks to Horace Wells first introducing nitrous oxide to his procedures back in 1845, we can honestly say that going to the dentist in today’s world really isn’t that scary of a thing. So look at your options when you go to the dentist and ask about other forms of sedation. It’s a far cry from “pass the liquor and bite down hard on this stick and let’s hope we don’t have to amputate anything from aftermath infection.”

How to talk to patients 101

December 6, 2013 By DentalBuzz Staff 4 Comments

dentistpatientcommunication

Have you ever wondered what kind of courses patients think you missed out on in college? They probably will never notice that you totally bombed the gold foil technique (neither will any dentist under 70, for that matter!). But they do wonder what you were taught about dealing with humans – the personal side, instead of the gushy clinical stuff.
Enter a bit of collegiate satire from a patient’s perspective. New DentalBuzz contributor Carolyn Roche has eight children and five grandchildren, a BA in Political Science from the University of Michigan, and is now studying English at Dixie State University in St. George, Utah where she lives with her husband, soon-to-be missionary for the Church of Jesus Christ of Latter-day Saints daughter, and two dogs. She occasionally begins her day with Special K, and would like to share this delightful suggestive nudge with all dentists and hygienists practicing now and into the future.

Lecture Notes on Dentist-Patient Communication

by Carolyn Roche

Professor Samuel Rose
Algonac Dental School
For Tuesday October 15, 2013

Today’s lecture is about communicating with your patient. No one wants to be the Frank Burns of the dental industry. You want your patient to have confidence in your wisdom and know that you will work on them with compassion and competence. We will discuss some guidelines about how and why you should maintain rapport and communication with your patient.

Acceptable Subjects of Conversation

Before you begin chewing out your patient for not flossing, break the ice by conversing about the following:

1. The weather. You can always jaw about the weather. Your patient has just come in from outside and can give you valuable updates. It will help them feel helpful to you.

2. The family:

a. You can drill him about his family. People always like to talk about their family.

b. You may talk about yours. You can forget about what Thumper said, “If you can’t say something nice, don’t say nothing at all.” It’s best to be honest with the patient or he won’t believe anything else you say. Tell him all the good and the bad about your family. Being open will encourage him to trust you as an honest person and like you as well. No one likes a goody-goody.

3. Recent acceptable news.

a. Crime. The patient will be happy to know which side of the law you are on. Always root for the good guy even though the bad guy is your brother. This could be another chance to talk about your family! Include all the crime details.

b. The economy. Let them know how much you earn and how much you have stashed away in safe investments. You will want to make an impression on them. Then make sure they pay the bill.

c. Medical news – if it throws a good light on professionals. If you have botched up anything recently, the patient will want to know the truth from the false rumors. Speak of your mistakes in detail. It’s okay to show off your knowledge. The patient will respect you more.

4. Remember to not get too personal with them. Forget the nonsense about building bridges to your patients. All patients should remain anonymous to you. You will be filling cavities for the rest of your life and to make YOU feel comfortable, think that they are just another cavity or tooth extraction. You will be less nervous and your patient will be less whiney. Once you get personal they will think they can complain about the pain. You don’t need that. It just wastes time.

How to Speak to Your Patient

However awkward, you must speak to the patient while you are working on them. Speaking to the patient with their mouth full is medically necessary. Make sure you have, at the least, the Hoover and a finger and a tool in their mouth.

1. Ask yes or no questions. A nod or a grunt means you haven’t frightened them enough to make them faint. Keep trying. Don’t mistake closed eyes for a faint; they are praying. There are no atheists in dentists’ chairs.

2. Ask questions that require a full sentence answer.

a. You can determine how frozen their mouth really is. If you can understand them, additional anesthetic may be required.

b. You can sue the patient for biting you. Dentistry can be an altruistic career, but remember your $1,500,000 in student loans need to be paid off before your children begin college.

After you have inflicted as much pain as possible, needle the patient about brushing and flossing. With the pain fresh in his mind he will be more likely to follow your recommendations. When you use these methods you will be filling your patients with tremendous motivation to have the healthiest teeth possible.

If You Need Help:

One of the great benefits of attending the Algonac Dental School is the support we offer to alumni opening their own practices. For a nominal fee of $500 –plus airfare, food, and accommodations- my staff and I will fly out and assess your new practice. We will help you streamline your operation. You won’t waste a moment in a day’s work after following our advice. For only $500 more, you can have the full, written report of our analysis and recommendations. NO OTHER dental school will offer this service! Call now for a FREE ESTIMATE 1-800-555-ROSE.

+++(Copy and hand out to students at end of class.)