Trish Walraven – Page 21

Worst Tasting Top Ten

August 30, 2010 By Trish Walraven 8 Comments

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.

Anesthesia buffering: Onpharma’s Onset

July 15, 2010 By Trish Walraven 13 Comments

After all the buzz in the past two years about a new type of carpule that also starts with an “O,” you may think you’ve seen this product before. In one sense it’s similar: it must be used in conjunction with your regular anesthetic instead of as an anesthesia alternative. What’s more exciting is that this just may change the way we prepare syringes for every single patient from now on.

Onset™ is the name of a new buffering agent created by Onpharma™ Inc. that will be available as soon as the final FDA review is complete. If you can answer yes to these questions, read on:

Do you want to eliminate the sting that can be caused by the acidity of local anesthetic?

Would you like to be able to give an injection and go to work immediately?

Are you interested in a product that will help you get your patients profoundly numb, even when infection is present?

What about tissue necrosis? Would you like to prevent it if possible?

[Read more…]

To juice or papoose is the question

July 1, 2010 By Trish Walraven 22 Comments

papooseormask No one likes the idea of seeing a child being restrained. Especially not at the dental office. But on the same hand, if a child is admitted to a hospital, has thousands of dollars spent to knock them out with potentially risky gas, and is in need of a procedure that takes only minutes to perform, which care is the right one?

Notorious press has given the papoose board a bad name. Granted, its utilization can be abused, especially as seen in the story that was profiled on ABC’s 20/20. General anesthesia isn’t without its opponents as well, especially when a child dies.

With that somber note hanging in the air, you may want to revisit David After Dentist and pick yourself up with a little sedation dentistry humor. Even if you don’t agree that his dad should have ever posted the video on YouTube, it’s still so freakin’ funny.

Children who can’t be cooperative still need a means of getting their dentistry done, so pedodontists must make choices that sometimes include the use of papoose boards or general anesthesia. For entertainment’s sake, let’s just call this polarizing dilemma by another name: Hugs vs. Drugs.

	Hugs	Drugs
Familiar name	Papoose board restraint	“Knocked out with the mask”
Kinder-sounding euphemism	Protective stabilization	Inhalation anesthesia
Risks	Creation of dental phobias Inadequate relaxation resulting in poor pain management Difficulty in treating a lengthy, complicated case	Aspiration May affect the developing brain (autism/ADHD) Death
Benefits	Can be used quickly and inexpensively without much training	Instantaneous and complete patient control
Perception	Brute force and inhumane treatment seen in Medicare clinics	Clean, modern care paid for by inscos and private payer

There have been accusations from both sides: allegations of “nest feathering” by morally outraged dental anesthesiologists, abuses of public funds to pay for unnecessary procedures, the ultimatums given that any child restraint is considered grounds for lawsuits, equating papoose boards with third-world dental care, or offering general anesthesia for simple extractions when a combination of restraint and other sedation would be less expensive and as effective.

As a dental professional, it is your responsibility to make well-informed choices about sedation and restraint methods. For instance, individuals with autism or cerebral palsy may find that restraints are not only necessary, but even welcomed when compared to the use of drugs that can do more harm than the good that the dentistry is trying to achieve. Restraints may not be a better choice for toddlers whose biggest problem is a helicopter parent or two who are freaked out about the psychological trauma of having an irreparable tooth pulled. If a parent freaks, most likely so will the child, so it may be your choice to pander to the whiny world of children who are more in charge than their parents. After all, it’s no big deal to go under GA for a five-minute ear tube procedure with the ENT, right? That’s expected.

No matter what you decide to do, as long as you’re doing it from a level of comfort with your ability, and most importantly, from a sense of compassion, you should be able to confidently make the call for each patient, no matter where it falls on this line.

But sometimes, you just want to throw up your hands and say “AHHHHH I QUIT!” because you don’t know how to manage a patient. That’s when it’s awesome to have someone in your contact list who you trust to make this call.

And then pass the buck to them, because referring out can be very, very gratifying at times.

Dental Infection Control Sucks

June 11, 2010 By Trish Walraven Leave a Comment

So maybe it was the equipment allowing backflow into patients mouths during extractions (blecch), or inadequate sterilization measures, but whatever the case, Hepatitis B has been officially contracted during dental procedures.

A free, volunteer-staffed program offered at a West Virginia high school found that three patients and two clinicians came down with Hepatitis B viruses that were tested and matched at a molecular level, indicating that the infections came from a common source.

All people involved at the Mission of Mercy clinic last summer were mailed letters last week encouraging that they be tested for the virus. The testing is being paid for by the state of West Virginia. (Insert your best West Virginia joke here. And then be ashamed of yourself for doing it).

If you have any response to this news, it should be to check your own infection control systems, to be sure that your high speed evacuation is up to par, that you aren’t just wiping down handpieces, and that every patient is treated with those universal precautions that were so important in dental school.

After all, you wouldn’t want this happening in an elite state, like Washington.

What music goes with teeth whitening?

May 20, 2010 By Trish Walraven Leave a Comment

LiteWhite

This company knows better than to show what a person looks like wearing cheek retractors. But the bald dude in the tradeshow booth just couldn’t keep his mouth shut, and so has inadvertently revealed the eerie side of DIY whitening treatments.

If the silly little LED lights aren’t bad enough, the company has solved the apparent problem of “what to do” for the hour-long treatment process: built-in music headphones for your MP3 player.

Ahh, the fringes of the ZOOM-persuaded target audience make one smile and wince at the same time. Thanks to Engadget for the help with next year’s Halloween costume.

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