• Archives
  • Products
  • Operative Dentistry
  • Dental Team Communication
  • Practice Management
  • News
  • Research
  • Dental Debates

DentalBuzz: a jolt of current

trends, innovations, and quirks of dentistry

  • Home – Latest Buzz
  • Bloglist
  • Indie Dental Showcase
  • Free Dental Timer
  • Practice printables
  • Podcasts

The Prophy Jet Challenge

May 28, 2019 By Trish Walraven 4 Comments

Why you should improve proficiency at air polishing

No, we’re not daring you to eat your Prophy Jet. Read on.

What has changed little over the past 50 years and is the most performed yet overvalued service provided in dental practices? If you guessed rubber cup polishing, you’d be correct.

Overvalued? Sure—from a health perspective, polishing is more or less a cosmetic procedure. Then why do most patients still get their teeth polished with prophy cups and paste? It’s certainly not because it’s the most thorough way to remove plaque and stain; if it were, we wouldn’t have the need for adjunct cleaning methods. Often, the bulk of plaque and stain is removed with curettes, ultrasonic scalers and lavage, and the polishing paste is merely the finishing touch—the smoothing out that makes everything feel nice again after a major prophy jam session.

No, the reason that rubber cup polishing is the method used on probably 90% of patients in the United States is because it’s less technique-sensitive and equipment-sensitive. Not because it’s better. It’s also because of tradition. We find that prophy polishing is the standard of care because of what we experienced as patients in our childhood and also how we were taught to polish in school. You do it not because it’s right, but because it’s easier.

Rubber cup polishing is good enough … well, at least until it isn’t. Nowhere is the incompleteness of a prophy cup polish more evident than when trying to perform one on an orthodontic patient in full brackets and wires. Only then do you switch up your routine and reach for an adjunctive polishing system. Why? Because you’re relatively inexperienced using alternatives like air polishing on a regular basis, which translates into a messy melee for you and the patient, so the trade-off needs to seem “worth it.”

The only way to combat inexperience, though, is with experience, which you won’t get unless you start using your prophy jet on a regular basis. This means you’re being challenged to replace your prophy angle with the air polisher—yes, even on patients without a lot of stain or without orthodontia! But first, let’s dispel some of the biggest myths about air polishing that may have already caused you to dismiss the thought of making this change.

Myth #1: Air polishing is too messy.

It can be, but only during the learning phase or if you’re using poorer-quality equipment.

After air-polishing my patients almost exclusively for more than 10 years, I’ve found that the Dentsply Prophy Jet and Cavitron Jet Plus machines are unmatched for not only longevity and quality but also the ability to minimize overspray. Some lesser brands may not mix the water and powder into a slurry properly, so you end up with excessive powder all over the patient’s shoulders afterward. If you learn how to adjust the powder control, better angulation, correct working distances between the jet nozzle and the tooth, suction management and even patient positioning, over time you will realize that air polishing is no more of a cleanup disaster than prophy paste.

Myth #2: Patients hate the taste of baking soda.

What’s worse when you go to the beach on a windy day: tasting salt spray or biting into a sandy hot dog? I’d much rather taste the ocean. Why? Because it’s expected. You expect to taste salt water when you splash in the waves. The same can be true for your patients if you prepare them before you blast: Let them know exactly what to expect before you use the air polisher on their teeth for the first time. Explain why you’re using it instead of pumice, and you may be surprised at how many patients are agreeable about trying something new, especially if it benefits them. Try to use a powder that has flavoring as well, because this reduces patients’ perception that they’re being scrubbed down with household cleaning agents.

Myth #3: Air polishing doesn’t clean as well or feel as clean as prophy paste.

These should probably each be their own myths, but since they’re related we’ll keep them together. While prophy paste spins around in circles and does smooth the teeth nicely, guess what? Polishing paste also has a way of exaggerating the feeling that the mouth is dirty. Maybe your patient experiences this:

  • Prepolish:“My teeth feel normal—a little grimy, but nothing I can’t handle.”
  • Midpolish: “I have a mouth full of soul-crushing tiny rocks and sand that will kill me if I swallow.”
  • Postpolish: “Wow, smooth teeth! What a relief that’s over. Much better than grit!”

It’s interesting how perception can be shaped by going to extremes. This same contrast is what makes people think that black charcoal toothpaste makes their teeth whiter. There’s not much of a “midpolish” grit with air polishing if you’re using sodium bicarbonate, however, because it has low abrasiveness—especially compared with pumice. Also, because it can be directed into pits, fissures and interproximal spaces, air polishing cleans at least 30% more of the tooth surfaces than rubber cup polishing. Be honest: How well do you polish the occlusals of molars with a prophy angle? You may be surprised at how often you’ve been neglecting certain areas of your patients’ teeth after you’ve switched to air polishing for a while.

Myth #4: Air polishing will make sensitive teeth more sensitive.

The opposite is more likely, actually. Every once in a while, I’ve encountered a patient whose roots were too sensitive for the air polisher, but the vast majority of patients with sensitive teeth do better than expected. This is likely because bicarbonate crystals are capable of blocking the openings of the dentinal tubules. Just be cautious not to hover over individual root surfaces for very long and you should be fine.

As an alternative to the Prophy Jet, there are air polishers that utilize glycine powder or erythritol. These newer powders are not only friendly to sensitive root surfaces, but they are also gentle enough to use for subgingival biofilm management.

Myth #5: The aerosol created by air polishing creates excessive contamination.

That’s why preprocedural rinsing is recommended as a universal precaution to reduce airborne bacteria—not just for air polishing, but also for ultrasonic scaling and even for prophy cup polishing. While it is true that jet polishing creates more aerosol than prophy angles, there’s not a significant difference in bacterial overspray caused by jet polishers versus ultrasonic scalers.

Myth # 6: Air polishing is more expensive.

Economics is certainly a consideration when it comes to implementing any technology. The initial setup cost for a quality jet polishing system, including an adequate number of inserts to maintain proper sterilization, can be daunting. However, once the equipment is in place, there’s much less waste compared to disposable prophy angles and single-serve prophy paste cups. The polishing powder is the only recurring expense once the system is in place, and you’ll find that the cost of it can be significantly less than polishing paste. My favorite sodium bicarbonate powder is supplied in simple tear packets by Young Dental and has excellent consistency and flavor, in addition to being affordable.

Probably the best reason to implement air polishing, however, is because in the long run it’s going to be less expensive for the practice in terms of efficiency. A patient with moderate staining takes less time to polish with an air polisher than a patient with light staining and a prophy cup. This means less operator fatigue, especially if you begin mixing up your routine and becoming flexible as to when you polish during a prophy. It doesn’t need to be at the end to be thorough, or even to gain patient acceptance.

The challenge

Even if you often still reach for the rubber cup at the end of an appointment, you will find that having strong air-polishing skills will help you better tailor the care you provide to meet each patient’s needs, instead of feeling like you’re running each mouth through the exact same routine, all day, every day. I didn’t even go into depth about the newer types of air-polishing systems available out there for you to try! But that’s because the first step you need to make is the step away from your prophy angle. Do it for a week, especially if you already have a neglected air polisher somewhere in your office. Dust it off, be patient, and rise to the challenge that you’ve made to yourself to change this one thing for a bit. You will be a better clinician for it.

Trish Walraven RDH, BS is a dental hygienist who lives in the suburbs of Dallas/Fort Worth. She was very reluctant to move all of her patients to jet polishing when her co-hygienist first suggested the change, but is very grateful to her and to all the patients over the years whose encouragement and feedback helped her realize that there was no going back to prophy cup polishes.

Ready to roll? Here’s a video tutorial from Dentsply to get you started:

Filed Under: Featured, Hardware, Instruments, Operative Dentistry Tagged With: air polishing, baking soda, dental cleanings, dental hygiene efficiency, Dentsply, Prophy jet, sodium bicarbonate

Battlebots: American Eagle vs Hu-Friedy

July 16, 2015 By Trish Walraven 9 Comments

Do you want to see a secret video of one dental hygiene instrument killing another? Sure you do.

But first, a confession: It’s not really secret. This video has been on YouTube since May of 2013 but as of the time I’m writing this it’s had less than a thousand views. I find it to be pretty scathing.

How can a video about dental curettes be scathing?

Because it challenged my opinion about my beloved Hu-Friedy instruments, that’s how.

As hygienists, we’ve been taught to “click” calculus deposits off of teeth. If you have a traditional stainless steel instrument, it needs to be sharp so that it can dig into the deposit, right? Right.

There’s sharp, and there’s hard. Sharpness is what gets you “clicking” the calculus off.  Hardness is… well, it can shift your whole method of OMG YOU WANT ME TO SHAVE WHAT? instrumentation.

We’ll get back to shaving and being hard in a little bit. (!) What I want you to do now though is to watch the video below so that you can understand the rest of this post (just please ignore the first 40 seconds of suck):

What just happened there? Pretty simply, there’s this thing called the Rockwell C hardness scale that measures the hardness of metal, it’s on a scale of 1-100, and when cryogenically-processed steel with a hardness of 60 meets plasma spray-coated steel with a hardness of 89, the softer metal is going to get damaged. That TOOL done got OWNED.

And why does this matter now? These two curettes, one made by American Eagle Instruments and the other by Hu-Friedy, are apparently in direct competition with one another, and Hu-Friedy is making a big stink about the claim that American Eagle’s instruments are sharper.

“Mine are sharper!”

“No, Mine are!”

It’s like that. You can pretty much ignore both sides, and take the marketing for what it is. LOOK AT MY SHINY NEW STUFF IT’S THE BEST (i love youuuuu).

Whatever. Especially the I Love You part. So, you remember Nevi 4, right? – the Traveling Plushie Scaler?

nevi4trishmolly

here I am hanging with Nevi and my co-hygienist at the ADA meeting in Vegas.

My mini-Nevi watching TV with his buds like he does sometimes.

No, I will NOT be posting the photos from that crazy after-party thing that happened with all Nevi’s friends – you know, the Travelocity roaming gnome, Chester Cheetah, the Noid, Stefon from SNL, yeah, that crowd – because I’m not going to give you blackmail material on me like that. But I did just make you look at a picture of my cutsie wootsie doggies, aren’t they just the most adorable schnauzers ever?

Anyways….

So yes, I understand the loyalty thing we’re supposed to have with a company like Hu-Friedy that respects hygienists and is nice to us and is the market leader and the oldest in the business. But sometimes, a product comes along that is actually different enough to give it a chance.

I’m going to say it. I think harder is better.  (shut up, the person who just muttered “you would.”)

Step to the left, Nevi plushie. You have your soft place in the world, and American Eagle XP has its place as well.

What I’ve noticed with using the XP instruments and their hard coating is that the texture of calculus feels really different. Like, it’s softer. Like, I don’t click it off. I shave it off.

SHAVE.

Shaving teeth instead of scaling? It’s really, really weird, but I like it. Who ever thought that you could slice through calculus like you’re carving a turkey? But it feels like that. Instead of biting off the whole chunk of tartar at once, the XP technology lets you lighten up your touch in an entirely different way than you do with even the sharpest stainless steel instrument.

Now, there is a down side to owning American Eagle XP instruments over traditional stainless steel ones – you have to baby them a little more because they can bang up against each other and shorten their lives. That part irks me, of course, because not only do I not want to have to put my instruments in cassettes, I don’t want to ever have to sharpen them either like you do with the Hu-Friedy EverEdge. I’m stuck somewhere in the middle.

And yeah, there’s that “sharp” thing again.

According to the study that was released yesterday by Hu-Friedy, compared to American Eagle XP instruments the Hu-Friedy EverEdge instruments will always be sharper. Also they launched the claim that XP instruments wear out faster because they aren’t able to be sharpened.

Does this mean Hu-Friedy is fighting back?

Well good then. That means they’re probably feeling threatened by a smaller, newer company, and competition is better for progress. It’s good for us because it means that we get to evaluate free instruments from both Hu-Friedy and American Eagle. And good for dental hygiene as a whole, too, because you’re not going to let a little emotion of loyalty get in the way of some good old-fashioned brawling to win your business. You’re free to explore all your options.

Let the metal shavings fly, and you know what they say about having competition, right? Steel sharpens steel. Iron sharpens iron.

And may we all have better instruments for it.

 

A blogger since 1997, Trish Walraven, RDH, BSDH is a practicing dental hygienist in the suburbs of Dallas, Texas and marketing manager for BlueNote Communicator, software that keeps dentists running on time for their hygiene checks. She’s having to take back the “harder is better” comment now with her new mattress. Oops.

 

 

References:

Hu-Friedy Commissions Independent Study to Evaluate Scaler Sharpness:
http://www.enhancedonlinenews.com/news/eon/20150715006545/en/sharp/scaler/dental 

RDH Magazine: No More Dull Instruments!
http://www.rdhmag.com/articles/print/volume-32/issue-5/features/no-more-dull-instruments.html

The Uncoated Truth:
https://www.hu-friedy.com/TheUncoatedTruth

RDH Magazine: How instruments increase productivity
http://www.rdhmag.com/articles/print/volume-33/issue-4/features/how-instruments-increase-productivity.html

That was cool, right? The shaving thing? Be sure to share this video with everyone that didn’t realize that SHAVING is what XP is all about.

Filed Under: Dental Debates, Featured, Instruments

WWII dentistry video

September 3, 2013 By DentalBuzz Staff 3 Comments

What was ideal dentistry like seventy years ago?

Thanks to dentist Dr. Mac Lee of Edna, Texas for bringing this Navy training video to our attention for this edition of TimeWarp Tuesday. You will be both impressed by the way things were done back then and relieved that dentistry has progressed so much since. Even though it’s a bit longer than you’d usually sit through, remember PEARLS! There are pearls here, even in the way, way back times.

Like Smears! They were doing bacterial profiles in 1944! And Check Out That Piece of Autoclave Artwork. That is definitely something that would look good in your practice, and you would have to drive it, like you would a classic auto, not daily, but just BECAUSE. Sure, the new one is faster, but the old is a CLASSIC and you would use it because it’s too cool just to keep it locked up in a museum somewhere.

Be sure to look out for these bitty tids of juice as well:

• Procaine. That looks like some scary stuff to be injecting into people.
• The long exposure time on the radiograph.
• 10 minute sterilization in a water bath? Really?
• The surgery cart and tongs are creepy awesome.
• What the heck kind of toothbrushing technique is that?

With an emphasis of keeping everything super clean, this is probably the most memorable line in the video:

“Never should there be a sign of the last patient.”

 

We should all hope there’d be no bits of him anywhere afterwards.

Filed Under: Instruments, Operative Dentistry, Timewarp Tuesdays Tagged With: dental history, dental training, WWII training video

Lumadent headlight review

May 30, 2013 By Trish Walraven 14 Comments

light Do you know how sometimes, when you get a new piece of equipment, it’s so Shifta La Paradigma that you can’t even THINK about working without it? You get a little anxious about the possibility of it failing and having to go back to the old way of doing things. What do you do?

You get yourself a backup, right? hoping that your original will keep going until FedEx arrives with your precious cardboard salvation. But then you realize that the backup is so Next Generation, your OLD one ends up becoming the backup. And that’s where I am with my Lumadent headlight. I have the old, the new, and opinions about them both, which are the real reasons you’re here. So let’s get to those, shall we?

Opinion #1: It’s Bright, Baby.

Not only is the Lumadent headlight well-focused and a good color, its shadowless light means that more photons are hitting your retinas, therefore the mouth that you’re looking at may be ACTUALLY MORE GROUNDED in reality. If you can’t see something, it’s not there.

Since I haven’t used any other lights except the Lumadent consider this a broad endorsement for headlights over any other sort of overhead illumination. Just about all of them have some sort of knob that will allow you to adjust the intensity, and I find that I rarely turn the Lumadent’s control any more or less than to the halfway position. I’ve learned how to control my head so that the light doesn’t shine in my patient’s eyes (unless I’m gesticulating wildly, then they might see a few blinding streaks) and the super bright just isn’t necessary most of the time. Also included is a flip-up composite filter to keep your accidental light curing to a minimum. I’ve heard some concerns about LEDs damaging user’s eyes over time which is one reason I tend to keep the power down, but don’t seem to have any problems with eyestrain in the two years I’ve been using one. The new model seems to be just as bright and as clear as the older one, so no change in this most important feature.

plugsOpinion #2: Cords are better. And worse.

But mostly better. I’ll explain. The cord replacement is much easier now that the light detaches completely from it. They’ve also switched to a longer initial cord which means that I don’t have to keep a too-long extension hanging around or knotted up in a tie wrap. You’ll notice that the plug-in at the battery has changed to a right-angle which should keep the tension off the cord. I was KILLING my extensions contacts and the light would flicker and just short out and be a huge pain.bulbs

What I’m less than thrilled with is the way that the right-angle attaches to the light itself. If you end up with a short in the new cord now, all you do is detach it right there, loupside, leave the light on the loupe, and plug in a new cord. But the cord sticks up at a weird angle and I’m forced to use yet another tiny tie-wrap to keep those wires from getting tangled in my hair and attached close to the frames. The other thing I do like is that the lens is easier to access and clean now that it’s not recessed. It’s the one on the left in this image. batteries

Opinion #3: This battery pack is serious.

My original battery pack served me well and would stay charged for a whole day, but its slick case in a sassy leather pouch clip probably caused the short outs due to occasional detachment problems. Not the clip, just the battery itself would skittle across the floor when I had a “way to go, Grace” moment. clip

Now that I have two batteries I forget to charge the new silver one, but I have yet to have it clunk out on me and switching back to the black one for backup. Once you go silver….

So this pack is so serious, it’s like Chuck Norris, it has it’s OWN clip built in. A very tough clip. One so tough that if you wear those cute scrubs with the flared legs and the knit waistline you can forget trying to spread the clip enough to get it to attach to your pants. But I adapted by figuring out how to wear it on a waist-level pocket. Now my biggest issue is leaning close to patients and inadvertently turning the light off at the black side switch. I really think it was better on the top when it was red and adjacent to the intensity knob.

Opinion #4: There’s no excuse for not using a headlight.

I’m just going to think I’m better than you if you don’t have one. That’s my throwdown. If you use the excuse that headlights cost too much? Compare the Lumadent with its “better” competitors, it’s so much less expensive, you can buy one for you AND your assistant. And for your higher power loupes, for that matter. What about the problem with wires and bulk? The Lumadent is so lightweight that once you adjust your behavior a little (all I did was to begin wearing a strap on my loupes instead of taking them on and off so that they hang around my neck when I’m not using them) they will become a much easier part of you than having to reach up and adjust a mounted light somewhere over your right shoulder, in space. And patients stop anticipating the bright light and never squint anymore when it’s time to open their mouths. PATIENT ACCEPTANCE IS AMAZING, and in my opinion, the BEST reason why you should get a Lumadent.

wiremanagement

 

 

 

 

 

This is my parting shot for you, a side view of the Lumadent attached to a pair of Through-The-Lens shielded SandyGrendel loupes with the custom mount that came with the light. See how it sticks up a little too high, and there are two tie-wraps, and a cord management doohickey making this all such a mess?

No? I don’t see it either, actually.

DBSmile1

 

 

For earlier insights about Lumadent and the company, click here to go to the DentalBuzz original review.

Filed Under: Instruments, Operative Dentistry, Products, Research, Technology Tagged With: dental headlights, dental loupes, LumaDent

Why the cone was cut

November 8, 2011 By Trish Walraven 1 Comment

Since this month is the 5th anniversary of the moment our practice switched over to digital radiography (and thank goodness we never have to endure the vinegary processing solutions again!), I thought it would be nostalgic to offer up this latest edition of Timewarp Tuesdays and honor The Cone.

Admit it, you can’t help but call the long cylindrical chunk of metal pointing out from your x-ray machine anything but a cone. Even though it probably wasn’t a cone when you were in dental school. It hasn’t been a cone for over 30 years.  But maybe you’re old enough to remember a cone getting pointed at you when you were a kid, like I am.

Back in the early 70’s it was all about sleek and modern – there was something a little sexy about the cone, like it was one-half of a pointy brassiere aimed right next to your eye. A woman would cram something in your mouth, tilt the cone at your face and then leave the room for a moment, giving you time alone with it to contemplate its form and function, maybe try a little small talk with it.

Intriguing, this cone.

Come to find out, it was just a cheap plastic pointer, as exemplified in this advertisement from 1945:

See what I mean about the wistful gaze, our GI mesmerized by that white cone because it reminds him of a part of his sweetheart back home? You can click on him to get a better look at the advertising copy. And AHHHHH! Seriously? Pointing it RIGHT AT HIS CAJONES? We’ve come a long way since then.

Plaskon touted that its cones could withstand “…the terrific impact of X-rays which can disturb the molecular structure of many materials.” Many materials… like human flesh?

Apparently the reason that cones were phased out was because they were an impedance to radiation safety, and so they have since been replaced with the familiar long cylinder collimators. About the same time that the medical community figured out that scatter radiation was preventable, they also realized that imaging could be improved with focused beaming techniques. So the cone is gone, even though the name lives on.

And so to honor the history of dental radiography, I now present you with this Dental Radiographic Cone homage collage:

BZZT! ZAP! [sizzle] ffffphP.  I can almost smell the singe of old wires firing up.

Filed Under: Instruments, Timewarp Tuesdays Tagged With: dental radiography, Plaskon, radiation safety

  • 1
  • 2
  • Next Page »

About

DentalBuzz explores rising trends in dentistry with its own slant. The speed at which new products and ideas enter the dental field can often outpace our ability to understand just exactly the direction in which we are heading. But somehow, by being a little less serious about dentistry and dental care, we might get closer to making sense of it all.

So yeah, a tongue-in-cheek pun would fit really nicely here, but that would be in bad taste. Never mind, it just happened anyways. Stop reading sidebars already and click on some content instead.

Recent Posts

  • Off-Label and Totally Legal: What the FDA Won’t Say About Fluoride Varnish & SDF
  • Dentists Rejoice over the Leica Camera Tariffs
  • It’s not OK for your dental practice to use free cloud-based communication
  • Patients ask, “Is it safe to go back to the dentist?”
  • Free “return to work guide” from the American Dental Association
  • Why COVID-19 increases your need for contactless payments
  • A virtual care package from worried dental hygienists
  • Lead Aprons feel so good! Here’s why.
  • What is this $&!% on my toothbrush?
  • The Prophy Jet Challenge
  • How to trick kids into brushing their teeth
  • These identical twins can both be your dentist

Article Archives

Contact Us

Guest columnists are welcome to submit edgy stories that cover new ground (no regurgitations, please!) , or if there's a topic that you'd like to see explored please punch in your best stuff here and see if it ends up sticking to the website.

Follow DentalBuzz on Social Media

  • Facebook
  • Instagram

DentalBuzz Copyright ©2008-2025 • bluenotesoftware.com • All Rights Reserved