Silver Diamine Fluoride Doesn’t Stain Sound Tooth Structure
SDF doesn’t stain sound tooth structure
Silver diamine fluoride (SDF) is an increasingly popular treatment in dentistry, primarily due to its efficacy in arresting dental caries. Yet we may forget that it is amazing for sensitivity which is its on-label use. SDF is a topical medicament that combines the antibacterial properties of silver with the remineralizing effects of fluoride. The application of SDF is minimally invasive and painless, making it an attractive option for pediatric and geriatric patients, as well as those with dental anxiety. Studies have shown that SDF can effectively halt the progression of caries, reducing the need for more invasive treatments like drilling and fillings .
One of the main indications for SDF use is in primary teeth, especially in children who may not tolerate conventional restorative procedures well. SDF is also indicated for root caries in older adults, which are challenging to treat due to the difficulty of maintaining moisture control and the high likelihood of recurrent decay. Additionally, SDF can be used as an interim measure to stabilize carious lesions until definitive treatment can be provided, which I do often in homebound settings.
A notable advantage of SDF is that it does not cause staining on sound tooth structure. While one of the common concerns with SDF is its potential to stain decayed areas black, but this does not affect healthy enamel and dentin. This selective staining property allows clinicians to distinguish between arrested carious lesions and healthy tooth structure easily. The non-staining characteristic on sound tooth surfaces makes SDF an excellent choice for patients concerned about the esthetic outcomes of their treatment. We recently posted a case study where we placed it on sensitivity on sound tooth structure and 1 month after, there was no staining. You can check it out HERE
As dental professionals continue to seek minimally invasive and patient-friendly treatment options, SDF stands out as a valuable tool in the prevention and management of dental caries .
-Shelley Brown, MEd, BSDH, FADHA
Crystal, Y. O., & Niederman, R. (2019). Silver diamine fluoride treatment considerations in children’s caries management. Pediatric Dentistry, 41(5), 292-298.
Horst, J. A., Ellenikiotis, H., & Milgrom, P. L. (2016). UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications, and Consent. Journal of the California Dental Association, 44(1), 16-28.
Clemens, J., Gold, J., & Chaffin, J. (2018). Effect and acceptance of silver diamine fluoride treatment on dental caries in primary teeth. Journal of Public Health Dentistry, 78(1), 63-68.
Gao, S. S., Zhao, I. S., Hiraishi, N., Duangthip, D., Mei, M. L., Lo, E. C., & Chu, C. H. (2016). Clinical trials of silver diamine fluoride in arresting caries among children: A systematic review. Journal of Dentistry, 44, 102-110.
Seifo, N., Cassie, H., Radford, J. R., & Innes, N. P. (2020). Silver diamine fluoride for managing carious lesions: An umbrella review. BMC Oral Health, 20(1), 145.
3 ways to answer “what’s your biggest weakness,” in your next dental hygiene interview.
3 ways to answer “what is your biggest weakness.”
One question that is often asked in an interview is "What is your biggest weakness?" Here are three effective strategies to use in your next dental hygiene interview:
Show self-awareness and growth: Acknowledge a genuine weakness you have identified in yourself, but emphasize how you are actively working to improve it. For example, you could say, "I used to struggle with time in hygiene school as it took me 3 hours to complete an appointment but now in my last semester I am able to be thorough and and efficient at the same time.”
Highlight a skill that is not essential for the job: Choose a weakness that is not directly related to the core skills of dental hygiene. This shows self-awareness without raising doubts about your ability to perform in the role. For instance, "I have a hard time remembering names so I like to write patients' names on a sticky note on each tray.”
Frame it as a learning opportunity: Discuss a weakness that you have successfully overcome in the past, demonstrating your ability to adapt and grow. For example, "In the past, I struggled with motivational interviewing, but I enrolled in a course and Now, I am effectively able to motivate my patients versus just lecture them.”
Remember, the key is to be honest yet strategic in your response, showcasing how you approach challenges and your commitment to continuous improvement. This demonstrates to the interviewer that you are self-aware, proactive, and capable of addressing weaknesses effectively. Best of luck on those interviews!
-Shelley Brown, MEd, BSDH, RDH, FADHA
Ultrasonic Tips with Nordent
I still remember the day we learned about the magneto ultrasonic device in dental hygiene school. Do you? I was so excited to be handed a machine to do it all and I wouldn’t have to use hand instruments ever again (I was obviously very naive in my thinking!) The day came in the clinic after learning about the technology in our lecture the previous day. I remember thinking “I just go for it?” and getting it set up, the correct amount of water mist, and figuring out the best way to hold the handle and the cord. And that’s what I did. Just went for it with no rhyme or reason and hoped it all worked out. Fast forward to a few years later when I was an instructor and teaching others how to use the ultrasonic. There is nothing quite like having to teach something that you have learned hands on before.
Early in my teaching career, I had the same mentality when it came to ultrasonic use-just go for it. But, after time and research, just “going for it” is probably not the best method for both you as a clinician and for your patients. There is so much science and research behind this machine that we use every hour and there are certain techniques that work better than others. One technique that gets lost as we hurry is channeling. This technique is critical to ensure the ultrasonic is working it’s best and both calculus and biofilm is removed without causing burnished areas or trauma to the tooth or tissue.
Here’s how it works:
1. Tip Orientation: The ultrasonic tip is placed at approximately a 0-15 degree angle to the tooth surface. This angle helps to direct the energy and vibrations produced by the ultrasonic scaler towards the calculus deposits.
2. Activation: The ultrasonic scaler is then activated.
3. Movement: The tip is moved in a controlled manner, following the natural contours of the tooth and focusing on areas with calculus buildup. The movement can be linear or curved, depending on the location of the deposits in small 2-3mm areas.
4. Adaptation: As the deposits are removed, the clinician adjusts the angle of the tip to ensure efficient and comfortable removal without damaging the tooth or surrounding tissues.
xoxo, Melia Lewis, MED, RDH
To learn more about this technique- channeling- and how to incorporate it into your practice, don’t miss our latest video which is highlighting Nordent LuxPoint magnetostrictive inserts.
The Perfect Dental PA with DentiMax
When I was a brand new dental hygienist, I was interviewing at offices all over my area trying to find the perfect first dental hygiene job. During one of the working interviews, the dentist would spend extra time during dental exams and take the time to thoroughly look through the radiographs. After the first few patients, one of the assistants pulled me aside and confided that the dentist is really particular on radiographs, and that mine were looking great! After that, I was sweating all day whenever I pushed that radiology button, hoping the image would turn out as well as I hoped.
This was many years ago and I definitely have learned so much about radiology and the techniques needed to have a successful image. One thing that is key to having a great radiograph? Great sensors known for its quality, just like the DentiMax Sensor. We have loved using it with our patients, and recently we were lucky enough to film our latest video with it. You can definitely see the quality of the images, even on video (which we all know throws it off at times). Plus, if you do decide to get a DentiMax sensor, they offer 1 on 1 training of your hygiene department or staff to help get the best images. With the combination of quality materials, videos from us at Hygiene Edge, and training straight from DentiMax, you’ll be feeling tip top with your radiology technique.
To learn more about the proper sensor placement to get the best image, definitely check out our latest video:
Also get up to $3000 of with this link: https://products.dentimax.com/hygiene-edge-exclusive-dentimax-discount.html
Thank you to DentiMax for supporing us at Hygiene Edge! To learn more, check out their website.
How Can I Get into Dental Hygiene Education?
We regularly get questions about being an educator. Usually the questions are “how did you get into education?” or “How do I break into education and get an educator role?” This is definitely a multifaceted question, but something I absolutely love talking about.
Education is so fun. We love being able to talk to coworkers about health, geek out with other educators about changes in learning, and stay up to date to help the next generation of dental hygienists. However, education can also be very tricky. If you are burnt out of dental hygiene, dental hygiene education may not be the answer. We still regularly work with patients, treat periodontal disease, and work one-on-one with patients all the time. But now in an education setting, we have an extra added layer of teaching at the same time. It is not the only way out of clinical Dental hygiene, but it is a fun way to keep dental hygiene interesting and may even renew your love for dentistry if you're feeling the sting.
So, what do we recommend to help you get into an education role? Here are a few things we have done that helped us get our foot in the door and introduce us to the amazing world of education.
Be a member of your professional organization. I know it is definitely a cost involved with joining an organization but being a member of a group of individuals who understand and love the profession is great for networking. I have found that Educators understand the value of a Professional Organization so there are many Educators part of the American Dental Hygienists’ Association, as well as working on a volunteer level of the organization. If you have the time and capacity, it might be great to volunteer for a role in your local component to get to know both educators and dental hygienists in your area. This has been such a great experience for me both personally and professionally and has helped with connecting with educators all over both my state and the country.
Take methodology courses now. Even before you start teaching, it's helpful to have teaching methodology courses before you jump into teaching. You'll have a broader range and knowledge of what education is instead of learning what is when you get into the role. Being a new educator can be overwhelming. Trying to add in methodology in addition can feel like a lot. There are many ways to get teaching education mythology online or through a local college or university, but we love hosting a monthly mastermind for educators called Hygiene Edgeucators. Each month, educators from all over the country come together virtually to talk about different teaching issues, problems, and work together in a mastermind to learn something new. Along with getting some methodology CE, you’ll also be networking with educators from all over the country since it is full of people from so many different schools. Having methodology classes will look great on a CV or your LinkedIn profile and help you stand out from other clinical dental hygienists applying for education roles.
Keep in contact with your instructors from your education. This is how I was first introduced to education. I reached out to a few of my past instructors and let them know I was interested in education if they had any opening or knew anyone looking. With that connection, they referred me to come interview for a clinical instructor position that I ended up loving and learning so much from. These educators are a great networking tool to keep the relationship you formed over a long two years after graduation.
Attend a conference. Educators love education (you might relate!). Attending even local component study clubs or your state dental hygiene association meetings is a helpful way to connect with educators face to face, for them to get to know you, and become friends with others in education.
I love having a role in an education, being part of the growth and changes in our education and future of dental hygiene, and have the opportunity to constantly learn through education. If you’re interested in a position in education, we are excited for you! Please connect with us so we can follow along and cheer you on with your journey.
xoxo Melia Lewis, MED, RDH
@meliardh
Pediatric Dental Radiology with Kilgore International
A few weeks ago, I was temping at an office that was new to me. My regular office that I see patients in is close to a university campus, so the majority of my patients are college students, professors, employees, pretty much anyone over the age of 18. This office, however, was close to a community full of families and an elementary school so I was lucky enough to see several pediatric patients throughout the day. Honestly, when first looking at the schedule, it made me a bit nervous. Did I remember how to work with and treat pediatric patients, especially when it comes to taking radiographs? Well, lucky for us in the dental field and in education, Kilgore International has an amazing pediatric radiology mannikin that is the perfect solution to help either the clinicians in your office or your students feel comfortable with placing and taking radiographs, either if it’s their first time working on with a ped or if it has been a while, like I had experienced.
Our latest video, thanks to Kilgore International, focuses on pediatric radiology placement and exposure to make sure you have the best possible image in a sometimes small or tricky situation. A few things to think about to have a successful image.
Sensor size. If a patient does not have their 1st permanent molar, generally a regular size 2 sensor will be too large for their mouth. Unfortunately, I have sometimes tried to use a larger one since either that’s all the office has or that’s what I have handy, but trying to get something too large to fit doesn't work well with kids. Also, once I’ve caused some tenderness, their trust in me is out the window and taking a radiograph is pretty difficult with no trust.
Timing. What is the most important part of your visit for the day? Is it a good set of radiographs due to pain, caries concerns, etc? Is it placing varnish? Is it teaching good home care? Whatever is the most important thing, do that first (after the fun part of riding in the chair, catching up, finding out the cool thing in their grade, etc).
Making it fun. Of course, we as humans want to have fun, especially kids. Unfortunately, sometimes pediatric patients are told either by friends, family, or media that the dental office is a “scary” place. Coming in with that thought, of course doing any kind of radiograph or treatment will be tricky! Keep your appointments fun to keep patients engaged and happy, and hopefully rethink the scary thoughts.
We know you’ll love working with the mannikin like we have! Definitely check out this video to learn more and to become the best at your pediatric radiographs.
xoxo Melia Lewis, MEd, RDH
Fixing Overlap on Your Bitewing
I regularly would tell my students in the radiology lab and even in clinic that “radiology is an art, not a science”. Do you agree with this? Seeing students try to understand the concepts of radiology and creating a 2D image of a 3D thing is tricky, and does need practice.
We know that there is so much science involved with radiology, when it comes to exposure, KVP, waves, etc. But, there is an element of art along with it- perfecting angles, sensor placement, patient comfort, and education to have the perfect exposure of a bitewing or periapical.
One of the trickiest parts of having the perfect bitewing is definitely horizontal angulation. Knowing where to place the tubehead is critical to prevent overlap. We know that this angle is such an important part of a bitewing. Without it, we will end up having overlapping contacts and overlapping teeth that cover the height of the bone and ultimately an undiagnosed radiograph.
How can we help prevent these diagnosed radiographs from happening? Practice! With ALARA, it can definitely be hard to practice radiology on our patients, but utilizing a manikin like the Kilgore Radiology Manikin is a game changer. Having this will allow you, your students, or your coworkers to be able to practice their techniques, feel confident in their radiology skills, and to make sure we understand the techniques and tricks when it comes to taking an x ray.
To learn more about this manikin, but also some helpful tips when it comes to taking proper bitewings, both molar and premolar images, definitely check out this video from us at Hygiene Edge.
xoxo Melia, RDH
A huge thank you to Kilgore for supporting our educational efforts here at Hygiene Edge! Their goals definitely align with ours- helping clinicians feel empowered to give the best possible care to our patients and communities.
Amber Teething Necklaces: What the RDH Needs to Know.
Picture this. Your 10 am patient slumps down in your op chair, tired eyes and feeling overwhelmed. After some questioning, you get to the bottom of your patient’s body language. They have a teething baby! Nothing is harder than being over exhausted, and having a teething baby is no help when it comes to sleepful nights. Your patient looks at you and asks “What do you think about Amber Teething Necklaces?”. They are desperate to try anything to help their little one and in turn help their family. How do you answer them?
For me, I love to follow up any question that I get from patients about the current research that is being presented on a topic. Starting your response as “the research shows” or “the research now shows” is a great For this subject of amber helping with pain, there isn’t great research to support the claim. In theory, amber once warmed up against skin releases succinic acid, a compound that is believed to have pain-relieving and anti-inflammatory properties. Then once, it is released with the warm body, it is then absorbed through the skin and provides the relief. Another aspect of amber is the believed calming and soothing capabilities. When the amber is warmed from the body, energy from the amber is released and has a calming effect on the child and body, potentially reducing fussiness and irritability. Unfortunately, there is no current research on amber when it comes to energy and calmness.
Unfortunately, there is research and evidence on the harm these necklaces can have on our tiny patients. First, since it is something worn around the neck, there is always a chance of trauma or breathing issues. Second, they usually are a strand of amber beads on a string, which pose a choking or ingestion hazard if the string ends up breaking. Since the patients using and wearing these necklaces are usually 6 months-2 years old, this is the most common age for strangulation or choking on anything, let alone a necklace worn both during the day and at night.
If you have a patient ask about these necklaces, it might be good to have some suggestions about what else can work for their child instead.
Questions like these are a great reminder to keep up with the latest research in health and dentistry, and knowing how to look and read research. I totally get it- having time to read and research isn’t always feasible, but knowing how to look at studies, see who is sponsoring them, and knowing the outcomes is so helpful to our patients and shows how much of dentistry and dental hygiene treatments are science and research based. The next time you have a patient ask you about a fad or a treatment, let them know what the latest research shows, or get back to them with some research to allow them to make their best informed decision and care.
Have you had patients or family members try out amber teething necklaces? What was their opinion?
xoxo, Melia Lewis, MEd, RDH
Sharpening Stone 101- Part 2 (Updated 2023)
This is part 2 of our series called Sharpening Stone 101. Find part 1 here!
Sharpening Stone Shapes
There are several shapes of stones you can purchase for your office and instruments. And most people learn one type and go with it for their entire career. I’m part of it! I learned about regular rectangle stones in school and honestly they are still my favorite, with the update of really liking a diamond card with the same shape. Here are the main shapes you’ll see in your distributor catalog:
Cone Shape- Great for removing wire edges, good for concave edges, tapers to fit different instrument shapes.
Wedge- Perfect for the face and the edges making it an all around stone.
Rectangle- Perfect for all hand instruments with straight cutting edges, which means most of our hygiene instruments. Scoops and periostial elevators aren’t the best candidates for a rectangular stone.
Sludge Layer
The sludge layer is a thin grey layer that appears on your sharpening stone as you sharpen. It’s a good thing! It it small amounts of metal being removed from the instrument, making a new, sharp edge on your instrument. If you have a build up on the sludge layer, wipe it off with a 2x2 gauze to keep the area visual to see if you’re using the right angle.
Hand piece mounted stone
Using a special sharpening stone that attaches to a hand piece might be the perfect solution to your sharpening needs, especially if your instruments are currently dull or misshaped, if you see double hygiene and only have a few minutes to sharpen, or if you have several hygienists in your office and go through instruments quickly.
There are some disadvantages of using this technique. First, it’s not very conservative due to how fast the bur is moving and can remove more of the instrument than with traditional hand sharpening. Second, if the hand piece is moving too fast, it can make the instrument hot and warp the shape slightly. We recommend practicing a few times on old instruments to get the hang of the power driven stone the first couple times to get then hang of it.
File Sharpening
Since files have at least 3 cutting edges on their face, a special sharpening stone called a tanged file is needed to sharpen. It's highly recommended to use loupes and a light as you sharpen your files. Check out the video to see the tanged file technique.
xoxo, Melia
Sharpening Stone 101- Part 1
Ever opened your dental supply catalog and peeked at all the different sharpening stones? There are hundreds of combinations of sizes, styles, amount of abrasiveness, and price. Here on Hygiene Edge, we are breaking down this daunting task of getting a new stone to every day language.
Different Stones
Arkansas Stone- This is a natural abrasive stone that has been used since dental hygiene was invented 100 years ago. It was one of the best for dental instruments for years due to how fine the abrasive powder particle size is. It’s perfect to have such a fine grit because our instruments are so tiny. They also require some sort of lubrication while sharpening.
Ceramic- These stones are made of artificial materials. Since they are man made, they are “newer” on the market compared to the Arkansas stone. They do not require oil or water during sharpening, but it’s a good idea to soak your stone first to easily clean off shavings that accumulate.
India Stone-This stone has a large abrasiveness, which means it will take away more of your dental instrument then other stones. It is perfect for deburring or fixing the shape of an instrument. They are usually orange or brown and are more course than an Arkansas. If you do have an extremely dull instrument, start with India and then finish with Arkansas or Ceramic.
Oiling- Yes or No?
Using oil for lubrication on your sharpening stone tends to be an older technique as it has been used with traditional sharpening stones. Most stones that are used today do not require oil since most people buy ceramic stones. There are several disadvantages to using oil. First, it tends to make the stone very slippery which is great and dissipating heat, but makes sharpening go a lot slower since the instrument can just slide right over the stone. It also can suspend metal shavings from the instrument and cause scratches and defects in your instrument as you sharpen. It also can cause problems with infection control due to handling the oil container if you are sharpening instruments in the middle of an appointment and can make clean up a bit more messy.
Water-Yes or No?
Instead of using oil, water is the most common form of lubrication. Though man made stones don’t require water as a lubricant, it can prevent silver marks forming on your stone and therefore makes clean up easier.
This is part 1 of Sharpening 101. Next week, we'll discuss sharpening stone shapes, other methods to sharpen hygiene instruments and how to sharpen files!
Have any sharpening questions? Let us know in the comments!