"Smile! You're on Intraoral Camera: A Close-Up on Dental Diagnostics"
Intraoral cameras are necessary for a practice, like this one from Mouthwatch. Learn from Melia Lewis the 4 reasons why.
#mouthwatchcamera
Do you have an intraoral camera in your office by chance? I’m not going to lie, when we are introduced to new technology or new things to do, it’s so easy to push back. We hygienists have so much on our plate and our appointments are very full already. However, if you are going to introduce something new, an intraoral camera is an amazing instrument in your armamentarium.
The difference between explaining and educating with words versus a patient actually seeing something with their eyes is astounding. I have seen this in my practice where I’ve been trying to explain calculus, a cracked tooth or a broken filling, and the patient isn’t interested, which I totally understand because the mouth is a weird place that we really don’t think about if we’re outside of the Dental field until we’re in pain. However, when I show them a photo of that tooth it automatically clicks the importance of the treatment.
Intraoral photos are key for recordkeeping. Whenever there is a lesion or inflamed gingiva, it’s so nice to have a photo because then there’s no questioning what you saw six weeks ago, a month ago, a year ago with your patient. We can definitely describe things and use our great descriptive words which I still recommend doing, but having a record of a photo is so much easier to understand and comprehend. It’s also so great if you have multiple practitioners or hygienists in your office because then when they look at the notes and read your descriptions, you can easily see what they were talking about in the photo. I personally have loved having a photo on hand that another hygienist took of an area that they were watching or concerned about.
So, when you start taking photos in your operatory, there is a little bit of a learning curve when it comes to the camera. We have really loved using the MouthWatch Intraoral Camera to take photos because it’s straightforward and easy to use. A few of the highlights of it are:
1. It’s guaranteed to integrate with all software. You simply plug it into a USB port on your computer and follow the easy step-by-step instructions on MouthWatch’s website for integrating it into your software. You're also backed for life by MouthWatch’s responsive U.S.-based support team should you need any help.
2. It’s easy to use. After you initially integrate it with your software, it'll automatically connect, and you can begin taking photos with just one press of the capture button. eliminating the headache of setting multiple things up which saves so much time.
3. The cost is amazing at just $299 per camera, especially if you’re just getting into photos and curious on how photos can change the way you work.
4. "And number four, you get a free 1-year warranty and a 30-day satisfaction guarantee, so you can try the camera risk-free!"
Check out our latest video that shows multiple tips and tricks to make your oral photography easier and better HERE
Thank you to MouthWatch for supporting us at Hygiene Edge and for supporting dental professionals in general. We love this brand and have loved working with them and using their products. They understand the importance of photography, telehealth in dentistry, and expanding access to dental care. To learn more about them, visit: WEBSITE. www.mouthwatch.com/. #sponsored #dentalcare #hygienist #mouthwatch #intraoralphotos
How often are you utilizing photos in your office?
XOXO Melia lewis, MEd, BSDH, RDH, FADHA
Should we do a PSA or Infiltration?
Check out Jessica Atkinson in this video case study where she has to decide whether or not to do a PSA or Local Infiltration.
When performing periodontal therapy, particularly in the maxillary molar region, the choice between using an infiltration injection or a posterior superior alveolar (PSA) injection can have significant implications for patient comfort and treatment effectiveness. An infiltration injection, where the anesthetic is deposited near the apex of the tooth, is often preferred for its precision and lower risk of complications. The anesthetic is delivered in close proximity to the targeted area, which allows for more focused pain management without affecting larger regions of the oral cavity. This technique is especially useful when treating a single tooth or a localized area, minimizing the risk of hematoma formation, which is more commonly associated with PSA injections.
On the other hand, a PSA injection is used to anesthetize the maxillary molars, targeting the posterior superior alveolar nerve. This approach allows for more comprehensive anesthesia, typically covering multiple teeth simultaneously. However, this method has an increased risk of complications, such as hematoma due to the proximity of the pterygoid plexus of veins and the maxillary artery. While PSA injections can be more efficient for treating multiple molars or performing extensive periodontal procedures, they require careful technique and an experienced hand to avoid complications. Additionally, PSA anesthesia may lead to a more pronounced loss of sensation in larger areas of the cheek and upper jaw, which some patients find uncomfortable during and after treatment.
Research comparing the effectiveness of these two injection techniques in periodontal therapy has shown that infiltration injections provide adequate anesthesia for most periodontal procedures involving maxillary teeth, especially when only one or two teeth are being treated. According to Meechan (2005), infiltration injections using articaine have been shown to have superior efficacy in anesthetizing maxillary molars compared to traditional lidocaine solutions used in PSA blocks, making them a preferred choice for many clinicians depending on the patient’s needs and the scope of the treatment plan (Meechan, J. G. (2005).
Meechan JG. The use of the mandibular infiltration anesthetic technique in adults. J Am Dent Assoc. 2011 Sep;142 Suppl 3:19S-24S. doi: 10.14219/jada.archive.2011.0343. PMID: 21881058.
Making Brushing a Bit Easier
A new brush for adolescent patients.
Now that it’s officially summer, I find that I start to see a different crowd of patients in my practice. Do you notice this as well? With school being out for a few months, my schedule is definitely getting more and more full with pediatric patients and especially teenagers. It’s always great to have a switch up in the schedule and see this younger population again, but what can we do as providers to help them? Being a teen is busy with many extracurriculars, friends, family, school, all the things. We are lucky to be in a healthcare environment to meet these patients where they are at, help support them in their life changes, and be a source of information about their health and oral health in a world full of lots of information.
So, what are some things we can help support these patients with? First, giving them great tools to use at home to decrease bacteria is key. Research shows that most patients only brush for 30 seconds-1 minute and with a manual toothbrush, and usually that time frame and technique isn’t cutting it. Unfortunately, due to this patient population's change in hormones, leaving biofilm puts patients at a high risk for inflammation and disease. Let’s support them with great products, like the SAMBA Toothbrush from Curaden US.
A few great features your patients will love:
A soft U shape to allow for different sizes and shapes of mouths
This brush is completely waterproof, allowing your patients to use it in the shower if they would like. It also lasts 25 days with 1 charge.
12,900 soft bristles allow for better access in hard to reach areas of the mouth.
We love this brush for teenagers to help keep their oral health with their busy schedules. To learn more about the brush check out our latest video:
See the brush in action below:
A huge thank you to Curaden US for supporting us at Hygiene Edge! We love great products to help our patients' lives be better, just like many of the Curaden US products. To learn more about the SAMBA Toothbrush, visit:
For dental professionals https://prof.curaden.com/us/product/samba.
For patients samba.us
#CuraproxUSA #CuradenUSA #sambatoothbrush #CuraproxSamba
Xoxo, Melia Lewis, RDH
If you want to try one as a dental professional visit: https://curaden.us/
and use the code HYGIENEEDGE for 20% off Samba (Off the already discounted price for dental professionals) Valid 9/1/24 – 10/31/24
Our patients can use the site https://curaprox.us/ and use the code HYGIENEEDGE for 15% off Samba Valid 9/1/24 – 10/31/24
How Full Can I Fill a Dental Autoclave?
Filling an autoclave in a dental office is a straightforward but important task that ensures proper sterilization of instruments. When you’re putting instruments into your autoclave, each brand and size are so different, but following some guidelines listed will help ensure that all of your instruments are properly sterilized and keep the health high for both your instruments, yourself, and for your patients.
Make sure you single layer instruments. It’s tempting to pile everything in to get everything through and ready for your next patient. However, instruments should be single layer placed with no overlapping to ensure the heat and steam reaches all areas of your instruments.
Make sure you have enough water. Before starting a cycle, make sure your water reservoir has enough distilled water to go through the entire process. Nothing is worse than having a cycle run half way through then error out due to water.
Check that bags aren’t touching the side of the autoclave. It’s easy for the corners of the bags to be touching the sides of the autoclave, especially if you have one that is round or have a unit where the bags/instruments stand up on their sides. When the paper or bags are touching the ends and sides of the machine, it can prevent proper movement of the steam and heat and decrease the chances of proper sterilization.
Make sure your bags are not too full. It’s so easy to stuff several instruments in a small bag just because they’ll fit. However, if they’re jam packed into an autoclave bag, there isn’t room for air and steam to circulate around each instrument. Instead, use a larger bag so each instrument can be next to each other for proper sterilization.
Don’t forget your test strips. Place test strips into each cassette or bag. There are color indicators on the outside of each bag or on your tape, but what about what’s happening inside? Having a test strip inside the cassette will help ensure the proper sterilization is happening with each kit.
We sometimes don’t put too much thought into sterilization. However, this can be the most important process we do in our clinical day to keep both us as clinicians and our patients safe from exposures. These patients are trusting us with their health and safety- it’s our job to know the best methods to keep them safe.
xoxo, Melia Lewis, MED, RDH
The New Samba Toothbrush
A new full mouth toothbrush.
Patients are looking for efficient products that get them high quality end results in less time. Luckily, we are now entering an exciting age of machine assistance to aid us in improving overall health. We are seeing these innovations in oral health too with a new robotic toothbrush called the SAMBA, from Curden US, is now helping patients remove more biofilm with its technology in a shorter amount of time, that is a win, win.
With a small-headed traditional toothbrush it is very easy to miss hard to reach areas in the mouth. It is a tedious task for many patients to individually brush each tooth. For a healthy and capable patient it is doable, but once you get a patient who has physical or mental limitations, adequate plaque removal becomes extremely difficult. That’s where the SAMBA can aid them, it is as easy as placing and holding the toothbrush in place while the engineered robotics do all the work for them. Once charged it is mobile so it can be used anywhere, many patients even use it in the shower as it is also fully waterproof.
I encourage patients who are doing well with traditional brushing to continue to do so. However, patients with a full adult detention who present with gingivitis or periodontitis from inadequate biofilm removal I recommend that they get support through the SAMBA. The most recent National Health and Nutrition Survey shows that 4 in 10 US adults 30 years or older had some form of periodontitis and it is present in those over 30 at a rate of 1 in 2 men and 1 in 3 women1. With this data we need patients to be doing better self care between visits at home or these rates of disease will continue. The SAMBA makes it very motivating for patients to invest in their oral health.
We invite you to check out the SAMBA in action in our latest YouTube video below. https://youtu.be/myef-ZpNQeo
You can learn more or order at:
For dental professionals https://prof.curaden.com/us/product/samba.
For patients samba.us
#CuraproxUSA #CuradenUSA #sambatoothbrush #CuraproxSamba
-Shelley Brown, MEd, BSDH, RDH
______________________________________
WANT ONE FOR YOURSELF OR A PATIENT?
If you want to try one as a dental professional visit: https://curaden.us/
and use the code HYGIENEEDGE for 20% off Samba (Off the already discounted price for dental professionals) Valid 9/1/24 – 10/31/24
Our patients can use the site https://curaprox.us/ and use the code HYGIENEEDGE for 15% off Samba Valid 9/1/24 – 10/31/24
_______________________________________
Eke PI, Thornton-Evans GO, Wei L, Borgnakke WS, Dye BA, Genco RJ. Periodontitis in US adults: National Health and Nutrition Examination Survey 2009–2014. J Am Dent Assoc. 2018;149(7):576–588. https://doi.org/10.1016/j.adaj.2018.04.023
Tips for Finding a Great Dental Hygiene Clinical Board Patient
My sister in law has been a dental hygienist for over 12 years. She’s had kids, moved to a different state and different country in the time, and they’ve now settled in California. She’s ready to get back into the hygiene world and work clinically in her town. But because it has been a bit since she’s taken WREB, she’s back at it again. With taking the test comes finding a patient. I’ve been teaching students and assessing patients for the exam for years, but being back in the spot of actually finding a patient has been tricky and is taking me back for when I took the exam, both a few years ago and when I graduated! Here are a few tips and tricks for finding a great patient over the years that we’ve been using to find the perfect patient.
Post about the exam and your need for a patient on local Facebook Groups. However, once you post it, many times they’ll be deleted in a short amount of time, depending on the group. Once you post it, watch your post to see who responds or messages, and get the conversation going right away. If not, the post may be deleted, and you’ll miss who responded. Also, keep an eye on your “other” message folder to see if anything messages you but it gets hidden.
Get your prescreening questions ready. When talking to a potential patient, make sure you ask a few screening questions beforehand to make sure they’ll qualify for the exam. Here are a few I like to ask: Are you allergic to anything? Any medical conditions such as heart disease or diabetes? Are you available on (insert test date)? Do your gums bleed when you brush (don’t include flossing. It’s pretty common for people’s gingiva to bleed if they rarely floss. If they’re a regular brusher with no bleeding, however, they may not qualify for the exam).
Ask other students, past students, or your senior who graduated the year before you for a recommendation. They may have a great lead or two you could follow up with. Sometimes the patient they used didn’t get the rest of their mouth treated and it may qualify, or the patient has a family member or friend to refer to you.
Reach out to surrounding offices. Sometimes, these offices have patients come in that qualify and cannot afford periodontal therapy. If they have someone like you to refer them to, it would definitely help both you and the patient.
Don’t get overwhelmed. I know, this is the least helpful advice. But for some reason, when someone puts in the work, it all works out! I’ve had student’s patients end up in jail the week before their exam, patients that go into early labor before, patients that have gone completely MIA. And for some reason, it all works out how it is meant to be.
How did you find your board patient? What are some of your tips to finding a great patient for your clinical exam?
xoxo Melia Lewis, RDH
Does the Pace You Move the Power Scaler Matter?
Slow down to speed up. Pace matters when it comes to being efficient with power scalers.
I recently recorded myself using the power scaler. If I had been grading myself I’d have taken points for going too fast. I think we all get excited to knock off all the big pieces before we have completed the area prior. Pace is important when it comes to power scaling. The pace at which the power scaler is applied plays a critical role in ensuring effective plaque removal while minimizing damage to tooth surfaces. The general recommendation is to maintain a slow, deliberate pace to allow the ultrasonic vibrations to break down plaque and calculus efficiently. Moving the scaler too quickly can result in missed areas and ineffective cleaning, as the vibrations need time to dislodge the deposits. A slow and steady pace ensures thorough coverage and better patient outcomes.
Two key techniques for optimizing the use of an ultrasonic scaler are channeling and the use of short overlapping strokes. Channeling involves methodically guiding the scaler along the tooth surfaces in a systematic manner, ensuring that each area is treated thoroughly. This technique helps to prevent over-application in certain areas while missing others, leading to a more uniform cleaning process. Short overlapping strokes are another essential aspect of effective ultrasonic scaling. By using small, controlled movements that overlap slightly, the clinician can ensure that every part of the tooth surface is adequately treated. This technique reduces the likelihood of leaving behind plaque or calculus, enhancing the overall effectiveness of the procedure.
Research has shown that these techniques, combined with a slow pace, significantly improve clinical outcomes. A study by Eberhard et al. (2015) found that using short, overlapping strokes with an ultrasonic scaler leads to more effective plaque disruption and a more thorough cleaning process. Another study by Dragoo (1992) highlighted the importance of a systematic approach, such as channeling, in ensuring comprehensive debridement, particularly in hard-to-reach areas like interproximal spaces. These studies underscore the importance of technique and pacing in maximizing the effectiveness of ultrasonic scaling. Check out channeling and overlapping strokes in our latest video:
Happy Preventing Shelley Brown, MEd, BSDH, RDH, FADHA
References
Dragoo, M. R. (1992). A clinical evaluation of hand and ultrasonic instruments on subgingival debridement. International Journal of Periodontics & Restorative Dentistry, 12(4), 310-323.
Eberhard, J., Ehlers, H., Falk, W., Acil, Y., & Albers, H. K. (2015). Ultrasonic debridement with different irrigation fluids influences clinical outcomes in chronic periodontitis patients: A randomized controlled trial. Journal of Clinical Periodontology, 42(10), 958-967. https://doi.org/10.1111/jcpe.12456
References
Dragoo, M. R. (1992). A clinical evaluation of hand and ultrasonic instruments on subgingival debridement. International Journal of Periodontics & Restorative Dentistry, 12(4), 310-323.
Eberhard, J., Ehlers, H., Falk, W., Acil, Y., & Albers, H. K. (2015). Ultrasonic debridement with different irrigation fluids influences clinical outcomes in chronic periodontitis patients: A randomized controlled trial. Journal of Clinical Periodontology, 42(10), 958-967. https://doi.org/10.1111/jcpe.12456
Dental Hygiene Lunch and Learn List
I know that it’s tricky at times to attend a conference to learn about a new product, or read the hundreds of emails that come through about the products. Plus, once you learn about something new, it’s always nice to have a person or contact to ask questions to, get answers, and actually be able to try it out. This is why I love a lunch and learn. It’s a great way to learn about something new in a set amount of time when I have a break during a clinical day. Plus, having the entire team learn about the products are so helpful to keep the conversation going in your practice.
So, what companies actually offer this service? We’ve compiled a list of the companies that do, and the best place to reach out to about it. Sometimes these educators are location based, so you might have to meet with a certain rep, but then you’ll get to know your local rep which is so helpful. Some companies hold them virtually, which is very helpful to connect with placed that no not have any local.
A note about lunch and learns. Usually, these are most of sales and product information, so CE credits usually are not provided. They are usually full of the science behind the product, but since they are sponsored and 1 comapny/product heavy, they cannot give CE Credit. However, still a valuable lunch to attend!
Here is the list!
Arm and Hammer/Therabreathe
This is a great lunch to attend with lots of free samples. Usually taught by a dental hygienist.
https://ahpro.oralcarepro.com/en-US/officeregistration
BioGaia
Held virtually at times that work for you. Probiotics for adults and kids
https://calendly.com/biogaia-lunch-and-learn/biogaia-lunch-learn?month=2024-09
Centrix
Learn more about SDF or other prevention products and solutions.
https://www.centrixvirtuallearning.com/lunch-and-learn/
Crest Oral-B
I’ve been to some where the reps bring lunch, or it can be just informational.
https://www.dentalcare.com/en-us/product/request-teach-and-learn
DMG
More dental tailored, but some great topics to learn about.
https://dmg-connect.com/learn-over-lunch-with-dmg/
Dr. Jens
I’ve been to a few of the Dr Jens presentations, and have loved them all.
https://calendly.com/drjen-cepresentation/dr-jen-ce-presentation?month=2024-08
Elevate Oral Care
Learn more about some of my favorite prevention products. So much great research and support behind them as well.
https://www.elevateoralcare.com/staff-meetings
GC America
These can be tailored to your office, speciality or interest. From direct restorations to prevention, there are several topics you’ll love to learn about. I really loved the MI Paste one.
https://www.gc.dental/america/lunch-and-learn
Ivoclar
Reach out to your local rep about meeting to learn about a few products, or a specific one you’re curious about.
Oxyfresh
I’ve never used these products before, but signing up for a webinar lunch and learn to learn more.
https://oxyfresh.com/pages/dental-pro-resources-and-educational-material
Phillips Sonicare
Reach out to you local rep for more information. In Person and can cover whitening products or power toothbrushes
https://www.philipsohclearning.com/
Risewell
Learn more about hydroxiapetite and andd how to incorporate the porudcts in your office. Reach out to Melia (melia@hygieneedge.com) and she can help you find your local rep.
https://risewell.com/?srsltid=AfmBOopLzqjqMW_QxmFnWpcRjRIkY892qjmZQKnlwiGCM_MIcCH9nG3P
Stella Life
Mouthrinse, probiotics, and more
Spry
This is a local company to me in Utah, and I use their products regularly. If you’re not talking about xylitol in your practice, it’s time to learn a bit more from some amazing educators.
https://xlear.com/our-educators/
Waterpik
Offered both in the USA and Canada
https://www.waterpik.com/pro/lunch-learn/
I’m excited for you to learn a bit more about these amazing products, gain some insight on how you can help your patients, and keep up your clinical skills!
Which ones have you attended?
xoxo Melia Lewis, MED, RDH
How do you know you are at the base of the pocket?
A review the getting to the base of the pocket.
Identifying when you are at the base of the junctional epithelium during periodontal therapy is critical to ensure that you are effectively removing calculus without damaging the periodontal tissues. Here are 4 key indicators based on my clinical experience and studies:
1. Tactile Sensation
Texture Change: As you reach the base of the pocket, you will notice a change from a rough to a smoother root surface, indicating the absence of calculus and the proximity to the junctional epithelium (Armitage, 1996).
Increased Resistance: The tactile sensation of the instrument changes, often with a slight increase in resistance, as you approach the base of the pocket (Cobb, 2002).
2. Probing Depth and Anatomy
Use the Probe as a Guide: Knowledge of the patient’s probing depths and anatomy can help you estimate when you are near the base of the pocket. The junctional epithelium typically lies at the apical extent of the probing depth (Lindhe et al., 2015).
Limit of Attachment: The junctional epithelium is attached to the root surface via hemidesmosomes and is sensitive to mechanical trauma. Over-instrumentation can lead to bleeding, which might indicate you have gone beyond the base of the junctional epithelium (Haffajee & Socransky, 1994).
3. Clinical Signs
Bleeding on Instrumentation: Light bleeding may occur as you approach the base, but excessive bleeding could indicate that you have disrupted the junctional epithelium (Newman et al., 2018).
Patient Discomfort: Increased sensitivity or discomfort may occur if you are applying too much pressure or reaching the attachment level.
4. Instrumentation Technique
Correct Angulation of Hand Instruments: Proper angulation of the curette or scaler is important. Keeping a hand instruments instrument’s blade against the root surface at a correct angle can help prevent inadvertent damage to the junctional epithelium (Pihlstrom et al., 1983).
See it in action in our video here: VIDEO
-Shelley Brown, MEd, BSDH, RDH, FADHA
References:
Armitage, G. C. (1996). Periodontal diseases: diagnosis. Annals of Periodontology, 1(1), 37-215.
Cobb, C. M. (2002). Clinical significance of non-surgical periodontal therapy: an evidence-based perspective of scaling and root planing. Journal of Clinical Periodontology, 29(S2), 6-16.
Haffajee, A. D., & Socransky, S. S. (1994). Microbial etiological agents of destructive periodontal diseases. Periodontology 2000, 5(1), 78-111.
Lindhe, J., Lang, N. P., & Karring, T. (2015). Clinical periodontology and implant dentistry. John Wiley & Sons.
Newman, M. G., Takei, H., Klokkevold, P. R., & Carranza, F. A. (2018). Carranza's clinical periodontology. Elsevier Health Sciences.
Pihlstrom, B. L., Michalowicz, B. S., & Johnson, N. W. (1983). Periodontal diseases. The Lancet, 366(9499), 1809-1820.
Using a Sharpening Test Stick
For the past year, I have taken on 1 day a week temping. This has been such a great experience for me, seeing so many different offices and how they run, schedule, and what software they use. One thing I have noticed when I step into different offices for the day? How instruments are so different, and how many need to be sharpened! It’s hard to find the time to sharpen (more videos on that coming soon) but once you determine your instrument is dull and either take the time to sharpen or send them out to a company, you’ll see a word of difference on how they actually work so much better, you’ll spend less time hand scaling, and less force needed with our hands. A helpful tool to check your instrument is a sharpening test stick. We have definitely used and loved using plastic air water syringes before as a substitute test stick, but really love using a regular test stick even more. I find it gives me a better indicator of when an instrument is sharp and ready to be used, other than sharpening too much or too little on an edge.
If you haven’t used a test stick before, or haven’t since dental hygiene school, this video is for you!
xoxo Melia Lewis, RDH