Graceys VS Universal Instruments
Here is a plea to have gracey instruments in your office. Hear me out- I know they’re an extra expense, you need to have 2 instruments per tooth, and they add extra mess to your tray. However, if you’re working on pockets greater than 4mm, these specialized instruments are key to reaching the base of the pocket. There is a huge difference between these two instruments, what they are used for, and how they each are utilized to treat very different patients. Let’s break them down.
Universal Instruments:
Design:
Blade Angle: Universal instruments have two cutting edges per working end. The blade is set at a 90-degree angle to the terminal shank.
Shape: The back is rounded, and the working end is semicircular in cross-section.
Cutting Edges: Both edges are used, allowing it to be applied to all tooth surfaces.
Application:
Designed for all areas of the mouth (hence, “universal”).
Commonly used for heavy deposits due to their robust design.
Examples: Columbia 13/14, Barnhart 5/6.
Technique:
Requires tilting the shank to achieve the correct blade-to-tooth angulation (70–80 degrees).
Effective but may require more precision to adapt correctly to curved surfaces.
Gracey Curettes:
Design:
Blade Angle: Gracey curettes have a 70-degree blade angle to the terminal shank, making only one cutting edge functional (lower edge).
Shape: Also has a semicircular cross-section, but the shank and blade are more angulated and area-specific.
Application:
Designed for specific areas of the mouth:
Example: Gracey 1/2 for anterior teeth, 11/12 or 15/16 for mesial surfaces, 13/14 or 17/18 for distal surfaces.
Ideal for fine scaling and root planing, especially subgingivally.
Provides better adaptability to root morphology and furcations.
Technique:
Easier to achieve proper angulation due to the pre-set blade angle.
Less effective for removing heavy deposits compared to universal curettes.
To learn more about graceys, the differences in graceys, and more, definitely watch these videos:
xoxo Melia Lewis, RDH @meliardh
Testing Your Waterlines with A-dec
Has there ever been a time when you’ve been sitting in a dental hygiene CE Course and have felt completely overwhelmed? Like the information is definitely important, but felt cumbersome to apply it to your clinical life? Waterline testing and shocking was that topic for me. I remember sitting in the webinar class 9 months pregnant trying to get some classes in before having a baby and life was quickly changing for me. I wasn’t super interested in the topic, but the speaker was amazing. I was blown away by the stats and facts about waterlines, bacteria, the importance of cleaning out our waterlines in the dental office, and how it was our responsibility to keep our waterlines below the CDC recommended 500 CFU/mL of water of heterotrophic water bacteria. I was also feeling very overwhelmed because we had not been shocking and testing at the office I was working at. I was feeling really awful, some shame, and didn’t know where to start.
However, once you actually see how it’s done and the steps broken down, it definitely doesn’t feel as overwhelming. We have loved going through each step with A-dec and seeing how we can easily perform testing, shocking and maintaining throughout our hygiene days when we already are stretched thin for time.
Honesty, the most important thing to remember when it comes to waterline testing is now is the time to start, and not stress about the past. I remember being so nervous to test my waterlines just in case something popped up that wasn’t desirable. However, knowing better means doing better from here on out.
If you’re feeling the same way about testing and shocking, we are so excited for this three part video series thanks to A-dec. During these series, we’re breaking down the steps to testing, maintaining and shocking to make it easy to use in your practice starting today. Plus, if you’re looking for an easy way to test out a shocking solution, A-dec has made it easy to order your very own samples. We actually used this sample ordering website to get the product to make these videos, which was very easy and shipped to us quickly.
This week, we’re introducing the 1st video of this series: Testing. Testing is crucial to know how to maintain your waterlines and very simple. Check it out below:
To learn more about the A-dec system of tablets, shocking solution, and more, please check out: https://www.a-dec.com/infection-control/icx
xoxo Melia Lewis, RDH
Podcast Features
This has been a busy few months for podcasting with the Hygiene Edge Team! We aren’t going to lie. We love a podcast to learn about new techniques, hear from others, and connect with professionals on a different level. It’s something about sitting in on a conversation that totally lets you get to know a person better.
Here is a list of some recent episodes! What ones have you listened to?
Jessica on Straight up with Steph- All about being an educator. This is perfect if you’re interested in education, learning more about education, or want to jump into an educator roll.
Jessica on Tale of Two Hygienists- Connecting Schools with Community
Shelley on Brush with Britt- Public Health Hygienist- Interested in learning more about mobile dental hygiene and how you can help a very underserved population? This is the place! Shelley has her own mobile practice and talks more about her experience.
Jessica on Brush with Britt- Emotional Resilience in Dental Hygiene School
Shelley on Straight up with Steph- Mobile Business and being an entrepreneur
What is your favorite podcast to listen to?
A glimpse into the next 100 years of dental hygiene according to AI
The next 100 years of dental hygiene, according to AI.
I asked chat GPT the following questions, and the answers are inspiring. A springboard for our profession to launch oral health into the future. I encourage you to review the following and choose your favorite and chase it to improve our profession and the oral health of the world. Let me know in the comments what you see for our future.
What do you think the dental hygiene profession will look like in 100 years with current health care trends.
Personalized, AI-Driven Treatment Plans: AI algorithms could develop highly personalized oral care plans based on genetic and lifestyle factors, providing recommendations and adjustments in real-time for each patient.
Nanotechnology for Preventive and Therapeutic Care: Nanotechnology may allow for microscopic devices to be embedded in the mouth, constantly monitoring oral health, delivering treatments directly to problem areas, and even rebuilding tooth enamel at a molecular level.
Genetic-Based Preventive Care: Genetic testing may become a routine part of oral health care, helping identify individuals at higher risk for conditions like periodontitis, allowing for earlier interventions or tailored preventive strategies.
Virtual and Augmented Reality Training and Treatment: Virtual and augmented reality could be used to train hygienists, provide remote consultations, and enable patients to visualize their treatment plans and oral health progression in real-time.
Widespread Use of Robotics in Clinical Settings: Robots may assist in procedures, improving precision, and perhaps even performing routine hygiene tasks, allowing hygienists to focus more on patient interaction and customized care.
Oral Health Integration in Holistic Health Programs: Oral health will be more closely integrated into overall health care, with hygienists working as part of interdisciplinary teams addressing systemic conditions linked to oral health, like diabetes and cardiovascular diseases.
What do you think dental insurance will look like in 100 years with current health care trends.
Comprehensive Health-Dental Insurance Integration: Dental insurance might be fully integrated with general health insurance, recognizing the link between oral health and systemic health. This could ensure that dental care is covered as an essential part of overall health maintenance, with fewer separate policies or exclusions.
Focus on Preventive Coverage and Incentives: Insurance plans might heavily emphasize preventive care, rewarding patients who adhere to preventive practices like regular check-ups, cleanings, and oral health monitoring. Coverage could extend to innovative preventive treatments, reducing the need for costly interventions later on.
AI-Driven, Personalized Premiums and Coverage: Using AI and data analysis, insurers might set premiums and coverage based on a patient’s unique risk factors, including genetics, lifestyle, and health history. Policies could adapt in real time, updating coverage and costs as a person’s oral health profile changes over time.
Global, Universal Access and Reduced Out-of-Pocket Costs: With health care trends shifting toward equity and accessibility, universal dental insurance could become common, making oral health care affordable and accessible worldwide. Out-of-pocket costs may decrease significantly as public health initiatives prioritize preventive and accessible care
What do you think work place ergonomics and safety will look like in 100 years with current health care trends.
Dynamic, AI-Enhanced Ergonomic Monitoring: AI systems may continuously monitor workers’ postures and movements, providing instant feedback and making real-time adjustments to workstations. This could help prevent injuries by encouraging healthier habits and reducing repetitive strain through subtle reminders or automatic adjustments.
Wearable Health Sensors: Health care workers might wear discreet, multi-functional health sensors that track stress, posture, and muscle strain. These devices could alert workers and managers when rest or adjustments are needed, fostering a proactive approach to both physical and mental health.
Exoskeletons and Robotic Support Systems: Exoskeletons or robotic assistive devices could help workers handle physically demanding tasks, reducing strain on muscles and joints. These could be standard in hospitals, aiding in lifting, bending, or assisting patients, thus lowering the risk of musculoskeletal injuries.
Ergonomics-Centric Workspace Designs: Workspaces will likely be designed with flexibility, automation, and ergonomics as primary factors, incorporating customizable lighting, noise control, and air quality adjustments to support worker health. Restorative spaces for breaks, complete with guided relaxation and stretching programs, may be embedded into the workplace, promoting overall wellness.
Use of A Sickle During Periodontal Therapy
This week, Jessica Atkinson demonstrates her technique for using a sickle scaler to effectively reach beneath the contact area during periodontal therapy. With its narrow, triangular-shaped tip, the sickle scaler is an ideal tool for navigating tight interproximal spaces. While it's traditionally not recommended for use on the cementum covered root surfaces due to the potential for damage, having a sickle scaler on hand during periodontal therapy is invaluable for scaling on enamel surfaces, especially when removing those last bits of tenacious deposits.
"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