For Dental Sales Professionals
Solutions Spotlight
February 2019
TM
Clean Water. Clear Choice.™
Using tablets for waterline compliance may come at a cost to your customer’s practice
The disadvantages of using tablets add up • $821/year for just one operatory*: Approximate cost for following tablet instructions for use (IFU)
DP365B Independent Water Bottle Cartridge For independent water bottles. Easily installed by dental staff onto existing pickup tube with included fitting.
• Shocking and monitoring: Required procedures included in ALL tablet IFUs - Necessary to maintain compliant CFU counts
• Tablets must be added at every water change and given the proper time to dissolve
With the DentaPure™ Cartridge, ensuring dental unit waterline safety has never been easier.
• Potential risk of staff daily exposure to chemicals
1 Simple installation
• Service technician calls may increase due to a gradual buildup of tablet residue and undissolved tablets potentially blocking connections and narrow passageways. Tablet residue and undissolved tablets may also adversely affect expensive handpieces over time.
1 Year of compliant water†
• Staff time and expense to manage daily tablet use as well as shocking and monitoring procedures per IFUs
All claims based on use with potable water. * Includes cost for initial shock, daily tablets, shocking per IFU quarterly waterline testing and labor. † Or 240L of water, if usage records are kept. All product names are trademarks of Crosstex International, Inc., a Cantel Medical Company, its affiliates or related companies, unless otherwise noted. © 2019 Crosstex International, Inc. 0119 DADV00619 Rev A
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FEBRUARY 2019
FOR DENTAL SALES PROFESSIONALS
Solutions Spotlight 20
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A New Age in Dentistry
Dealing with Toxic Coworkers
First Impressions
The look and feel of the reception area is important, but keeping it free of germs and infection is critical to the health of patients and staff.
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Safe Water, Safe Patients
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Biotec Custom Steri-Centers: Sterility assurance for any size practice
Infection Control in the Dental Practice: Questions to Ask
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Medical Waste Management
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Editor’s Note
Growing attention to the hazards of contaminated dental unit water has led more dental clinicians to take the necessary steps to protect their patients.
A Picture’s Worth a Thousand Words Improvements in intraoral camera technology help dentists expand their care.
With so many new digital impression options available, it’s important to offer your dental customers a proven solution that meets the needs of their practice.
Quickbytes
Technology News
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News
February 2019
First Impressions
Digital Impression Technology
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EDITOR’S NOTE
LAURA THILL Editorial Staff Editor Laura Thill lthill@ sharemovingmedia.com
A New Age in Dentistry Our tradition at
First Impressions Magazine is to begin each year by offering readers a glimpse of newer products, technologies and services, which they, in turn, can share with their dental customers. We hope this year’s Solutions Spotlight helps clinicians remain leaders in their field.
That said, not every dental patient is on board with the value of newer dental treatments – a continuous source of frustration for providers who genuinely care about their patients’ health. The good news is, based on current findings, it’s becoming difficult for the public to discount the importance of preventive dental care. As researchers continue to connect the dots between oral health (particularly periodontal disease) and other chronic conditions, such as diabetes, heart disease and asthma, payers, regulators and providers are getting the message. Patients will likely have a harder time ignoring care and treatment. For instance, in October 2018, Dominion National, a dental insurer and administrator of dental and vision benefits, released a study indicating people with chronic health conditions such as asthma, diabetes and heart disease who received preventive dental care covered by Capital BlueCross’ BlueCross DentalSM benefits had fewer emergency room visits and hospital stays. Before that, in September 2017, dental insurer United Concordia released a study examining the medical benefit when an individual absent a chronic medical condition regularly sees their dentist two times a year for checkups and cleanings, compared to those who do not. “The dental/medical connection has picked up momentum in the past two decades,” says Dominion National Vice President of Marketing Jeff Schwab, whose company not only provides dental and vision benefits, but administers dental benefits on the part of medical insurance providers. “Overall, oral health professionals and physicians recognize the benefit of closing the information gap between them,” he says. Short of sharing patient records, primary care providers – particularly pediatricians – can continue to promote dental care to their patients; meanwhile, dentists can discuss the oral/medical connection to their patients, help detect signs of several chronic health conditions through oral exams, and refer patients to the appropriate healthcare provider. 2019 isn’t just a new year for your customers. It looks to be the start of a new age in dental healthcare.
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Managing Editor Graham Garrison ggarrison@ sharemovingmedia.com Founder Brian Taylor btaylor@ sharemovingmedia.com Senior Director of Business Development Diana Craig dcraig@ sharemovingmedia.com
Director of Business Development Jamie Falasz, RDH jfalasz@ sharemovingmedia.com Art Director Brent Cashman bcashman@ sharemovingmedia.com Circulation Wai Bun Cheung wcheung@ sharemovingmedia.com Weekly Drill Editor Alan Cherry acherry@ sharemovingmedia.com
First Impressions is published bi-monthly by Share Moving Media 1735 N. Brown Rd. Ste. 140 • Lawrenceville, GA 30043-8153 Phone: 770/263-5257 • Fax: 770/236-8023 www.firstimpressionsmag.com
First Impressions (ISSN 1548-4165) is published bi-monthly by Share Moving Media., 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2019 by Share Moving Media. All rights reserved. Subscriptions: $48 per year. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Share Moving Media., 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors.
First Impressions editorial advisory board Shannon Bruil, Burkhart Dental Frank Cohen, Safco Steve Desautel, Dental Health Products Inc. Nicole Fox, Patterson Dental Suzanne Kump, Patterson Dental Dawn Metcalf, Midway Dental Supply Lori Paulson, NDC Patrick Ryan, Benco Dental Co. Scott Smith, Benco Dental Co. Tim Sullivan, Henry Schein Dental
Clinical board Brent Agran, DDS, Northbrook, Ill. Clayton Davis, DMD, Duluth, Ga. Sheri Doniger, DDS, Lincolnwood, Ill. Nicholas Hein, DDS, Billings, Mo. Roshan Parikh, DDS, Olympia Fields, Ill Tony Stefanou, DMD, Dental Sales Academy
“Safety is our best marketing tool” “When we designed our office, we put a large window in our sterilizing room. People asked why we wanted patients to see dirty instruments. Easy – we want them to see how effectively we practice and trust that everything is completely sterile for their safety. And because it’s unique and cool, their word-of-mouth becomes our best marketing tool.” Dr. Ileana T. Toro, DMD Dr. Junot J. Franco, DMD Village Park Advanced Cosmetic and Family Dental
Better care, by design Are you ready to design for safety? Midmark can help you design your clinical space to achieve the workflows you need, from your instrument processing area to your operatory. 1.800.MIDMARK | midmark.com
© 2019 Midmark Corporation, Miamisburg, Ohio USA. All rights reserved.
PRACTICE POINTS
BY KRISTINE BERRY, RDH, MSEC, SENIOR CONSULTANT
Dealing with Toxic Coworkers Editor’s note: Dealing effectively with problematic coworkers can help your dental customers maintain successful and satisfying work lives, according to Kristine Berry. The following piece offers practical solutions for dental professionals who may need to address this issue.
There’s one in every dental office. She’s the colleague who is always late
to poor work performance, absenteeism and health problems. Sometimes outstanding employees who see no solution to a toxic coworker look for a new job. In today’s competitive work environment, where finding and retaining talented people is increasingly difficult, this is a loss few dental groups can afford. Complaining to management or the owner about a problematic coworker is often ineffective and can backfire, making you look like the problem. But, there are some useful steps you can take to deal with this common workplace challenge. Remember, if you believe you have some control, you do.
to the huddle and never cleans her operatory on time. She’s apologetic, comes prepared with an excuse, and promises this will be “the last time!” You’ve been the nice guy, and have even covered up for her. But, now, you are sick of it.
Or, in another scenario, this may be the coworker who takes credit for work you did. She steals your ideas and talks about you to others. A master of double-talk and double-dealing, she’ll deny everything and try to convince you – and others – that you’re the crazy one. You are angry and obsessed with her behavior, and sometimes you wonder if you are going crazy. The issue of problem coworkers has received less attention than that of managing a problematic boss of abrasive employees. Yet, in one study, 80 percent of people have reported that a single coworker has contributed significant stress to their workday. This stress isn’t just dangerous to employees; it has a negative impact on the entire dental practice and company. It can lead
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Look first to yourself Are you the problem? Do you listen without interrupting? Do you take everything personally? Are you willing to change? Taking
responsibility for your part will make it much clearer regarding how to proceed with a problematic peer.
Make sure this isn’t about a personality conflict or office politics Gender, race, culture and religion affect behavior in the workplace. What may be offensive to you may be reasonable to someone of another race or culture. For example, customs vary as to what is considered acceptable vs. abrasive behaviors. The rules of workplace behavior may have been hidden from co-workers, absent from professional resources or a result of family upbringing. Your coworkers may be unaware of the impact of their actions or words. What you might find offensive may be regarded as reasonable to someone of another race, culture, generation or country/ state of origin. Some may not have received the training or tools to resolve conflicts or issues. For example, one team member shared that growing up, she often laughed when disciplined, as it was a way to save face in front of her older siblings. In her world smirk or laughter was a go-to reaction, not a sign of insolence or insubordination. However, she brought this behavior into the office, and when her manager provided her with feedback, he believed she was uncaring and perhaps not a good fit for the practice. Understanding critical gender, racial and cultural disparities can provide a new perspective and lead to a conversation for expected professional behavior.
Classify the problem objectively
People, communications consultant Muriel Solomon strongly suggests immediately taking control when a coworker is deceitful, manipulative or exploitive. Stay calm, and be firm and up-front. Refuse to be drawn in, but state how you perceive the problem as clearly and courteously as possible. Understand this behavior has insecurity and anxiety at the root. Reinforcing this person’s self-efficacy and self-confidence in their tasks might influence them to take more ownership of their actions rather than steal yours. You may have to repeat this several times as needed.
Toxic behavior can consist of any action that creates emotional distress sufficient to disrupt organizational functioning. Hence, a toxic co-worker is defined as any individual whose interpersonal behavior causes psychological pain in coworkers, sufficient to disrupt organizational operation.
Measuring the problem helps make it less threatening. Not every problematic colleague is the same. One approach is to identify whether this situation falls into one of three categories: difficult, challenging or toxic. Determining this will help you take the right steps. • Difficult. This is a situation that can usually be solved by a single action. For example, your coworker loves to schmooze and interrupts your workflow with comments, personal problems or requests for help. A one-on-one friendly conversation in which you explain why this is a problem for you usually helps. Offering to go to lunch together, or scheduling time to talk, can help avoid turning a pesty colleague into an enemy. • Challenging. This is a situation that requires more work on an ongoing basis. Take the coworker who turns every situation into a competition and can’t seem to grasp the concept of teamwork. In her book, Working with Difficult
• Toxic. Like some chemicals in the workplace, certain coworkers may be genuinely harmful to your health. In fact, these people are like a hidden cancer in the workplace, according to psychologists Alan A. Cavaiola and Neil J. Lavender. In their book Toxic Coworkers: How to Deal with Dysfunctional People on the Job, they list a range of personality disorders that, when taken to the extreme, can tear a workplace apart. Toxic behavior can consist of any action that creates emotional distress sufficient to disrupt organizational functioning. Hence, a toxic co-worker is defined as any individual whose interpersonal behavior
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PRACTICE POINTS
causes psychological pain in coworkers, sufficient to disrupt organizational operation. In extreme cases, abrasive behavior can impact productivity to the point of paralysis. In some cases, the best solution is to avoid the toxic person as much as possible, keeping all interactions matter-offact and brief. If that is not possible in your office, consider scheduling a time to speak with this person. If you are successful at creating self-awareness, which changes the toxic behavior, you and your co-workers’ suffering ends and the toxic person may even be grateful for your willingness to take the
b. “These perceptions are doing you damage.” 4. Describe the perceptions as specifically as you can. a. “I observed that you do/say….” (Be direct.) 5. Avoid generalities, such as: “You are rude/harsh/ aggressive/insensitive.” 6. Describe the impact this person’s behavior has on others. a. “When you don’t arrive on time for the huddle, I feel that you are treating us disrespectfully.” 7. Set consequences for further negative perceptions: a. “If this continues, I will have to talk with our office manager, Cathy. (Clearly state the consequence.)
This stress isn’t just dangerous to employees; it has a negative impact on the entire dental practice and company. It can lead to poor work performance, absenteeism and health problems. time to bring this to his/her attention. “It meant a lot that she cared enough to talk to me,” said one former toxic coworker after a teammate took her out to lunch. The following steps are designed to help ensure an intervening conversation is a win-win for everyone involved: 1. Describe the individual’s value to you as a co-worker; don’t bother intervening if they don’t have any value. 2. Explain that you believe you owe it to him or her to clue them in and make them aware of the growing problem. a. “I had a choice whether or not to talk to you about this, and I feel a responsibility to let you know about these negative perceptions.” 3. He/she is not the problem. Rather, negative perceptions about his/her interactions with others are the problem. a. “I don’t want you to be perceived this way.”
If the situation is truly harmful, it may be time to talk to your manager or owner. Intervention at this level starts when the toxic employee’s supervisor sits down with this person to address his/her conduct. The intervention is similar in sequence to the above steps, but the supervisor has the authority to: • Determine conduct expectations. • Evaluate conduct. • Set limits and consequences for continued unacceptable conduct. • Offer help, such as training, specialized coaching or additional resources. • Monitor for improvement.
It is important to emphasize that speaking with, or coaching, a toxic employee assumes your office has a code of conduct and a culture intolerant of mistreatment. If this is not the case, you might consider the cost of staying vs. the costs of leaving. If you have no authority over the toxic co-worker who is making you miserable, and management refuses to intervene, or intervenes unsuccessfully, then another option is to consider other employment opportunities; buff up your resume, brush up on your networking skills and beef up your savings. Our jobs and careers are an integral part of who we are. Dealing effectively with problematic coworkers can help us maintain successful and satisfying work lives.
Kristine Berry RDH, MSEC has worked as a clinician, a dental board examiner, a dental operations executive, a practice management consultant, an educational manager for a global Fortune 500 company and an operational director, overseeing $23 million of revenue for dental service organizations in NH and NC. Currently, she is a senior consultant, specializing in enhancing group practices. She invites dental professionals who have a sticky situation at work to contact her via email at kristine@kristineberry.com.
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INFECTION CONTROL
BY LAURA THILL
First Impressions The look and feel of the reception area is important, but keeping it free of germs and infection is critical to the health of patients and staff.
The dental reception area is the initial point of reference for patients, who expect a clean, welcoming environment that attests to the professionalism of the practice. Anything less may make them think twice about returning, according to Leann Keefer, RDH, BS, MSM, director of clinical services and education, Crosstex, A Cantel Medical Company. “We never get a second chance to make that first impression,” she points out. “The appearance of the reception area reflects the attitude and habits of the dentists and staff,” says Keefer. “It’s critical to make a positive, lasting impression. In addition, the reception area should be designed to optimize patients’ mood and well-being, as well as improve their perception and experience.” Patients are reported to comment more frequently on their experience in the reception area than on the dental team’s clinical skills, she adds. “Clinical care and staff/patient relationships are key to having patients return, but don’t
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underestimate the power of how the dental office presents itself to patients.” Achieving the ideal look and feel of the reception area is only half the battle. Upper respiratory and seasonal illnesses are easily spread, making it imperative for the dental staff to follow regular infection control protocols. “Upper respiratory and seasonal illnesses can be spread through direct contact with mucous membrane; cross-contamination with clinical contact surfaces; and droplet transmission, including sneezing and coughing, which spreads the pathogens by large particle droplets that carry microorganisms,” says Keefer. “People with flu can spread it to others up to about six feet away,” she continues. “Most experts think that flu viruses spread mainly by droplets made when people with flu cough, sneeze or
talk. These droplets can land in the mouths or noses of people who are nearby, or possibly be inhaled into the lungs. Less often, a person might get flu by touching a surface or object that has flu virus on it, and then touching their own mouth, nose or eyes.” (https://www.cdc.gov/flu/about/disease/spread.htm) People often misread their seasonal illnesses, Keefer continues. For instance, a sick person can be contagious before his or her symptoms appear. “If you have a cold, you’re contagious for one or two days before your symptoms develop and for two weeks after you are first exposed to the virus,” she says. “With the flu, people are the most contagious in the first three to four days after symptoms begin. However, it is possible to infect others a day before symptoms start. Children and those with weakened immune systems may pass the virus for longer than seven days.”
First lines of defense The reception area receives heavy traffic, from early morning to evening. If left unattended, it inevitably will become cluttered with waste and carry the potential for cross-contamination, notes Keefer, who recommends daily cleaning and maintenance, with emergency cleanups throughout the day as needed. “The staff shouldn’t ignore details that can differentiate the practice,” she explains. “They should take 10 minutes to sit down and carefully view the reception area through the eyes of a patient. “Boxes of facial tissues and pump bottles of alcohol-based hand rub should be appropriately placed for patient use in the reception area,” Keefer continues. “Wastebaskets with lids should be positioned for easy access to avoid used tissues being left on tabletops or hidden under chairs.” It’s also important to account for patient demographics when selecting and arranging furniture, she points out. “Given that some patients value their privacy and are concerned about other people’s germs, it’s better to arrange small groupings of chairs than line them up along the perimeter of the room.”
How clean is that surface? Cold viruses have been shown to survive on surfaces for several days, while flu viruses are capable of being transferred to hands and causing an infection that can survive on hard surfaces for 24 hours. The staphylococcus aureus bacteria that cause MRSA infections can survive for days to weeks on surfaces. MRSA bacteria can live on surfaces for longer than some other bacteria and viruses because they survive better without moisture. Generally, MRSA bacteria survive for longer on hard surfaces than on soft surfaces. Germs generally remain active longer on stainless steel, plastic and similar hard surfaces than on fabric and other soft surfaces. Other factors, such as the amount of virus deposited on a surface and the temperature and humidity of the environment, can also affect how long cold and flu germs stay active outside the body. The dental staff should follow surface disinfection protocol for housekeeping surfaces using the appropriate chemical/ cleaner and process with dwell time. That said, they should be
The dental staff should follow surface disinfection protocol for housekeeping surfaces using the appropriate chemical/cleaner and process with dwell time. That said, they should be mindful, as strong cleaning solutions used to kill germs can cause respiratory problems.
Posting respiratory etiquette and hand hygiene signs in the reception area can serve to remind patients to cover their coughs and wash their hands, she says, noting that posters may be downloaded from the following websites: • http://www.health.state.mn.us/divs/idepc/dtopics/ infectioncontrol/cover/ • http://www.health.state.mn.us/handhygiene/how/clean8.pdf
mindful, as strong cleaning solutions used to kill germs can cause respiratory problems. They should wear appropriate personal protective equipment (PPE) during cleaning and maintenance, including a Level 1 ASTM face mask, safety eye protection and heavy-duty utility gloves, says Keefer. “PPE must be donned/doffed appropriately, and hand hygiene should be performed immediately after doffing PPE.” It’s important to take a consistent, organized approach, she says. “Cleaning from high to low, and back to front, helps avoid dust and debris falling back onto the surface,” she explains. “Durable, washable surfaces – including both healthcare grade and those manufactured for commercial use – are easier to clean. Clean first, then use an appropriate level of sanitizer or disinfectant as indicated, based on the surface being treated. (The friction of cleaning removes most germs, leaving remaining germs to be addressed by the sanitizer or disinfectant.)
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INFECTION CONTROL “Sanitizing reduces germs on inanimate surfaces to levels considered safe by public health codes or regulations,” says Keefer. “Disinfecting destroys or inactivates most germs on inanimate objects, with the exception of bacterial spores and prions. It is important to follow the manufacturer’s instructions for use and maintain the safety data sheet binder for any cleaning materials or products used in the office. Microfiber cloths and flat mop heads are recommended due to their ability to pick up and hold dirt, as well as efficiently absorb liquid, notes Keefer. “The absorbency of microfiber is up to seven times its own weight in liquid, which is great for cleaning spills or glass surfaces, without leaving streaks.” It can be
helpful to keep color-coded, microfiber cloths on hand for each purpose, she adds. “Using machine washable microfiber cloths can help cut the cost of disposable cleaning products, such as paper towels. By folding the microfiber cloth into thirds lengthwise, and then again in half provides, multiple clean surfaces during cleaning and dusting. And, it’s better to spray a cleaning/ disinfecting product directly onto the cloth as opposed to the surface to reduce aerosol and respiratory hazards. In addition, she recommends adhering to the following protocols: •W indows, doors, walls and mirrors. All floors, walls, surfaces, cabinets, drawers, and equipment must be capable of being quickly and easily cleaned and disinfected. Using a microfiber cloth, damp wipe vertical surfaces and ledges, paying particular attention to smudges and fingerprints; use a cleaning agent as needed. • High Touch Surfaces. This includes – but is not limited to – door handles, cabinet knobs, light switches, remote controls, phones and sink faucets, which should be cleaned and disinfected daily with an EPA-approved disinfectant. If high-touch surfaces become visibly dirty, they should be immediately cleaned and disinfected. • Furniture. Regular vacuuming of upholstered items can refresh the fabric and keep furniture looking good. The dental staff should spot clean any fabric and use appropriate solutions for vinyl and leather surfaces. They should dust light bulbs and replace burnedout bulbs. Using plug protectors in electrical outlets help keep younger patients’ fingers safe. • Tables and wood. All wood trim on furniture and tables should be dusted. A mixture of a cup of olive oil and a quarter-cup of white vinegar can nourish the wood and help it retain its shine. Plus, the vinegar is a natural germ killer. In addition, the furniture legs, the front of the reception desk and other surfaces should be scrubbed.
Toys, games and play equipment can be easily wiped clean. It’s helpful to limit toys to those that are washable, with fewer parts and smooth/flat surfaces.
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be spot cleaned as needed, and cleaned every three • Interactive toys. Toys, games and play equipment can months. Hard flooring should be cleaned using a be easily wiped clean. It’s helpful to limit toys to those that broom or dust mop, followed by flat-head mop for are washable, with fewer parts and smooth/flat surfaces. light cleaning. Colorfast, plastic toys can be disinfected using a solu•O dors. Odors can be particularly offensive to patients tion of a ½ cup of bleach per gallon of water. Toys should and staff. A good ventilation system be soaked for five minutes, then with charcoal filters can help minirinsed and air dried. mize unpleasant odors. Cautionary • Electronic equipment. TeleviLoose items should be kept use of disinfectant/deodorant sprays sions, monitors and cords should organized in containers, office is recommended, as patients may be be wiped with a dry microfiber allergic or have respiratory concerns. cloth approved for electronics and policies should be saved in no-scratch surfaces. The entire plastic sleeves in a three-ring Throughout the day, the dental staff surface of remote controls, keybinder, and magazines and should practice proper hand hygiene. boards and mouse pads should be wiped. It’s particularly imporpamphlets should be stored in Washing hands with soap and water is the best way to get rid of germs. If soap tant to address buttons, which are clear plexiglas holders and wall and water are not available, an alcohola source of cross contamination. based hand sanitizer (minimum 60 perAlternatively, single-use disposmounts to keep them orderly. cent) is recommended. The staff should able surface barriers may be used offer respiratory prevention packets (i.e., to protect electronics. a disposable surgical mask, facial tissues and cleansing wipes) • Trash and Recycle Containers. Loose trash should be to all symptomatic patients. And, they should attempt to isolate picked up throughout the day and properly disposed of. all patients with suspected illnesses. When checking the trash bin for emptying, staff should Loose items should be kept organized in containers, office refrain from reaching into, or pushing on, the trash liner to policies should be saved in plastic sleeves in a three-ring compress the trash. Rather, they should leave the liner in binder, and magazines and pamphlets should be stored in container, close the top, and twist and tie a knot in the top clear plexiglas holders and wall mounts to keep them orderly. of the bag. (When disposing of the trash bag, it should be “While studies have shown low fomite contamination of the carried away from one’s body.) All surfaces of the trash conglossy pages, some offices are removing magazines from the tainer should be wiped down with a surface disinfectant wipe reception area and asking patients to bring their own reading and allowed to air dry before replacing it with a new liner. materials and children’s toys to reduce the risk of cross con• Flooring. Carpets should be vacuumed daily using a tamination,” says Keefer. HEPA filter, low decibel vacuum cleaner. They should
Infection prevention resources The CDC offers a number of resources, including its Summary of Infection Prevention Practices in Dental Settings: Basic Expectation for Safe Care (2016) and Respiratory Hygiene/Cough Etiquette in Healthcare Settings, which are designed to limit the transmission of respiratory pathogens spread by droplet or airborne routes. The strategies primarily target patients and individuals accompanying patients to the dental setting, who might have undiagnosed transmissible respiratory infections; however, they apply to everyone – including dental healthcare personnel – with signs of illness, such as cough, congestion, runny nose and/or increased production of respiratory secretions. Additional information related to respiratory hygiene/cough etiquette can be found in the 2007 Guideline for Isolation Precautions (available at: http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf). Recommendations for preventing the spread of influenza are available at: http://www.cdc.gov/flu/professionals/infectioncontrol/.
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INFECTION CONTROL
Safe Water, Safe Patients Growing attention to the hazards of contaminated dental unit water has led more dental clinicians to take the necessary steps to protect their patients.
There are no shortcuts to obtaining compliant dental water. Without the right products and protocols, however, dental practices will not be able to meet the acceptable standard for water delivered to patients during non-surgical procedures. What’s more, even though compliance with water safety standards in the United States has not been required by law, that is changing. “A dental practice simply will not achieve compliance without effective, EPA-validated products used in accordance with the correct protocols,” says Jerod Mendolia, marketing assistant, Sterisil, Inc. “At Sterisil, our philosophy is embodied in the acronym, PPC: Products + protocols = compliance. We have applied this methodology with great success in various
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settings, from mid-sized five-chair clinics to Ivy League dental schools.” New technology is important, he adds. But unless clinicians are educated on the appropriate protocols and develop a conscientious attitude, “we are setting them up for failure.”
A serious business Because dental water is used as an irrigant solution in conjunction with high-speed rotary handpieces, potentially contaminated aerosols and spatter can carry waterborne pathogens through the air, increasing the potential for infections. Unwanted health implications associated with contaminated dental unit coolants
range from the exacerbation of existing asthma symptoms due to endotoxin exposure to complex bacterial infections, such as Legionnaires’ disease, according to the Organization for Safety and Asepsis Prevention (OSAP). In recent years, two high-profile cases have linked dental unit water to serious infections, notes Mendolia. The first incident occurred at Dentistry for Children in Jonesboro, Georgia. A second incident occurred at Children’s Dental Group in Anaheim, California. In both cases, Mycobacterium were isolated as the cause of infections in pediatric patients who received a pulpotomy procedure with contaminated dental unit water, he points out. Although the Centers for Disease Control and Prevention (CDC) has recommended that water delivered to patients during non-surgical dental procedures meet Environmental Protection Agency (EPA) standards for drinking water (<500CFU), some question whether this is sufficient in a clinical environment. “In 1995, the American Dental Association challenged dental unit manufacturers to develop the equipment necessary to deliver effluent handpiece water with <200CFU,” says Mendolia. That standard has since been raised to the <500CFU/ml drinking water standard. “Currently, there are many products on the market validated to deliver levels of disinfection well below 200CFU. I don’t think it is unreasonable to expect dental professionals to meet this higher standard considering the number of products and protocols available with advertised effectiveness claims at ≤10CFU.”
storage can lead to incubation of existing bacteria in the tank to >500CFU. Most waterline treatment products will have some sort of disclaimer stating for use with potable water. So, contaminated storage tank water would be unsuitable for use with many chemical treatments based on this alone. “Since the introduction of the independent bottle reservoir, chemical treatments have become a viable and convenient method for reducing effluent dental water microbes,” he continues. “When dental clinicians follow the instructions for use (IFUs), they can expect good results. However, when using municipal tap water, they must do so with caution. Municipal contaminants like chlorine and copper can interfere with the efficacy of some chemical treatments. The best regimens will always feature both shock and maintenance
“ Tap water is not suitable for the dental setting for many reasons, but particularly due to the infinite variability in water chemistry. If clinicians are using residual disinfectants to control microbes in a dental chair, these details matter. Distilled water will always save the dental practice a lot of headaches in the end, trust me.”
The right solution For many dental professionals, the importance of delivering safe water during patient treatment is clear. Navigating their options, however, can sometimes be tricky. There are several methods available for treating water, notes Mendolia, and clinicians must stay informed in order to best serve their patients. There are advantages and disadvantages to each. There are many filter options capable of removing some level of microbial contaminants, but without the presence of a residual disinfectant, filtration alone is insufficient to consistently maintain and prevent microbial growth downstream from the filter, according to Mendolia. For best results, filtration should be paired with an ion exchange-based product for shock and residual disinfection. “Clinicians should steer clear of filtration methods that require water storage in a tank,” he says. “Unless the practice has something like a UV light after the tank, water
– Jerod Mendolia, Sterisil, Inc.
treatments that are compatible with one another. Whenever possible, clinicians should use distilled water in their bottle reservoirs for the best results.” In theory, in-office distillers are a viable solution, notes Mendolia. However, they are often associated with water test failures. “The machinery of distilling demands regular cleaning and disinfection to ensure the water purity and microbial viability,” he explains. “Once water has been heated into a gas and condensed back into liquid, it no doubt will be above room temperature. This increases the likelihood you are incubating bacteria as it’s stored. Without a residual disinfectant or some sort of shock treatment prior to introduction to the chair, it’s unlikely the 500CFU drinking water standard will be met, and the practice risks violating the manufacturer’s labeling. “Don’t get me wrong,” he says. “Distilled water is much better than municipal tap water in just about every way. But physically distilling water is not the most effective method. Deionized water is essentially the same thing, and the process by which it
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INFECTION CONTROL is created does not increase the bacterial content. It is for this reason, all Sterisil systems employ this technology as the final purification step. Now you have a very pure base water to which a residual disinfectant can be introduced, with minimal interference from microbes or chemical contaminates.” Pre-sterilized water is clean enough for any dental procedure, says Mendolia. “However, once it is introduced into a dental chair, it is unlikely to meet the <500CFU standard,” he points out. “Unless the dentist intends to irrigate with singleuse pipettes or purchase a very expensive sterile water generator, this will not be a viable option.” And, the cost of purchasing sterile water makes this an unaffordable option for many dental practices, he adds. Mendolia recommends that dental practices use their bottle reservoirs for their intended purpose. “The independent bottle reservoir was designed to isolate the dental unit from
the product did not expire prematurely). If both tests pass, the practice can begin testing every six months. If there is a test failure, the clinician should shock immediately and retest per the waterline treatment manufacturer’s IFU. I personally recommend testing through a third-party lab that specializes in dental water microbes, like Agenics. They offer HPC counts and many other water chemistry metrics that help diagnose problems should they arise.”
Legal precedent Compliance with water safety standards in the United States has not been required by law. But, that’s quickly changing. “Water compliance may not have been the law in 2016, when 73 pediatric patients contracted Mycobacterium infections from contaminated dental water at Children’s Dental Group in Orange County, California,” says Mendolia. However, in 2019, it will become a law in California, he points out, noting that eventually much of the country will likely follow suit. “What I try to impress on people is that this issue isn’t going away,” he says. “Now that there are legal precedents associated with patient vs. clinicians, and manufacturers vs. clinicians, with regard to this topic, it will be difficult for dental clinicians to prove in court that they are not responsible for any infections related to dental water in their practice, even if they weren’t legally required to take action.” That said, for some dental professionals, cost will always be an obstacle. “We must focus on the relative cost per liter differences among the various products, relative to their overall need for water,” says Mendolia. “If a large practice intends to confront this problem head on, it would serve them well to go with the option that has the lowest cost per liter. That’s not always the lowest initial cost, but the purchase will pay for itself with time. Sometimes dental practices just want to get their toes wet, so to speak. “Low cost options like Citrisil tablets are a good place to start, with the same great treatment you get from the higher end products,” he says. But, they’re not as convenient as a long-term solution. “The low-cost options in this category always leave something to be desired when it comes to efficiency and cost per liter.” As more practitioners are on board with the need for waterline treatment, they are looking for solutions that provide enhanced efficiency and require less staff involvement, notes Mendolia. “We are here to help,” he adds.
“ A dental practice simply will not achieve compliance without effective, EPAvalidated products used in accordance with the correct protocols” municipal tap water and provide a conduit through which antimicrobial treatments could be introduced,” he says. “Tap water is not suitable for the dental setting for many reasons, but particularly due to the infinite variability in water chemistry. If clinicians are using residual disinfectants to control microbes in a dental chair, these details matter. Distilled water will always save the dental practice a lot of headaches in the end, trust me. “Dental practices should always consult with their dental unit manufacturers and their waterline treatment providers about water testing,” Mendolia continues. “Minimum standards for water testing should be followed whenever possible, even though they are recommendations rather than requirements. If the dental practice’s protocols are in line with these standards, it is off to great start.” A passing water test verifies the absence of bacteria and validates the dental practice’s disinfection efforts, he points out. “According to OSAP, dental practices should be testing within 30 days of introducing a new product or new protocols, and then every 30 days thereafter,” he says. “The initial test validates the product and protocol’s efficacy, and subsequent tests validate the protocol execution throughout the product’s lifespan (assuming
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INFECTION CONTROL
• How does the practice currently process its handpieces? • Do the material setup tubs match the practice’s instrument setups? • How does the practice dispose of biohazardous materials? It’s important to determine where to bring contaminated instruments into the steri-center, as well as where to leave sterile, ready-for-use instruments. In addition, it’s important to measure the space and identify electrical outlets, as well as where plumbing and lighting will go. (If necessary, is it possible to move any of these utilities?)
Biotec Custom Steri-Centers: Sterility assurance for any size practice Sterility assurance depends on good design of the space desig-
nated for instrument processing.
First and foremost, steri-centers must be designed to comply with OSHA and CDC standards. In addition, a well-designed steri-center facilitates organization, efficient processing of dental instruments and the quick turnover of dental instrument setups. In many cases, traditional straight-line steri-centers work very well. But older, Ushaped centers, which do double duty as supply storage areas, do not! That said, the use of modular dental cabinetry and some custom-built modules can make any size or shape of space become a functional efficient steri-center. And with the growth of larger group practices and DSO-type facilities, many practices require a mega-sized steri-center to accommodate the flow of staff and trays. A well-designed steri-center should incorporate the systemized processing of instruments, the use of cassettes, and protocols for color coding of instruments, handling biohazardous materials, cleaning instruments and storing sterile instrument setups. Some points to consider when designing a steri-center include: • Is the current steri-center in need of a face lift? • How many procedures does the dental practice perform each day? • What is the current protocol for procedure setups? (Using instrument cassettes not only saves time, but will reduce the amount of space required.)
The large group practice The large practice presents a unique set of challenges for a private practitioner. Given the magnitude of instruments that require processing, and the movement of staff entering and exiting the sterilization center, the space must be well designed to maximize efficiency and guarantee efficacy. In one particular case, for instance, Biotech, Inc. created a steri-center with two entries: a pass-through from the hallway outside the space at one end for receiving contaminated trays, and a pass-through at the other end of the steri-center for the sterile trays to be picked up for use with the next patients. This design greatly minimized the staff traffic in and out of the work space. Another possible bottleneck is having a single sink in these large practice steri-centers. Having a double sink with two faucets, multiple Hydrim type washers, and ultrasonic cleaners need to be considered to prevent one area of the instrument processing from slowing down the recycle time. Sufficiently analyzing the work flow and procedures completed at the practice, as well as consulting with the staff that does the instrument processing, help ensure the final steri-center design is best suited to each particular practice.
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Solutions Spotlight First Impressions asked
a handful of manufacturers about new products and services in 2019 that will help dental practices flourish. Here are their responses.
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ACTEON
Editor’s Note: Sponsored by ACTEON.
The Piezotome™ CUBE is a brand-new ultra-
sonic bone surgery device designed to provide superior, minimally invasive, compassionate care when performing extractions and other pre-implant bone surgery procedures. The high-frequency, ultrasonic vibrations of the CUBE disrupt the PDL and cut bone without damaging soft tissue, making it especially effective with ankylosed teeth. The extremely thin extraction tips preserve even the thinnest of bone in the buccal area for socket preservation and to facilitate immediate implant placement. Patients experience less trauma, less pain and less swelling post operatively compared to other methods, such as burs or manual forceps, potentially reducing the need for opioids and other dangerous pain medications.
The CUBE is designed to grow with the dental practice, with tips for such applications as bone block grafting, sinus elevations, ridge splitting and crown lengthening. The CUBE is a must for any clinician placing dental implants or looking to keep challenging extractions in-house. Powered by the Dynamic Power System Inside (DPSI), the CUBE’s power can be increased by 30 percent, or decreased by 10 percent, making it the most powerful handpiece available, with the capacity to provide the gentlest treatment when necessary. The LED-lit handpiece weighs 20 percent less than other comparable units, for superior ergonomics and unsurpassed visibility in posterior areas. Touch-screen operation ensures precise control of power and irrigation. Distributor sales reps can begin a discussion with their dental customers by asking: • “Doctor, how do you currently perform atraumatic extractions, or extractions followed by immediate implant placement?” • “How do you preserve the socket during atraumatic extractions?” • “How do you perform bone grafting procedures?” • “Are you aware there is a new and faster way to perform these procedures, with less trauma to your patients?”
Some dentists may have a few concerns, such as: • “I can’t afford to pay $7,200 for an extraction machine.” • A CUBE costs more compared to a pair of forceps or a high-speed handpiece. But, with the versatility to perform bone block grafting, crown lengthening, sinus elevation (internal and lateral) and ridge splitting, it’s much more than an extraction machine. And, is it possible to put a price on decreased patient trauma, increased patient comfort, easier-to-perform extractions and better outcomes? • “I need more time to consider such a large investment.” • This is an investment with a quick ROI. If you perform five extractions each week, at an approximate cost of $90 per extraction, the practice will break even after 80 extractions, or 16 weeks. (Keep in mind the ROI is faster for a practice that performs more surgical extractions, which are more expensive.) The Piezotome™ CUBE from ACTEON provides less trauma and less drama for patients and clinicians alike. Learn more at www.acteongroup.com/us or set up a demo at info@acteonusa.com.
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SOLUTIONS SPOTLIGHT
Cranberry Editor’s Note: Sponsored by Cranberry.
The fit of
a face mask is integral to its effectiveness and the protection it provides. An ill-fitting mask increases the exposure to airborne bacteria, ultimately leading to contamination. A pleated face mask – the most popular design in dental – exposes gaps around the sides and bottom chin of the face due to its standard size and shape. Cranberry’s new 360 Face Masks feature an exclusive 3D design for complete coverage and protection. The mask forms a V-shape, which prevents collapse, and the sides of the mask are designed with curved edges that allow it to lay flat against the skin, removing gaps commonly found with pleated masks. In addition, an anti-fog cushion is built into the top of the mask to reduce fogging to the practitioner’s eyewear and aids in absorbing sweat and moisture buildup on the bridge of the nose.
Reducing the gapping of the practitioner’s mask increases the overall effectiveness of infection control in the operatory, thereby protecting the health of both the practitioner and the patient. Distributor sales reps can initiate a discussion with their dental customers by asking:
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• “Doctor, are you experiencing any gapping issues with your current procedural face masks?” • “Are you experiencing fogging issues with your current face masks?”
Practitioners may be skeptical about the unique design of Cranberry’s 360 Face Masks. But, they can rest assured that the design serves a purpose by creating a complete 360-degree seal of protection. To ensure a consistently low price, Cranberry has bundled the boxes with 40 masks per box and will support introductory promotions to encourage practitioners to try the 360 Face Masks. 360 Face Masks are available in ASTM Level 2 and 3, and in two sizes – small and regular – to conform to different face shapes.
Crosstex, a Cantel Medical Company Editor’s Note: Sponsored by Crosstex International Inc., a Cantel Medical Company.
Crosstex Liquid Ultra™ Solution, an EPA-registered dental unit wa-
to remove bacteria and biofilm, as well as to slow the regrowth of biofilm. Following terline treatment designed to kill biofilm bacteria in dental unit waterlines, is the the application of the shock product, the only such product guaranteed to: residual product must be flushed from the dental unit waterlines prior to patient treatment. • Kill biofilm bacteria. Sales reps should also ask what the dental practice is cur• R emove existing biofilm from dental unit rently using to treat its waterlines. Is shocking required as part of waterlines (DUWLs). their protocol, or would the dental team prefer a more hands-on • Prevent and suppress the formation of biofilm in DUWLs. approach to waterline treatment? If the dental practice currently uses tablets, sales reps Crosstex Liquid Ultra Solution provides multiple treatment opshould inquire how frequently the waterlines are being shocked. tions for bottle-fed systems to provide the flexibility that an office Which brand of tablets does the practice currently use? Reps may need: should explain that shocking is an ongoing requirement for tablet • As a weekly treatment. Think Pink Once a Week™! use. They should introduce Liquid Ultra Solution as a shocking • In conjunction with a tablet protocol. Liquid Ultra Solution method to help maintain compliance with the tablet IFUs and may be used as a shocking solution to ensure compliance review the products features and benefits. with daily waterline treatment Instructions for Use (IFU). Sales reps should point out that following highly publicized (It is important for tablet users to note that all tablet IFUs bacterial outbreaks in pediatric clinics in Georgia and California, require shocking at some point. If practices are not shockCrosstex was called upon for guidance and remediation suping, their CFU counts may be higher than they realize.) port. Liquid Ultra Solution, in combination with the installation of • As a shocking solution. Liquid Ultra Solution may be DentaPure™ Cartridges, was used to bring these clinics back used to rapidly treat waterlines prior to initiating a new into compliance, ensuring safe dental visits. treatment protocol or to quickly treat dental unit waterThe dental team should refer to the Liquid Ultra Solution IFU lines with extremely high CFU counts. available at www.crosstex.com for precautionary statements, disposal and troubleshooting information. Distributor sales reps can begin a discussion with their All product names are trademarks of Crosstex International dental customers by ensuring they are familiar with the term, Inc., a Cantel Medical Company, its affiliates or related compashocking. For those unfamiliar, a shock is a periodic method of nies, unless otherwise noted. rapidly treating dental unit waterlines – NOT evacuation lines –
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SOLUTIONS SPOTLIGHT
Hager Worldwide
Editor’s Note: Sponsored by Hager Worldwide.
The One Touch Revolution is a topical anesthetic gel that offers practical benefits for both the clinician and the patient. The 20-percent benzocaine formula provides fast and temporary relief, and the unique pump-action jar dispenser delivers the exact amount of gel needed with every application. Clinicians waste less and save money. As an added benefit, only a single pump is needed to treat a quadrant, and the pump seals off the dispensed material from the remaining contents, helping reduce the risk of cross-contamination. Even better, patients will appreciate the comfort provided by the fast onset, as well as the two pleasant flavors of strawberry ice and cool mint. Distributor sales reps can begin a discussion with their dental customers by asking:
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• “Doctor, how is your topical anesthetic currently dispensed?” • “Are you finding it difficult to prevent more anesthetic than you need from coming out of the dispenser?”
Some dentists may be concerned that One Touch Revolution costs more than their current brand of anesthetic. Distributor sales reps should remind them that One Touch Revolution ensures a lower cost per use, since the efficient dispensing method yields more applications. Your dental customers can count on greater convenience, improved efficiency and better patient results.
MouthWatch Editor’s Note: Sponsored by MouthWatch.
Patients trust pictures! Photographs are easy to understand, even for those without clinical expertise. MouthWatch has created an affordable intraoral camera that produces high-quality diagnostic images. Patients will have a better grasp of the treatment they require, permitting dentists and hygienists to become solution providers, rather than having to sell patients on the need for treatment.
In addition, the dental practice is guaranteed seamless integration with its imaging software. And, single-button operation makes intraoral photography efficient and easy for the entire team to use. When a dental practice adds a MouthWatch intraoral camera, it can count on a number of benefits, including: •C rystal Clear Images. Your dental customers can capture clearly illuminated, diagnostic quality images with the press of a button. • E asy integration. The MouthWatch intraoral camera integrates seamlessly with all popular imaging software, including Eaglesoft, Dexis, Schick, Apteryx. • E rgonomics. Weighing in at 31 grams and boasting an ergonomic handle, the MouthWatch intraoral camera is designed for ease of use with every patient, all day long. • Precise focus. The camera’s fixed-focus lens ensures clinicians spend no time focusing it manually, and avoid the frustration often associated with the auto-focus hunting. • Ease of use. Clinicians save time with every patient interaction. One quick, lag-free click on the capture button saves intraoral photos straight to the patient’s chart. No keyboard or mouse clicks are involved.
• Lifetime customer support. It doesn’t take an IT person to set up a MouthWatch camera. Should the dental practice encounter a problem, the MouthWatch team is available by live chat, phone or email to quickly find a solution. • Instantaneous capture. There’s no such thing as having to wait for a MouthWatch intraoral camera to warm up. The clinician can capture images immediately. • Money-back guarantee. The MouthWatch one-year warranty, 30-day no-risk satisfaction guarantee and lifetime technical support ensure clinicians can depend on their intraoral camera to perform as it should.
Distributor sales reps can begin a discussion with their dental customers by asking: • “Doctor, how do you currently present cases to your patients?” • “Do you have a camera in every operatory?” • “Are cameras a part of your standard workflow with new patients?” Some dentists may have a few concerns, such as: • “We’ve had integration issues with previous cameras.” •M outhWatch intraoral cameras are guaranteed to integrate with all imaging software. In addition, MouthWatch offers lifetime technical support. • “Our previous cameras have had full-face mode or autofocus, which hasn’t been easy to use.” •M outhWatch intraoral cameras feature fixed-focus, which is sharp and saves time. MouthWatch does not charge monthly fees for support or upgrades of capture software. There are no license restrictions.
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SOLUTIONS SPOTLIGHT
Palmero Editor’s Note: Sponsored by Palmero.
Safety and infection
prevention are crucial to any dental practice. When additional protection is needed to safeguard the entire face from infectious agents, the CDC suggests the use of a face shield. However, safety compliance can often be dependent on whether the product is comfortable for the clinician.
At Palmero, we understand the importance of face shields and the need for comfort and reliability to safeguard the entire face from infectious agents. Palmero’s Dynamic Disposables™ Snapeez™ Face Shield offers the ultimate in Personal Protective Equipment, meeting both CDC and OSHA bloodborne pathogen guidelines. It’s the next generation of face shields, with an easy-to-use, snap-on disposable lens that provides a self-sealing face shield, preventing exposure to bloodborne pathogens. The Dynamic Disposables Snapeez Face Shield is lightweight, disposable and cost effective, offering extremely comfortable coverage. Unlike some systems that use an eye glass style frame to support the shield, the Dynamic Disposables Snapeez Face Shield delivers a more comfortable and secure fit. In addition, its ultra-light-weight frame does not require a cumbersome nose bridge. The reusable wraparound ergonomic frame design allows the face shield to be worn with or without prescription eyewear. Both the full- and half-shield sizes have Ultra-Clear™ Technology to prevent fogging, glare and static electric buildup. The crystal-clear plastic allows for excellent front and peripheral
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vision with protection dental care providers can trust. Because it is disposable, the shield is guaranteed to be scratch free for optimal visibility.
Distributor sales reps can begin a discussion with their dental customers by asking: • “Doctor, are you aware of the CDC guidelines that state, ‘Dental health care personnel should wear protective eyewear with solid side shields or a face shield during procedures likely to generate splashes or sprays of blood or body fluids or the spatter of debris’?” Some dentists may have a few concerns, such as: • “I wear loupes. Will they fit?” • Dynamic Disposable Snapeez are compatible with most average loupe sizes, giving clinicians wraparound protection meeting OSHA and CDC guidelines and protecting against splashes, sprays and splatter from bloodborne pathogens. Compliance is now stress-free and easier than ever before with Dynamic Disposables Snapeez. The snap-on shield is easy to use and remove, making enhanced safety a simple choice for your customers’ practice.
Preventech Editor’s Note: Sponsored by Preventech.
The ésa® (extended
straight attachment) disposable prophy angle brings super-simple compliance to all 50 states.
Both handpieces feature proven air-driven performance. No recharging or batteries required! They run at 5,000 rpm, which is perfect for prophys, and are backed by a 2-year warranty.
Currently 39 state dental boards subscribe to the CDC Guidelines, which recommend that all dental handpieces and their attachments be heat sterilized between patients, adding if a semi-critical item is heat-sensitive, DHCP should replace it with a disposable alternative1. In 11 states2, state dental practice acts mandate the heat sterilization of handpieces. This isn’t a recommendation. It’s the law. With infection control and sterilization of instruments becoming more transparent to patients, more states may be on the verge of adopting similar mandates. ésa fits a number of heat-sterilization-tolerant handpieces: Midwest® Shorty®, Rhino®, Star® Titan and our ésamate® lubefree handpieces. Because ésa® eliminates the nose cone, it’s 50 percent lighter and costs less to use than traditional handpiece and DPA connections. ésamate® handpieces are available in two models: ésamate® ST, with an aluminum housing that weighs just two ounces; and our new ésamate® MW, which features a stainless steel housing and weighs 3.2 ounces. Both handpieces are heat-sterilization-tolerant, offer a 360° swivel and connect quickly and easily to ésa® disposable prophy angles.
Sales reps can begin a discussion about CDC compliance with their dental customers by asking: • “Doctor, how do you handle infection control procedures for low-speed or dental hygiene handpieces?” • “Do you heat sterilize your low-speed handpieces after each patient?” • “Are your low-speed handpieces heat-tolerant?” • “What types of low-speed handpieces do you use?” Some dentists may have a few concerns, such as: • “It’s too costly to purchase the necessary number of handpieces to ensure compliance with heat sterilization recommendation or requirements.” • The CDC Guideline states, “If a semi-critical item does not come in contact with mucous membranes or nonintact skin,” heat sterilization is NOT required. In these states, using an ésa® DPA, along with a plastic barrier on the handpiece, cuts the cost on infection control in half. For samples of the ésa DPA, or for more information, visit www.preventech.com/esa-dpa/.
References: 1 2
“Summary of Infection Prevention Practices in Dental Settings” Centers for Disease Control and Prevention, March 206, P14. State Dental Practice Boards in CA, FL, KS, OH, OR, SC, VA and WA require semi-critical items be sterilized after each patient.
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SOLUTIONS SPOTLIGHT
Septodont Editor’s Note: Sponsored by Septodont.
Performing the right
injection is the first step toward a pain-free patient experience. Anesthesia is a first and essential step for most dental procedures.
But dentists face a variety of issues when using a traditional syringe, such as: • Adhering to the recommended injection time (One milliliter in one minute). • Variations in pressure, which can damage tissue and cause discomfort to the patient. • Keeping the quality of injections consistent throughout the day. With the Dentapen, these challenges are greatly reduced. Dentapen is a new generation of electronic syringe to perform pain free injections. Like most electronic syringes, the Dentapen injection is monitored with a constant flow, at the right pace. This gives dentists the opportunity to focus more on needle insertion1, leading to better control of the injection and a reduction in pain for the patient. For instance, during a study done on 50 dentists who received a palatal injection, 96 percent of them preferred injections from
an electronic syringe vs. manual syringe, and their pain perception was reduced by a factor of two. What makes the Dentapen different is that it is a self-contained, cordless, intuitive device that matches dentists’ habits. There is no console, no foot pads, and no tubing or proprietary disposables. It can be held in two different ways – by the wings, like a manual syringe, or pen-like, for a precise injection during special procedures. Dentists can use any local anesthetic cartridge and their favorite dental needle. And patients find the small, modern look to be less threatening and more reassuring, helping them to relax. For over 80 years Septodont has been a global influence in manufacturing dental materials and local anesthetics for the dental community. Today they are a leader in pain management with a presence in over 150 countries with regulatory approvals to match. For more information, visit www.septodont.com.
References: 1
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Hochman, MN, Chiarello D, Hochman CB, Lopatkin R, Pergola S. Computerized Local Anesthesia Delivery vs. Traditional Syringe Technique. NY State Dent J. 1997; 63:24-9.
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Shofu Editorâ&#x20AC;&#x2122;s Note: Sponsored by Shofu.
Beautifil Flow Plus X, a durable NEW UPDATE to the latest-generation composite restorative, indicated for both anterior and posterior teeth, allows clinicians to place direct restorations with an excellent self-leveling ability and outstanding physical properties, absolutely equivalent to those of conventional hybrid composites. Thanks to its proprietary Giomer technology, NOW containing a patented nano S-PRG filler, Beautifil Flow Plus X benefits the adjacent tooth structure for sustainable caries prevention, while encompassing the ability to polish to a high and long-lasting luster. The trilaminar structure of the bioactive S-PRG filler particles forms a stable zone of interaction, designed to sustainably release and recharge at high concentrations. The S-PRG filler releases fluoride and other bioactive ions inhibiting plaque formation and minimizing postoperative hypersensitivity. In addition, the filler particles buffer and neutralize acids.
A complete system for all indications Beautifil Flow Plus X is an injectable hybrid composite available in two different viscosities, F00 and F03, for restorative build-up and filling. The newly developed thin-walled needle tips facilitate application directly from the syringe, allowing clinicians to easily and smoothly dispense the right amount of material at any time for precise direct restorations. Beautifil Flow Plus X F00 (Zero Flow) and F03 (Low Flow) both provide optimal viscosities for anterior and posterior restorations.
The flowability of F00 (Zero Flow) is so low that the material does not slump during layering. This easy-to-handle composite helps clinicians accurately restore the occlusal morphology, including cusps and marginal ridges. It flows well during application and has excellent shape retention while sculpting. By comparison, the selflevelling F03 (Low Flow) paste thoroughly wets the cavity walls, making it an ideal solution for filling. It can be used to line cavity floors, fill small occlusal cavities or create cervical restorations. Beautifil Flow Plus X features improved mechanical properties, optimal polishability and a durable luster. Simple final polishing and excellent physical properties ensure superior long-term results. The unique design of the needle tips ensures the paste neither sticks to the needle opening nor oozes at the end of delivery. Clinicians can easily and precisely shape occlusal posterior restorations without wasting material. A reliable, state-of-the-art restorative system, Beautifil Flow Plus X includes nine common tooth shades, plus opaque dentin, enamel, bleach and effect shades, characterized by exceptional shade stability. This assortment covers all indications of direct restorative dentistry, allowing clinicians to meet all aesthetic requirements in both multi and single-layer techniques.
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SOLUTIONS SPOTLIGHT
Solmetex Editorâ&#x20AC;&#x2122;s Note: Sponsored by Solmetex.
In June 2018, Solmetex released its latest-version amalgam separator, the
NXT Hg5 High Volume Amalgam Separator. Suitable for larger practices with 11-20 operatories, the NXT Hg5 High Volume Amalgam Separator meets or exceeds all requirements of the EPA Dental Regulation. In addition, Solmetex offers a turn-key solution to amalgam waste recycling, including recycling services included in the cost of the product, as well as an online Compliance Center available 24/7, which houses all of the practiceâ&#x20AC;&#x2122;s recycling documentation.
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1IMP_300
The NXT Hg5 series of Amalgam Separators are available in three sizes to suit your customers’ dental practice: The high-volume product (for larger practices), the standard NXT Hg5 Amalgam Separator (for practices with 1-10 operatories,) and the NXT Hg5 mini Amalgam Separator (suitable for practices with 1-4 operatories, where space is a concern). Design improvements to the new NXT Hg5 High Volume ensure an easier collection container change out. Distributor sales reps can begin a discussion with their dental customers by asking: • “Doctor, do you have an amalgam separator currently installed?” • “How many operatories does your practice have?” • “If you currently have an amalgam separator installed, is it ISO 11143:2008 certified?”
Some dentists may have a few concerns, such as: • “I no longer place amalgam in my practice. Why do I need an amalgam separator?” • You may no longer place amalgam, however, you are most likely still removing amalgam from your patients’ mouths. • “According to the EPA, I have until July 2020 to install an amalgam separator. I think I’ll wait to purchase my separator.” • It may not pay to wait until we get closer to July 2020. Prices are still low at the moment. At the same time, installers are affordable and available. The demand for both the product and installers will only increase as we near the deadline date.
Design improvements to the new NXT Hg5 High Volume ensure an easier collection container change out.
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February 2019
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SOLUTIONS SPOTLIGHT
Tuttnauer U.S.A Co., Ltd. Committed to better dentistry
Editor’s Note: Sponsored by Tuttnauer U.S.A Co., Ltd.
Dental teams today face challenging sterilization workloads and strict regulatory requirements, making it more important than ever before to depend on a sterilizer that delivers optimal results, without sacrificing convenience.
At Tuttnauer, our single focus on sterilization and infection control enables us to offer products to help practitioners meet today’s challenging workloads and regulatory requirements. The EZPlus series fully automatic sterilizers meet the most current sterilization standards ANSI/AAMI ST55. Both the 9-inch and 11-inch models feature the dynamic air removal technology and an active closed-door HEPA filtered airdrying system to maintain sterility and ensure efficient drying of packs and pouches. In addition, the door remains closed throughout the dry cycle, encouraging the staff to leave the pouches/packs in the unit until all items are completely dry. This very important feature helps ensure the safety of patients, staff and doctors. Distributor sales representatives can initiate a discussion with their dental customers about the EZPlus series by asking the following questions: • “Doctor, how old is your sterilizer? Is it time to replace it?” • “What type of sterilizer are you comfortable using? What model are you replacing and what chamber size does it have?”
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• “Does your current model sterilizer meet all of the needs at your office?” • “Would you say your office needs to change from a manual autoclave to a fully automatic system? Will doing so free up time for the staff to work more closely with patients and perform/assist with procedures that add to the bottom line?” • “Has the volume of items to be sterilized at your office increased, decreased or remained the same? Do you need a larger, smaller or equivalent chamber size than you currently have?”
Some dentists may question the best way to maintain an EZPlus autoclave: • Regular cleaning and maintenance of a sterilizer is critical to keep the device in good working condition. • Do not overload the sterilizer trays. Overloading sterilizers is the number one cause of sterilization cycle failures, including inadequate sterilization and drying. • When using pouches, do not overlap or stack the pouches. Place pouches on trays in a single layer or use a pouch rack. • Always use steam-distilled water with the physical characteristics detailed in the sterilizer manufacturer’s operator’s manual. Tuttnauer is the only manufacturer to offer a two-year warranty on parts and labor, as well as an additional 10-year warranty on the chamber for all of its fully automatic autoclaves.
Zirc
Editor’s Note: Sponsored by Zirc.
Did you know that dental items have been reported to be the second most common foreign object ingested or aspirated by adults? Zirc has developed Airway Armor, an innovative safety device designed to protect the patient’s airway. Airway Armor is the first of its kind on the market to serve as a barrier to swallowing or aspirating objects, allowing dentists to practice safely and confidently. This latex-free safety device is disposable and serves as a stable, comfortable, protective barrier in the mouth. It is easily placed and retrieved and is invaluable in all situations where other protective barriers are not viable options.
• “What precautions are you taking to protect your patients and your practice during these procedures?”
Airway Armor is a safe alternative to gauze packs, which typically cause patients discomfort. In addition, gauze packs can be difficult to place, absorb moisture and frequently need to be replaced. They have also been known to become lodged or aspirated into the airway, causing unnecessary risk to the patient. By contrast, Airway Armor is easy to place and durable, while giving practitioners fullmouth accessibility. It is available in three sizes –small, medium and large – to ensure a proper fit for any size mouth.
Some dentists may have a few concerns, such as: • “Will it make my patients gag?” • Flexible, yet durable, Airway Armor can be positioned within the mouth to keep most patients comfortable without gagging. • “Why is the cost so high for a disposable item?” • Although Airway Armor is disposable, it is made of a durable material uniquely engineered to ensure its comfort, fit and effectiveness. It’s a simple, worthwhile precaution that can protect the practice from a costly malpractice lawsuit.
Distributor sales reps can begin a discussion with their dental customers by asking: • “Doctor, are you doing procedures that expose your patients to the risk of ingesting or aspirating a dental object?”
Airway Armor gives practitioners and patients alike peace of mind during treatment, including extractions, implants, restorations, orthodontics and pediatric procedures, by enabling them to provide the safest possible care to their patients.
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February 2019
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INFECTION CONTROL
Medical Waste Management BY DR. KATHERINE SCHRUBBE, RDH, BS, M.ED, PHD.
Rules, regulations and standards of care abound in the dental profes-
should be noted that the Centers for Disease Control and Prevention (CDC) states that dental healthcare facilities should dispose of medical waste regularly to avoid accumulation, and any facility generating regulated medical waste should have a plan for its management that complies with federal, state and local regulations to ensure health and environmental safety. Also, dental team members handling waste should be trained in appropriate methods and informed of the potential hazards.1 Having a clear plan, as well as understanding the risks involved, will streamline processes and productivity related to medical waste disposal. Many times, team members are confused with the terms defining the various types of waste. There are basically two types of waste generated in dental practices: regulated and nonregulated medical waste. General medical waste is defined as any solid waste that is generated in the diagnosis, treatment or immunization of human beings or animals in research pertaining thereto, or the production or testing of biologicals. (The term excludes hazardous and household waste.). Only a small percentage of medical waste is infectious and needs to be
sion. In order for the dental team to comply, all team members must have a clear understanding of the requirements and mandates. In short, it can be overwhelming.
While the primary goal of the dental practice is to provide the highest quality patient care and the best patient experience, all while ensuring patient and staff safety, team members must be efficient, well-organized and competent in the completion of the tasks and duties related to the requirements and mandates. This creates a culture of standardization and calibration. The instrument processing protocols, how to prepare and turn over operatories, and hand hygiene are all examples of tasks that should happen like clockwork. What to dispose of â&#x20AC;&#x201C; the where and how of waste management â&#x20AC;&#x201C; is also one of those tasks. Dental team members who are unsure of the appropriate steps to take may be making costly errors that hurt the dental practice.
Managing medical waste in the dental setting Letâ&#x20AC;&#x2122;s review the types of medical waste produced in the dental setting and the protocols for management and disposal. It
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INFECTION CONTROL regulated.2,3,4 Infectious waste, which is regulated, is a very small subset of medical waste (about 3 percent) that has proven to be capable of transmitting an infectious disease.3 The Bloodborne Pathogens standard uses the term regulated waste to refer to the following categories of waste, which require special handling: • L iquid or semi-liquid blood or other potentially infectious material (OPIM). • I tems contaminated with blood or OPIM, which would release these substances in a liquid or semi-liquid state if compressed.
scalpel blades, ortho wires, broken sharps instruments, burs, biopsy specimens and excised tissue.3 The practice management team must be certain that dental team members are trained and have a clear understanding of how to separate regulated waste from nonregulated waste to ensure a purposeful segregation. The practice incurs a cost from regulated waste because it must be picked up and transported off-site by qualified waste hauler vendors; therefore, only items that are considered infectious should be placed in regulated waste receptacles (commonly known as the red biohazard bags or red biohazard sharps containers). Non-sharp regulated waste items, such as those listed above, must be disposed of in red biohazard bags. Contaminated sharps, however, must be disposed of in red biohazard sharps
Reusable containers shall not be opened, emptied or cleaned manually or in any other manner that would expose employees to the risk of percutaneous injury.
• Items that are caked with dried blood or OPIM and are capable of releasing these materials during handling. • Contaminated sharps. • Pathological and microbiological wastes containing blood or OPIM.5
Most of the regulated waste in dental offices consists of contaminated sharps and extracted teeth. However, other examples of regulated medical waste categories in dentistry, such as those listed above, include liquid blood or saliva; two-by-twos or cotton rolls saturated/caked with blood or saliva; used needles,
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containers. OSHA points out that contaminated sharps shall be discarded immediately or as soon as feasible in containers that are closable, puncture resistant, leakproof on the sides and bottom and labeled or color-coded. OSHA also states that, during use, containers for contaminated sharps shall be easily accessible to personnel and located as close as is feasible to the immediate area where sharps are used or can be reasonably anticipated to be found, maintained upright throughout use, replaced routinely and not allowed to overfill. Lastly, when moving containers of contaminated sharps from the area of use, OSHA states that containers shall be closed immediately prior to removal or replacement to prevent spillage or protrusion of contents during handling, storage, transport or shipping, and
INFECTION CONTROL Once procedures are complete, staff members should dispose of any disposable sharps in the operatory sharps containers. All other used items from patient care that have not been disposed of in red biohazard bags or sharps containers may be safely thrown out in the regular trash.
placed in a secondary container if leakage is possible. The second container shall be closable; constructed to contain all contents and prevent leakage during handling, storage, transport or shipping; and labeled or color-coded according to this standard. Reusable containers shall not be opened, emptied or cleaned manually or in any other manner that would expose employees to the risk of percutaneous injury.6 The CDC recommends that sharps containers be located as close as possible to the work area.1 Accordingly, every operatory should have a red biohazard sharps container, which should be stored in a place inaccessible to small children who could mistake a red container for a toy or surprise box. Once procedures are complete, staff members should dispose of any disposable sharps in the operatory sharps containers. All other used items from patient care that have not been disposed of in red biohazard bags or sharps containers may be safely thrown out in the regular trash. Items such as barriers, gloves, masks, bibs, lightly soiled gauze and cotton rolls are not considered infectious or dangerous to the environment.3 Medical waste is primarily regulated by state environmental and health departments. The Environmental Protection Agency (EPA) has not had the authority to oversee the handling of medical waste since the Medical Waste Tracking Act (MWTA) of 1988 expired in 1991. It is important for the dental team to contact
their state environmental program before they dispose of medical waste. They should contact their state environmental protection agency at www.epa.gov, as well as their state health agency, for more information regarding their state’s regulations on medical waste.2 It should be noted that the dental practice remains responsible for the regulated waste it generates until it is destroyed or rendered non-hazardous. This concept, which is called cradle-to-grave liability, means that even after waste leaves the practice, any cleanup for any damage it may cause is the responsibility of the generator (the practice); so, the practice should carefully select a licensed waste hauler.3,4 Recordkeeping for the disposal of waste must meet state regulations. The most critical record is the waste manifest – a tracking document that comprises the name of the generator (dental practice), transporter, disposer and the waste itself. It also may include the description and quantity of waste, date, type of container and the type of final disposal.4 All manifest records must be kept for three years.4 The management of medical waste in a dental practice is a critical component of compliance to federal, state and local agency standards. Regardless of the practice size, all dental team members must be aware of what to dispose of, and how and where to dispose of it. Otherwise they risk taking a haphazard approach to the disposal of hazardous materials, causing potential risk to patients and staff, as well as the environment.
References:
1. C enters for Disease Control and Prevention. Guidelines for Infection Control in Dental Health-Care Settings --- 2003. MMWR 2003;52(No. RR-17). Available at: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr5217a1.htm. Accessed November 18, 2018. 2. U .S. Environmental Protection Agency. Medical Waste. Available at https://www.epa.gov/rcra/medical-waste#who%20regulates%20medical%20waste. Accessed November 18, 2018. 3. Miller CH, Palenik CJ. Infection Control and Management of Hazardous Materials for the Dental Team. 5th ed. St. Louis: Mosby Elsevier; 2013;192-196. 4. OSAP Interact Training System Workbook. OSHA and CDC Guidelines; Combining Safety with Infection Control and Prevention. 5th Edition; 2017. 5. U .S. Department of Labor. Occupational Safety and Health Administration. Bloodborne Pathogens Standard; 1910:1030. Most frequently asked questions concerning the bloodborne pathogens standard. Available at https://www.osha.gov/laws-regs/standardinterpretations/1993-02-01-0#waste. Accessed November 18, 2018. 6. U .S. Department of Labor. Occupational Safety and Health Administration. Bloodborne Pathogens Standard; 1910:1030. Available at https://www.osha.gov/ laws-regs/regulations/standardnumber/1910/1910.1030. Accessed November 18, 2018.
Editor’s note: Dr. Katherine Schrubbe, RDH, BS, M.Ed, PhD, is an independent compliance consultant with expertise in OSHA, dental infection control, quality assurance and risk management. She is an invited speaker for continuing education and training programs for local and national dental organizations, schools of dentistry and private dental groups. She has held positions in corporate as well as academic dentistry and continues to contribute to the scientific literature. Dr. Schrubbe can be reached at kathy@schrubbecompliance.com.
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The Power of Integration
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Infection Control in the Dental Practice: Questions to Ask
Are dentists and their staff taking proper precautions to prevent crossinfection in the dental office? OSAP has prepared the following checklist. Answers are drawn from current dental infection control recommendations from the Centers for Disease Control and Prevention (CDC), the American Dental Association (ADA), and OSAP. 1. Do you heat-sterilize all your instruments, including handpieces, between patients? In keeping with Centers for Disease Control and Prevention, American Dental Association and OSAP recommendations, dental care providers should be heat-sterilizing all instruments that penetrate or contact a patientâ&#x20AC;&#x2122;s oral tissues. Although autoclaves are most commonly used to sterilize dental instruments, some offices may have other types of heat sterilizers. Chemical-vapor sterilizers (chemiclaves) and dry-heat sterilizers also are appropriate for sterilizing dental instruments. The dental team should heat-sterilize instruments that have been used on a patient before they are introduced to treat the next patient. Most dental instruments are designed to withstand repeated heat sterilization.
2. How do you know that the sterilizer is working properly? Most practices use a variety of methods to ensure that the office sterilizer is doing its job. In addition to monitoring the sterilizerâ&#x20AC;&#x2122;s gauges and readouts for proper temperature and (for autoclaves
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and chemical-vapor sterilizers) pressure, the dental team should wrap and seal instruments in packaging equipped with a chemical that changes color on exposure to heat and/or some other combination of sterilizing conditions. These color-change indicators also help to identify instrument packages that have been sterilized, so thereâ&#x20AC;&#x2122;s no chance that contaminated instruments could inadvertently be selected to treat the next patient. In addition, the dental team should routinely test their sterilizer using a vial or envelope containing spores. Called biologic monitoring, subjecting commercially prepared, sealed spore strips or vials to a sterilization cycle, then culturing the spores to ensure they have been killed, is the highest guarantee that a sterilizer is functioning and being utilized properly. Most practices use biologic monitoring weekly or monthly in combination with colorchange indicators on each instrument packet and monitoring of the sterilizer gauges and readouts.
3. Do you change your gloves for every patient? Every dental care provider should use new gloves for each and every patient. For procedures that are likely to involve splash or spatter, the dental team will also don a new mask, as well as wear protective eyewear and apparel (possibly a gown or clinic jacket).
4. D o you disinfect the surfaces in the operatory between patients? Between patients, the dental team should disinfect all surfaces they are likely to touch during treatment. This eliminates the possibility of a dentist or auxiliary dental care provider transferring germs from a contaminated surface to the patient. To save time in preparing the treatment room for the next patient (and hopefully minimize their time in the waiting area), many practices choose to cover surfaces, such as light handles, tubing and chair
Between patients, the dental team should disinfect all surfaces they are likely to touch during treatment. This eliminates the possibility of a dentist or auxiliary dental care provider transferring germs from a contaminated surface to the patient.
controls, with a plastic barrier film that keeps the surface underneath free of debris. Instead of disinfecting these surfaces between patients, the dentist or dental team member simply removes and discards the barrier and places a new, clean barrier on the surface for the next patient. Most practices choose to cover some surfaces and disinfect others between patients. Some practices disinfect all surfaces between patients; others use protective barriers for all surfaces in the treatment room.
OSAP focuses on strategies to improve compliance with safe practices and on building a strong network of recognized infection control experts. The organization offers an online collection of resources, publications, FAQs, checklists and toolkits that help dental professionals deliver the Safest Dental Visit for their patients. Plus, online and live courses help advance the level of knowledge and skill for every member of the dental team. For additional information, visit www.osap.org.
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SALES FOCUS
Digital Impression Technology With so many new digital impression options available, it’s important to offer your dental customers a proven solution that meets the needs of their practice. Editor’s note: First Impressions would like to thank Dentsply Sirona for its assistance with this article.
Advances in digital
impressioning technology leave dentists with plenty of choices. Newer digital impressioning systems scan faster and more accurately than ever before. Many capture full color intraoral scans, without the use of powder. And, 3D printing has further expanded the capabilities of CAD/CAM, enabling dentists to incorporate aligners, night guards and surgical guides in their restorative procedures. But, there’s no one solution for every dental practice and distributor sales reps must understand the needs of their customers – and how those needs may change in years to come. For instance, what does the practice require in terms of scan times? What are its case requirements and software needs? Will
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the office function more efficiently using open or closed systems? How important are .STL file exports, which can enable the dental team to work with the lab of their choice? Some digital impression systems offer growth opportunities with the dental practice’s technology, while others do not. Currently, the office may opt to scan and send the digital impression to the lab for fabrication, whereas in the future, it may decide to bring the complete process in-house. By investing in a technology that is incapable of upgrading to full chairside, the practice will likely
spend more in the long run and eventually have to re-learn a new technology. Larger, multi-location practices require even more options, as they may begin with digital impressions, and later evolve into a hub-and-spoke model, permitting them to add milling capability and produce restorations for smaller practices within the organization. Inexpensive ride-share services can enable same-day return of final restorations, while improving the patient experience and controlling costs. Connectivity, ease of use and expansion possibilities all play an important role in CAD/CAM dentistry. All that said, with so many solutions available, it’s important for a dental practice to select a proven technology, which comes from a well-known, trustworthy source, and is backed by a strong support and training infrastructure.
High-end vs. lower-priced
Start a discussion Sales reps can help their customers determine the right digital impressioning system for their practice by discussing the dental team’s goals – both short-term and in the next 1-5 years. Some good probing questions include: • “Doctor, how often do you need to adjust or remake crowns?” • “Are you interested in offering your patients clear aligner orthodontic therapy?” • “Would you like to improve your patients’ experience?” • “What is your plan for completely digitizing your practice?”
The number of digital impressioning systems required by a midsized dental practice can vary from one practice to the next. Sales reps and their dental customers should consider the size of the practice – including staff size and patient flow – and the number of operatories it has, as well as practice workflow.
When it comes to digital impressioning technology, dentists get what they pay for. Entry level products may require powder; or, they might scan without full color. Some lower-end systems require scan fees, increasing the real cost of ownership. They often have limited output options, and are not always expandable to a full chairside system without mixing and matching other manufacturers’ products. By comparison, investing in a high-end solution ensures the above needs are covered, and the dental team can count on exceptional training and support. In short, the more expensive – and more advanced – digital impressioning systems are more likely to provide the right solution for the needs of an individual practice. The number of digital impressioning systems required by a mid-sized dental practice can vary from one practice to the next. Sales reps and their dental customers should consider the size of the practice – including staff size and patient flow – and the number of operatories it has, as well as practice workflow. For instance, a practice that includes, say, three hygienists and two dentists, and does not capture digital impressions until treatment is determined to be necessary, can certainly work with one digital impressioning system. Larger dental practices, or those that capture digital impressioning scans for every patient, may require more than one unit, but this is less common.
Some dentists may be concerned about the time it will take to learn to use a more advanced digital impressioning system, and to educate and train their team. It’s true it can be daunting to learn new technology, particularly while running a busy dental practice. But, training – and patience – is imperative when incorporating new technology into a practice. Sales reps should encourage their customers to plan on extra time for patient visits for the first few months to avoid a backup. The increased efficiency they will experience once they are comfortable using their new digital impressioning system will more than make up for any time lost upfront. If cared for properly and serviced regularly, your dental customers will be able to depend on their new digital impressioning system for years to come.
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SALES FOCUS
A Picture’s Worth a Thousand Words Improvements in intraoral camera technology help dentists expand their care. Editor’s note: First Impressions would like to thank MouthWatch for its assistance with this article.
Crystal clear images,
easy integration and lightweight, ergonomic handles are just a few of the features dentists can count on when they purchase an intraoral camera. As the technology continues to become more sophisticated, more cameras will offer plaque detection modes and transillumination features, and higher resolution will likely become the norm.
Intraoral cameras are considered a powerful tool designed to help with documentation and case presentation to patients. Armed with a clear image, dentists can help patients understand any health issues that exist and why a particular course of treatment is necessary. Depending on how sophisticated the camera is, it may offer multiple resolutions, imaging techniques and focusing options. Some higher end models feature multiple diagnostic modes.
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Intraoral cameras can range between $299 for a basic camera to $5,000 for a camera featuring the most sophisticated technology. When properly cared for, though, they can be expected to work for many years. The dental team should follow the manufacturer instructions for use, storage and cleaning to ensure a long life for the camera.
Engaging your customers Intraoral camera technology not only can help your dental customers more easily explain a particular case to their patients (especially new patients), they can better inform the dental team – or the insurance provider – about the patient case. They will save time, facilitate workflow and build patient trust.
Better informed patients are more likely to trust their dental team and return for another checkup.
Distributor sales reps can initiate a discussion with their customers by asking a few pointed questions: • “Doctor, how do you currently present cases to your patients?” • “Do you have an intraoral camera in every operatory?” • “Are intraoral cameras a part of your standard workflow with regard to new patients?”
Whether your dental customers opt to purchase a basic or a high-end intraoral camera, it’s important that clinicians incorporate the imaging technology into the standard workflow of their practice. Indeed, a premium camera that is locked away in a drawer and only used by one dentist does the practice little good. Rather, there should be an intraoral camera in every operatory, which is easy to use, can easily integrate and produces accurate, quality diagnostic images.
Sure, some providers have experienced integration problems in the past and are concerned adding a new camera would be more trouble than it’s worth. They may balk at the cost of a new camera, or worry it will be too heavy or too delicate. Today’s newer intraoral camera technology addresses all of these concerns and more, and promise greater office efficiency for years to come. And, better informed patients are more likely to trust their dental team and return for another checkup.
February 2019
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CHAMPIONS for CHANGE Gala Benefitting Oral Health America for 29 years
Wednesday, February 20, 2019 5:30 p.m.-9:00 p.m. J O I N U S AT S O L D I E R FI EL D’ S U NI TED C L U B 1410 Museum Campus Drive, Gate 14, Chicago, IL 60605 Together we honor Dr. Larry Coffee, founder of the Dental Lifeline Network, with our Champion for Change Award, and we recognize Ivoclar Vivadent as a Million Dollar Donor. $375 per ticket or $3,750 per table Contact Liz Kelly at 312-836-9900 or Liz.Kelly@oha-chi.org.
oralhealthamerica.org/gala
oralhealthamerica.org/gala 180 N. Michigan Ave., Suite 1150, Chicago, IL 60601 • 312-836-9900 • info@oralhealthamerica.org OralHealthAmerica •
Smile4Health •
Smile4Health
Editor’s Note: Technology is playing an increasing role in the day-to-day business of sales reps. In this department,
QUICKBYTES
First Impressions will profile the latest developments in software and gadgets that reps can use for work and play.
Technology News Amazon Echo Show Consumer Reports gives a thumbs-up to the new Echo Show from Amazon. The $230 speaker features a 10-inch HD touchscreen and a Zigbee smart home hub. The previous Show sounded OK, but the new model takes a substantial step forward, featuring robust bass and smooth trebles, says Consumer Reports. Most of all, it delivers effective imaging – the sense that the instruments and voices extend beyond the speaker’s physical enclosure, as though the music is being performed in the same room with you. Note to YouTube addicts: You might want
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to stick to your laptop for those videos; the Show doesn’t offer voice commands for YouTube, which is owned by Google (which has its own smart speakers).
Smartphone magnifier Want to display a video, PowerPoint or website for an account? Slip your smartphone into the Smartphone Magnifier from Uncommon Goods (www.uncommongoods.com) and view at about double the size of your display. The portable magnifier measures 7.5 inches long, 4.9 inches wide, and 7.7 inches high, and costs about $30.
Better-quality photos For smartphone photographers concerned about high-quality, print-ready results, Moment lenses are worth the investment, according to product-review website Wirecutter. The wide lens is said to expand the iPhone’s field of view just enough to feel like a fresh perspective (about 0.63x magnification). The 2x telephoto lens extends the iPhone’s optical zoom a bit farther without degrading image quality as digital zoom can, even with a dual-lens iPhone, according to the reviewers. Both lenses are said to produce clear images with little to no distortion across the entire frame. Both lenses require a Moment case to mount to, which is an additional $30 purchase available for iPhones 6 to X, as well as Samsung Galaxy S8 and Google Pixel compatible models.
Home cooking … fast “The microwave oven did not revolutionize home cooking,” writes Florence Fabricant, a food and wine writer in the New York Times. “Nor did sous-vide gadgetry.” Now there’s a new contender: the Brava oven, a countertop appliance that essentially uses light bulbs to cook food – a system called Pure Light, which was originally developed in the solar industry. Writes Fabricant, “At a demonstration a few months ago, I was struck by the ease of use and the results, which include the ability to cook a steak that’s invitingly seared on the outside and properly rosy within. The oven can reach 500 degrees in seconds, without preheating. What was really impressive was how several ingredients, like proteins and vegetables, can be precisely cooked simultaneously. This is not an appliance that I would want to own, and it teaches you nothing about cooking. But someone who wants robotically prepared food may find it to be a blessing.”
Digital petsitter iPhone photo printer The iPhone printer from Hammacher Schlemmer is said to produce photo quality pictures as it charges an iPhone. In as little as 55 seconds, it prints 300-dpi resolution 4-by-6-inch color pictures using a thermal ink ribbon and special paper that makes photos waterproof, fingerprint-proof, and fade-resistant, according to the company. A free app lets users print photos from an iOS or Android smartphone or tablet, while a USB slot allows printing directly from memory cards, flash drives, and PictBridge-capable digital cameras. It comes with removable 20-sheet capacity paper tray, ink ribbon cartridge, and 40 sheets of photo paper. The printer is compatible with iPhone 5 and iPod 5th generation and later, including X and 8. The app is compatible with iOS 6.0 and Android 4.0 and later. Cost: About $160.
The Petcube Play monitoring camera is said to quell pet owners’ concerns when they’re working late and don’t have an on-call pet sitter, reports The New York Times. A wide-angle lens sees the entire room, and the camera offers crystal clear night-vision mode and an app-controlled laser pointer. Of course, one thing the app can’t do – get your cat to stop tearing apart your fabric ottoman. Cost: About $150.
Lost your wallet? The lost-wallet locator from Hammacher Schlemmer is a homing device that slips into a credit card slot. It connects to a smartphone via Bluetooth and uses a free iOS/Android app to display your wallet’s location on a map and activate the phone’s ringer when your wallet is near. If out of the locator’s 100-foot range, your wallet’s last known location is displayed on the app’s interactive map. Charges via micro USB cable. Cost: About $40.
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February 2019
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NEWS
Industry News Patterson Companies names new president of Dental segment Patterson Companies announced that Eric Shirley will join Patterson as president of the Dental business unit effective February 4, 2019. Shirley most recently was the chief commercial officer at Midmark. “After completing a thorough search, Eric was the clear choice to lead Patterson Dental into the fuEric Shirley ture,” said Mark Walchirk, President and CEO of Patterson Companies. “His track record in the dental industry, combined with his leadership experience and ability to drive performance, made him an ideal candidate for this critical role at Patterson.” Shirley joins Patterson with more than 26 years of dental industry experience in various leadership roles. Most recently as the Chief Commercial Officer at Midmark, he drove revenue and operating improvements within Midmark’s Dental, Medical and Animal Health divisions. Prior to Midmark, Shirley held leadership positions at Dentsply Preventive Care and Dentsply Professional as well as various roles at several other dental manufacturers. He also is a past chairman of the Dental Trade Alliance, and is involved in several philanthropic organizations, including TeamSmile, Oral Health America and the Dental Lifeline Network. “Having been a part of the dental industry for my entire career, I have always viewed Patterson as a leader in our space, providing unparalleled expertise and constant focus on the customer,” said Shirley. “I am excited to join the Patterson team to build on the legacy Patterson Dental has established and drive towards continued success for our customers.”
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Shirley holds a Master of Business Administration from the UCLA Anderson School of Management, and a bachelor’s degree in journalism from Long Beach State University.
Burkhart Dental receives top honor in Seattle Business Magazine’s 2018 Family Business Awards Program Tacoma, Wash.-based Burkhart Dental Supply announced it received the Heritage/Legacy Award, the highest honor, in the 2018 Family Business Awards program sponsored by Seattle Business magazine. According to a Seattle Business magazine representative, the Heritage/Legacy Award is the most distinguished award of the program and many prominent, multi-generational, family businesses from throughout the state submitted applications for that and the other honors. Criteria for the annual Family Business Awards include innovation, growth, and business transformation. “This year, we honor 11 family businesses that have shown through many years of effort and persistence the stuff that makes running a family enterprise satisfying, exhilarating and – ultimately – rewarding,” notes the article about this year’s honorees on the Seattle Business magazine website. The Burkhart article notes that company values include providing strong, customer-oriented service and honoring its 400 employees, including about 150 in Washington. Dedicated to helping its clients succeed, in the past five years, Burkhart sales have increased almost 20 percent. The company services 7,500 dental offices with dental supplies, equipment and technology, equipment service and repair, and consulting services. Burkhart President Lori Burkhart Isbell received the honor at a reception hosted by Seattle Business magazine. To read the article about Burkhart, visit: www. seattlebusinessmag.com/family-business/2018-familybusiness-awards-heritagelegacy-burkhart-dental-supply
CareCredit integrated into Henry Schein’s dental, veterinary practice management software solutions Henry Schein Inc (Melville, NY) and CareCredit, a Synchrony solution, announced the integration of CareCredit’s financing tool into Henry Schein’s dental and veterinary practice management software solutions. The integration offers dental and veterinary practices more financing options for their patients and pet owners, while improving practice efficiency, the company said. CareCredit integrates into Dentrix and Easy Dental, practice management software solutions offered to dental professionals by Henry Schein One, a joint venture of Henry Schein. CareCredit will give Henry Schein’s customers the ability to process CareCredit transactions that automatically write back to the ledger. The company recommended that practice teams who accept CareCredit and use Dentrix, Easy Dental, AVImark, and ImproMed practice management software contact their software provider for more information and to request a demo of the integration features.
Heartland Dental Reaches 900th supported office milestone Heartland Dental (Effingham, IL) announced that it recently crossed the milestone of 900 supported offices. Heartland Dental reached this milestone this year by continually supporting the opening of brand new “De Novo” offices and affiliating with existing dental offices throughout the country. In 2018, the company increased its footprint to 37 states.
Solmetex names Kevin Danahy as President Solmetex, LLC announced that Kevin Danahy has been named as President, a new position at Solmetex, reporting directly to CEO, Nick Mozzicato. Danahy most recently served as Vice President of Global Emerging Technologies and Specialty Sales at Zimmer BIOMET, and before that served as Vice President of Global Robotics Clinical & Technical Sales. Danahy brings more than 17 years of senior management experience in accelerating revenue growth and building high performance teams to drive long-term success.
Benco Dental New Appointees Josh Angotti, Territory Representative Benco Dental is pleased to welcome Josh Angotti to the Gateway region. Angotti earned a degree in communications at the University of Kansas. Jeannine Ciulla, Territory Representative Jeannine Ciulla joins Benco Dental in the Rocky Mountain region. Ciulla earned a degree in business management from the University of the Pacific. She brings 12 years of management and dental industry experience to Benco. Jim Curd, Territory Representative The Benco Dental team in the Ohio Valley region welcomes Jim Curd. Curd earned a degree in business from Indiana University. He brings three years of technical experience in the dental industry to the Benco family. Jillian Deo, Territory Representative Jillian Deo joins Benco Dental in the Gotham region. Deo earned a bachelor’s degree in human relations from St. Joseph’s College and a Master’s degree from Long Island University. She brings six years of dental sales experience to Benco.
Nora Feyl, Territory Representative Benco Dental is pleased to welcome Nora Feyl to its Desert region. Feyl earned a degree in communications from the University of Washington and brings six year of experience to Benco customers in her region. Mary Flanagan, Territory Representative Mary Flanagan joins Benco Dental in the Rocky Mountain region. Flanagan, a Registered Dental Hygienist, earned a B.S. degree in dental hygiene. Flanagan brings three years of dental sales experience to Benco customers. Stacy Semack, Territory Representative The Benco Dental team in the Hudson region welcomes Stacy Semack. Semack earned a bachelor’s degree in marketing from the University of Hartford. She brings five years of industry experience to Benco.
www.firstimpressionsmag.com
First Impressions
February 2019
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Henry Schein Appointee Announcements Trevor Pollack, Field Sales Consultant Trevor will represent Henry Schein Dental in the Metro New York area. He is new to the dental field and recently graduated from the University of Maryland with a Bachelorâ&#x20AC;&#x2122;s degree in Economics. Renee Garfin, Field Sales Consultant Renee will represent Henry Schein Dental in the North Los Angeles, California territory. She has six years of experience in the dental field and most recently worked as an Account Executive for AXE Trailers. Counce Drennen Ashcraft II, Field Sales Consultant Counce will represent Henry Schein in the Birmingham, Alabama territory. He has one year of experience in the dental field, working as a Territory Sales Representative for another distributor. Hope Rain, Field Sales Consultant Hope will represent Henry Schein in the Tampa, Florida area. She is new to the dental field and recently graduated from Southern Illinois University of Edwardsville with a Bachelorâ&#x20AC;&#x2122;s degree in Psychology and a minor in Communications. Jon McManemin, Field Sales Consultant Jon will represent Henry Schein in the Dallas / Fort Worth, Texas territory. He is new to the dental field and previously worked as a Client Relations Director at Aveanna Healthcare. Mark Rocha, Field Sales Consultant Mark will represent Henry Schein in the Hartford, Connecticut region. He has 15 years of experience in the dental field, all of which he spent working at another distributor. Nick Fallat, Field Sales Consultant Nick will represent Henry Schein Dental in the Cincinnati, Ohio region. He has nine years of experience in the dental field and most recently worked at Horkeys Kulzer Dental as a Territory Sales Manager. Lindsey Wachholtz, Field Sales Consultant Lindsey will represent Henry Schein in the Metro New York area. She has three years of experience in the dental field and most recently worked as a Market Development Manager for The Coca-Cola Company.
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John C. Puleo, Field Sales Consultant John will represent Henry Schein Dental in the Metro New York, New Jersey and Central New Jersey regions. He is new to the dental field and previously worked in sales at Beta Graphics, Inc. Melanie Jimenez, Field Sales Consultant Melanie will represent Henry Schein Dental in the New Jersey area. She has more than four years of experience in the dental field and most recently worked as a Sales Representative at Newark Dental. Brandon Unser, Field Sales Consultant Brandon will represent Henry Schein in the Milwaukee, Wisconsin area. He is new to the dental field and previously worked as a Sales Intern at Vita Companies. Nick Austin, Equipment Sales Specialist Nick will represent Henry Schein Dental in the Baltimore, Maryland region. He has five years of experience in the dental field and most recently worked as a Restorative Territory Manager at Dentsply Sirona. Orlando Vargas, Equipment Sales Specialist Orlando will represent Henry Schein in the Dallas / Fort Worth, Texas area. He is new to the dental field and previously worked as Vice President of Sales at Ice Shaker. Mike Muellenbach, Equipment Sales Specialist Mike will represent Henry Schein in the Wisconsin territory. He has 15 years of experience in the dental field and most recently work as Equipment Specialist at another distributor. Kristi Valentine, Digital Tech Specialist Kristi will represent Henry Schein in the Houston, Texas area. She has 15 years of experience in the dental field and most recently work as a Clinical Specialist at Acteon North America, Inc. Jon Carpenter, Digital Tech Specialist Jon will represent Henry Schein in the Raleigh, North Carolina area. He is new to the dental field and most recently worked as a Senior Healthcare Sales Executive at PhoneTree. Taylor Black, Digital Tech Specialist Taylor will represent Henry Schein in the Portland, Oregon area. She is new to the dental field and most recently worked as a Sales Associate at Gameday Media.
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Tokuyama Dental America Inc.
740 Garden View Court, Suite 200, Encinitas, California 92024 Call: +1 (877) 378-3548 | Fax: +1 (760) 942-7212
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