MI Paste or Fluoride for Ortho Patients

Transcription

Decmeber 2010 – Volume 6, Issue 12
with Perio
Reports by Trisha E. O’Hehir, RDH, BS
Discussion from Hygienetown.com
MI Paste or Fluoride
for Ortho Patients
hygienetown from trisha’s desk
Sweeten Mom’s Kisses to
Reduce Baby’s Risk of Caries
by Trisha E. O’Hehir, RDH, MS, Hygienetown Editorial Director
Babies are born germ free. Moms, dads, siblings, caregivers their saliva through normal kissing and sharing of food. At two
and even the family dog share their oral flora with babies via years of age, Strep mutans levels were measured in the children
saliva. Before teeth erupt, there is little chance Strep mutans will revealing 10 percent in the xylitol group positive for Strep
colonize, without the benefit of nonsloughing enamel surfaces. mutans, 30 percent in the chlorhixidine varnish group and 50
When teeth erupt, kids are susceptible to bacterial colonization. percent in the fluoride varnish group. The difference between
This provides a “window of infectivity,” according to Dr. Page the xylitol group and the fluoride group was fivefold!
Caufield of New York University.
When the children were five
In a 1993 article in the Journal of
years of age, results showed a long
Trisha Live
Dental Research, bacterial levels were
lasting result with 70 percent less
monitored in 46 mother-child pairs
need for restorative care in children
Here’s where you can catch Trisha live! To schedule
from the child’s birth to five years of
of
the moms who chewed 100
Trisha to speak at your next national, state or local denage. By 26 months, 38 of the chilpercent
xylitol-sweetened gum
tal hygiene meeting, e-mail [email protected].
dren had acquired Strep mutans.
compared to the other two groups.
January 13-15, 2011
Only eight children escaped Strep
These findings continued at this
Rocky Mountain Dental Conference Denver, Colorado
mutans colonization during the five
level through evaluations at ages six
January 22, 2011
years. When compared, moms and
and 10.
Make Yourself Indispensable Phoenix, Arizona
kids had the same oral bacteria. The
Xylitol reduced the levels of
January 29, 2011
window of infectivity identified by
Strep mutans in the mothers’
Drs. McCawley & DeTure Fort Lauderdale, Florida
Dr. Caufield and his team was 19 to
mouths, allowing for much less
February 26, 2011
26 months of age.
likely transmission to their babies.
Make
Yourself
Indispensable
Spokane,
Washington
If mom or the primary caregiver
True caries prevention begins when
has an oral flora replete with acidthe mother is pregnant. Efforts to
producing Strep mutans, these bacteria are freely shared through establish a healthy oral flora include daily xylitol use, good oral
saliva with the infant by kissing, tasting food first before feeding hygiene, healthy eating habits and now oral probiotics to change
the child and sharing food. Besides being an opportunity for the oral flora to one conducive to health. With these changes in
Strep mutans colonization, it is also the perfect place to prevent place, the stage is set for the baby to be protected when the first
Strep mutans sharing, by helping moms share sweet kisses com- teeth erupt. Other researchers have shown that if Strep mutans
posed of noncariogenic oral flora. Xylitol and oral probiotics will transmission can be prevented for the first two years of a baby’s
make the difference.
life, the baby has less risk for future caries activity. Beginning a
Dr. Eva Söderling and her research team from the University baby’s life with sweet xylitol kisses should be the first step in preof Turku in Finland reported in the Journal of Dental Research in venting childhood caries. n
2000 about the transmission of Strep mutans between moms and
babies. The 195 pregnant moms in the study all had high Strep
In This Section
mutans counts at the start of the study. There were three groups.
One group of mothers chewed 100 percent xylitol-sweetened
3
Perio Reports
chewing gum four times daily, beginning when their babies were
9
Townie Choice Awards 2010
three months old and continuing until they were 24 months.
21 Short Commentary:
Moms in the second group had fluoride varnish applied to their
Treating Returning Soldiers with a Traumatic Brain Injury
teeth every six months for two years. Similarly, the third group
23 Message Board: MI Paste or Fluoride for Ortho Patients
had chlorhexidine varnish applied every six months. Nothing
was done to the children in this study. The moms simply shared
n
n
n
n
1
December 2010 » hygienetown.com
You care
enough to
brush with
toothpaste...
WHAT IS
XYLITOL?
Go to
whyxylitol.org
VISIT US ONLINE:
Shouldn’t you be using
a nasal spray with xylitol?
The only nasal spray with 100% Xylitol, Xlear®
(pronounced “clear”) has been clinically shown
to reduce airborne contaminates in the sinuses
and upper respiratory tract, while soothing and
moisturizing. Like brushing, a daily spray should be
a part of your family’s health routine.
www.xlear.com
Available at:
And other fine stores.
hygienetown perio reports
Perio Reports
Vol. 22 No. 12
Perio Reports provides easy-to-read research summaries on topics of specific interest to clinicians.
Perio Reports research summaries will be included in each issue to keep you on the cutting edge of dental hygiene science.
Caries and Perio Found Together
Vitamin B12 and Folate
Prevent Aphthous Ulcers
With studies showing caries and
periodontitis found together and
other studies showing either one disease or the other, research is contradictory. Both are bacterial in nature,
impacted by the accumulation of
bacterial biofilm. It is suspected that
salivary pH might contribute to disease selection, with an acid pH leading to more caries and a basic pH
contributing to calculus formation
and periodontitis. Research hasn’t evaluated this theory.
Researchers from the University of Oulu in Finland compared
the incidence of both caries and periodontal disease in a group of
5,000 adults older than age 30 who were part of a national health
survey. Clinical examinations were conducted by five field teams in
community settings using a headlamp for light, a mouth mirror, a
periodontal probe and explorer. Compressed air was available to
dry teeth prior to examination.
The deepest probing depth for each tooth was recorded in
one of three categories: none, 4-5mm or 6mm. Dental caries
were recorded if cavitation was present and the lesion was
extending into the dentin.
Of this group, 65 percent had 4mm probing depths; 21 percent
had 6mm probing depths; and 29 percent had dental caries. The
caries incidence was significantly lower than reported for the UK or
the U.S. Perhaps the use of xylitol in Finland is responsible.
In the group with 6mm probing depths, 44 percent also had
caries. In the periodontally healthy group, 23 percent had caries.
More severe periodontal disease and caries tend to be found in the
same patients.
Recurrent aphthous stomatitis (RAS) is a widespread, common oral mucousal lesion. Incidence levels vary with reports as high as 50 percent in women
and 40 percent in men. The lesions are small, oval in
shape with necrotic tissue in the center and a red
inflamed border. The lesions are painful, especially
with eating and regular oral hygiene. RAS is more
common in younger people than older people. This
difference might be explained by dietary intake of
nutrients. Younger people are less likely to eat healthy,
well balance meals than older people.
Researchers at the University of Connecticut in
Farmington analyzed the dietary intake of 100 subjects who experienced at least three episodes of RAS in
the past year. These findings were compared to
age- and gender-matched participants in the U.S.
National Health and Nutrition Examination Survey
(NHANES). Dietary intake was evaluated using
DietCalc software that calculates specific nutrients
based on the reported food intake. This allowed daily
nutrient comparisons between the two groups.
Nine nutrients were identified for comparison:
vitamins A, B6, B12, C, E, thiamin, riboflavin, niacin
and folate. Those in the RAS group had higher levels
of seven of the nine nutrients than the controls. The
two nutrients that were lower in this group were vitamin B12 and folate. This correlates to seven percent of
the recommended daily intake level for vitamin B12
and 20 percent of the recommended level for folate.
Just how vitamin deficiencies affect RAS is unknown.
Clinical Implications: Observe your patients to see how often
they present with both caries and periodontal disease.
Clinical Implications: Increasing dietary B12 and
folate or adding nutritional supplements seems an
easy way to prevent recurrent aphthous ulcers.
Mattila, P., Niskanen, M., Vehkalahti, M., Nordblad, A., Knuuttila,
M.: Prevalence and Simultaneous Occurrences of Periodontitis and
Dental Caries. J Clin Perio 37: 962-967, 2010. n
3
Kozlak, S., Walsh, S., Lalla, R.: Reduced Dietary
Intake of Vitamin B12 and Folate in Patients with
Recurrent Aphthous Stomatitis. J Oral Pathol Med 39:
420-423, 2010. n
perio reports hygienetown
Systemic Markers After SRP and SX
Periodontal infection is associated with several systemic
inflammatory markers. Low-grade systemic inflammation is
evident by increased concentrations of biomarkers including
C-reactive protein (CRP), leucocyte counts, serum amyloid-A
and other blood markers.
Researchers at the University of Pisa in Italy monitored
these serum inflammatory markers at baseline, and days
seven, 30, 90 and 180 following SRP. They were also monitored after flap surgery out to day 270. The 14 study subjects all had chronic moderate periodontitis. Baseline
probing depths revealed an average of 64 pockets measuring 4mm or more per patient. Patients all received baseline
data collection, oral hygiene instructions and full-mouth
SRP completed within 24 hours. Pockets were reduced at
three months to 16 and by six months to 15. Surgery was
done in two sessions after the six-month visit and resulted
in further pocket depth reductions to eight pockets per
patient on average.
CRP levels increased after the SRP visit and to a lesser
level after each surgery. Other serum markers also showed
more significant increases after SRP, with much smaller
impacts after the two surgeries. This is most likely attributed
to the fact that full-mouth
SRP was done when the
area of periodontal infection was considerably larger
than the areas undergoing
localized surgery. The
extent of periodontal infection influences the changes
in inflammatory markers
following treatment more
than the particular treatment provided.
Scanning electron microscope image of
circulating human blood
Clinical Implications: Treating a full-mouth with moderate periodontitis will lead to higher serum levels of
systemic inflammatory markers than levels immediately
following localized periodontal surgery.
Graziani, F., Cei, S., Tonetti, M., Paolantonio, M., Serio, R.,
Sammartino, G., Gabriele, M., D’Aiuto, F.: Systemic
Inflammation Following Non-Surgical and Surgical Periodontal
Therapy. J Clin Perio 37: 848-854, 2010. n
C-reactive Protein Produced Systemically
Periodontitis, as well as other systemic diseases are associated
with elevated levels of C-reactive protein (CRP) measured in
both serum and gingival crevicular fluid (GCF). Treatment of
periodontitis reduces CRP levels.
CRP is produced by the liver in response to inflammation or
tissue necrosis. Even mild serum levels of CRP are evidence of a
tissue damaging process going on somewhere in the body.
Recent research shows evidence that CRP can be produced in
small amounts by cells other than hepatic cells. Based on these
findings, researchers at the University of Adelaide in South
Australia wondered if CRP might originate in gingival and periodontal tissues as well as systemically from the liver.
If CRP is synthesized in gingival tissues, signs of mRNA
would be present in tissue samples. Tissue samples were collected from patients undergoing periodontal surgery and from
periodontally healthy patients undergoing crown lengthening or
who allowed a tissue biopsy prior to tooth extraction. GCF samples were also collected and analyzed.
Tissue samples were collected from 46 subjects with periodontal disease and 13 periodontally healthy subjects. GCF flow
in those with periodontal disease was double that of the healthy
subjects. Polymerase chain reaction was used to determine if
CRP was manufactured within gingival tissue. No evidence of
mRNA was found in the tissue samples. The authors conclude
that CRP measured in GCF is indicative of systemic inflammation, either periodontal disease or infection somewhere else in
the body.
Clinical Implications: Chairside kits are being developed
that have the potential to provide an alternative to blood
tests for measuring systemic CRP that might reflect systemic
inflammation.
Megson, E., Fitzsimmons, T., Dharmapatni, K., Bartold, M.: CReactive Protein in Gingival Crevicular Fluid May be Indicative of
Systemic Inflammation. J Clin Perio 37: 797-804, 2010. n
continued on page 5
hygienetown.com « December 2010
4
hygienetown perio reports
continued from page 4
Oral Cancer Screening Devices Compared
In 2008, oral cancer cases numbered 35,000, with 7,500 deaths. ViziLite Plus with
TBlue and the VELscope were developed to enhance oral cancer screening exams in the
hope of identifying lesions not readily seen by clinicians.
Researchers at Moti Lal Nehru Medical
College in India compared two diagnostic light
systems, ViziLite Plus and VELscope. The study
took place at a rural district hospital in central
India. A total of 258 patients were examined
using an overhead dental light and found to have
Prescribing antibiotics to prevent infection resulting from third
clinically innocuous lesions that the examiners
molar extractions is a topic of considerable debate. In 2007 the
decided required no further attention other than
American Heart Association issued new antibiotic prophylaxis guidelines
routine follow-up. Subjects were randomly
based on current evidence of the risks associated with antibiotic overuse.
assigned to examination with either the ViziLite
Adverse reactions to the drugs and development of drug-resistant bactePlus system or the VELscope. All subjects then
ria are greater risks than infection.
underwent surgical biopsies.
Researchers at the University of Otago, in Dunedin, New Zealand
The ViziLite system was used on 102 subcompared impacted third molar extractions in the same patient with and
jects. Biopsies revealed one mild dysplasia, two
without antibiotic prophylaxis. Ninety-five patients were divided into
moderate dysplasias and one cancer. None were
two groups and each served as their own control, receiving the assigned
correctly identified by the ViziLite or the cliniantibiotic dose for one surgery and a placebo for the other surgery.
cians. ViziLite correctly identified 74 out of 98
Group one received 1g of amoxicillin one hour before surgery. In addibenign lesions as negative. Incorrectly identified
tion, group two also received 500mg of amoxicillin every eight hours for
as positive were 24 benign lesions.
two days after surgery.
The VELscope was used on 156 subjects.
No significant differences were observed between test and placebo
Tissue biopsies revealed 11 dysplasias, and one
groups
for pain, swelling, temperature or trismus. Post-operative
cancer. The VELscope correctly identified five
infections occurred in just six cases or two percent of the 380 extracdysplasias and the cancer, thus half were correctly
tions. Three dry sockets were reported in the placebo group and one
identified by the VELscope. The VELscope
in the group receiving one dose of amoxicillin. In the group receiving
correctly identified 56 of 144 negative findings
multiple doses of amoxicillin, one patient experienced a dry socket
and six of the 12 positive findings. Eighty-eight
after both the antibiotic and the placebo. Differences between the
VELscope positives were actually benign.
groups were not significant as the overall rate of post-operative infection was so low.
Clinical Implications: Identifying precancer-
Antibiotics for Third Molar Extraction
ous and cancerous lesions is difficult for clinicians, and the VELscope appears to provide
benefit in identifying cancer, but also identifies as positive lesions that are not cancer.
Doing an oral cancer screening examination
on every patient is essential.
Mehrotra, R., Singh, M., Thomas, S., et al: A
Cross-Sectional Study Evaluating Chemiluminescence and Autofluorescence in the Detection
of Clinically Innocuous Precancerous and
Cancerous Oral Lesions. JADA 141: 151156, 2010. n
5
Clinical Implications: Each case must be evaluated individually,
however the risks associated with taking antibiotics seem to outweigh the risks due to infection after extractions.
Siddiqi, A., Morkel, A., Zafar, S.: Antibiotic Prophylaxis in Third
Molar Surgery: A Randomized Double-Blind Placebo-Controlled
Clinical Trial Using Split-Mouth Technique. Int J Oral Maxillofac Surg
39: 107-114, 2010. n
Probiotics.
They aren’t just for
digestion anymore.
© 2010 Oragenics, Inc. All Rights Reserved.
Introducing EvoraPro™ probiotic
mints from Oragenics – the first
professional-strength probiotics
for oral health.
Oragenics probiotic products were developed from basic
research begun 25 years ago at the Harvard-affiliated
Forsyth Institute in Boston. This body of research has
shown that a few key naturally occurring oral bacteria
can act as antagonists to harmful oral bacteria. EvoraPro
and EvoraPlus are 100% natural, and will not harm tooth
enamel, dental work, bridges, or dentures.
Used just once a day for 10 days after a professional
cleaning, EvoraPro supports dental and gingival health
and extends the “fresh from the dentist” clean. Each mint
contains an extra-strength blend of ProBiora3® probiotics.
These beneficial bacteria bind to teeth and go deep
under the gingival margin, crowding out harmful bacteria.
Let us help you maintain your patients’ oral health while
making them more active in their own care. For more
information, call us at 877-803-2624 ext. 248 or visit
www.ForEvoraPro.com.
A 2009 Journal of Applied Microbiology study determined
that use of ProBiora3 promotes periodontal and dental
health by helping to maintain a healthy balance of bacteria
in the mouth1. Since a professional cleaning removes both
good and bad bacteria, the days immediately after a
cleaning are an ideal time to replenish the good bacteria
that are essential for oral health.
1. Journal of Applied Microbiology, 2009; 107: 682-690.
EvoraPro PROBIOTIC MINTS AT A GLANCE
• Professional-strength probiotics for oral care
• Contains ProBiora3 blend of beneficial bacteria
After using the 10-day supply of EvoraPro, patients
should use regular-strength EvoraPlus® for ongoing
maintenance. Used daily over a period of weeks,
EvoraPlus substantially reduces levels of certain oral
bacteria associated with bad breath. Beneficial bacteria
in EvoraPlus also produce a continuous low dose of
hydrogen peroxide as a natural metabolic by-product.
In a four-week laboratory study, this process provided
continuous whitening on stained dental surfaces.
877-803-2624 ext. 248
• Promotes healthy bacterial balance in mouth
• Extends effects of professional cleaning
• Does not harm tooth enamel, dental work,
or dentures
• 100% natural
I
www.ForEvoraPro.com
See us at the Yankee Dental Congress in Boston,
January 27 – 29, Booth 2034.
townie choice awards 2010
That Time of Year is Here!
The 2010 Townie Choice Awards
Anesthesiology
Cosmetic
Dental Hygiene
Infection Control
Periodontics
Practice Management
Radiology
10
11
11
16
17
19
20
We all look forward to this magical time of year, when we dim
the lights, stoke the fire, pour ourselves a mug of hot cider, curl up
on the couch and, like caffeinated Tasmanian Devils, tear through
the pages of the December issue of Hygienetown Magazine to find
out which dental companies, products and services were awarded
the highly sought-after Townie Choice Awards! It’s a time of mirth
and whimsy, when we all get together online afterward to debate
with friends and colleagues the final results of the most important
annual poll in dentistry. Happy holidays, indeed! Yes, friends, welcome to the official 2010 Townie Choice Awards showcase!
You can pick up the phone and talk to a few of your dental
hygiene friends to find out what they use. You can scan the message
boards of Hygienetown.com to see what dental hygienists are
debating. But do you have the time to sift through the facts or the
arguments when you need to help place the order right now? For
seven years, the Townie Choice Awards have cut to the chase and
answered the basic root of your practice’s purchasing concerns,
“What are other dental hygienists using right now?”
After months of tabulating thousands of votes cast by honestto-goodness, real-world, practicing dentists, we are pleased to present the winners in each of our TCA categories – from
Anesthesiology to TMD. As in years past, in some instances, the
race to the finish was close; in others, winners were determined by
a large margin. You can find the list of runners-up as well as the
winners from the past seven years on Hygienetown.com. Thank
you for your participation and continued support of Hygienetown!
For the first time this year, TCA voters who cast
their ballot by August 7, 2010, were eligible for our
$500 early-bird drawing. Congratulations to Dr. George
Valentine of Middletown, Connecticut, for winning the
$500 Early Voter prize! Dr. Valentine began practicing
over 37 years ago and has been a member of Dentaltown since 2002.
“I feel that by participating in the Dentaltown surveys and
Townie Choice Awards, I can at least, in a small way, return something to an organization (Dentaltown) that I feel offers the premier
forum in dentistry for active exchange of professional experiences,
ideas, concepts and solutions to the many issues and problems facing dental providers and practices today.”
9
anesthesiology tca 2010
Congratulations To Our $1,000 Winner
Joshua Haremza, DDS
Voters of the Townie Choice Awards were automatically entered in a
drawing to win $1,000. This year’s winner is Dr. Joshua Haremza of
Mendon, New York.
Born and raised in New York, Dr. Joshua Haremza graduated Magna
Cum Laude in 2005 from State University of New York at Buffalo School
of Dental Medicine and completed his one-year general practice residency
at Strong Memorial Hospital in Rochester, New York. Dr. Haremza currently practices with 11 staff members and two other doctors in Palmyra,
New York, a suburb of Rochester, where he started as an associate in 2006,
and purchased 50 percent ownership in January 2008.
He now lives in Mendon, New York with his wife, Joanne, and two
Beagles, Banana and Oscar, which many Townies might recognize from his
posts on Dentaltown.com.
“I like using Dentaltown because it keeps me up to date on new technologies and advances in dentistry. I refuse to become one of those dentists
that is still using technology from 20 years ago and Dentaltown is the best
way to make sure of that.”
Anesthetics: Local (Injected)
Septodont: Septocaine
Septocaine is consistently the number-one branded product in
the U.S. Septocaine is indicated for local, infiltrative or conductive anesthesia in both simple and complex dental procedures.
It’s available in two formulations so you can decide which
epinephrine concentration is right
for the patient and the procedure.
For more information call 800872-8305. (Votes: 678 of 1,031)
Anesthetics: Topicals
Sultan Healthcare, Inc.: Topex
Anesthetics: Technique System
Milestone Scientific: STA System
The STA System utilizes computer-controlled
local anesthetic delivery to enhance the
injection process for dentists and patients.
Intraligimentary injections can be administered more precisely as STA provides audio
and visual confirmation of proper needle
placement and controls the flow of anesthetic.
Visit www.stais4u.com. (Votes: 72 of 1,031)
Syringes
Hu-Friedy: Aspirating Anesthetic Syringe
Hu-Friedy’s Aspirating Anesthetic Syringe is
Topex is a fast-acting 20 percent
ergonomically designed with proportional
Benzocaine topical anesthetic. It can
finger and thumb grips which increase conbe used to comfort patients with
trol and adds comfort during aspiration
ulcers, wounds and other minor
while reducing hand fatigue. Hu-Friedy’s
mouth irritations and eliminates the
syringes are available in two styles, a
gag reflex when performing radiographs, periodontal and prosType A and Type CW. Visit www.huthetic impressions. Available in seven patient-pleasing flavors.
friedy.com for more information. (Votes: 288 of 1,031)
Visit www.sultanhc.com. (Votes: 208 of 1,031)
continued on page 11
10
tca 2010 cosmetics
dental hygiene tca 2010
Cosmetic Bleaching: In-Office System
Discus Dental, Inc.: Zoom1/Zoom2/Zoom! Advanced Power/
Zoom! Advanced Power Plus
Zoom is faster and easier than ever before. With
a redesigned patient kit with everything needed
for a procedure, along with the award-winning
Zoom whitening lamp, comprehensive training
materials and a full suite of professionally
designed marketing materials, Zoom is a true
practice builder. (Votes: 238 of 1,043)
Cosmetic Bleaching: Take-Home System
Ultradent Products, Inc.:
Opalescence/Opalescence Treswhite Supreme
Cosmetic Bleaching: Over-the-Counter Products
Proctor & Gamble: Crest Whitestrips
The Crest Whitestrip Supreme Professional Strength Whitening
System offers the highest concentration of take-home whitening
available through the dental office among leading brands. The
kits include: 14-percent-longer upper-strips and 18-percentlonger lower-strips. Whitens up
to 18 teeth. For more information, visit www.crest.com.
(Votes: 520 of 1,043)
Laboratory: Veneer & High Aesthetic
Glidewell Laboratories
Our smile-makeover specialists extend a warm thanks for this
Opalescence is available in a carbamide peroxide and hydrogen per- award. These technicians take great pride in working with you to
oxide formula for superior whitening. The sticky and viscous con- handcraft the beautiful smiles your patients desire. We appreciate
sistency prevents the gel from leaching when placed. It’s
your support and look forward to helping you meet your patients’
combined with potassium nitrate and fluoride for
expectations in the future.
sensitivity and is available in a variety of concenCall 800-854-7256 or visit
trations, flavors and kit configurations to meet
www.glidewelldental.com.
all whitening needs. (Votes: 520 of 1,043)
(Votes: 96 of 821)
Dental Floss: Coated
Proctor & Gamble: Crest Glide
Dental Floss: Floss Threaders
Oral-B: Super Floss
Glide Floss is designed to resist shredding. It
removes plaque and helps prevent gingivitis
for healthy teeth and gums. With Glide Floss,
you’ll be able to easily slide floss between
teeth due to the light coating of natural wax.
For more information, visit www.crest.com.
(Votes: 470 of 1,236)
Oral-B Super Floss is ideal for cleaning
braces, bridges and wide gaps between teeth.
Its three unique components – a stiffened
end, spongy floss, and regular floss – all work
together for maximum benefits. Available in
regular or mint flavor, each box contains 50 premeasured
strands. For more information, visit www.oralbprofessional.com.
(Votes: 424 of 1,236)
Dental Floss: Pre-strung Flossers
Johnson & Johnson Healthcare Products:
REACH ACCESS Flosser
Dental Floss: Unwaxed
Johnson & Johnson Healthcare Products: REACH
The REACH Access Flosser makes flossing as easy
as brushing. Convenient, disposable snap-on heads
are filled with shred-resistant floss, and the toothbrush style handle with comfortable, easy-to-hold
grips and an angled neck reaches back teeth where
most problems begin. Fits into toothbrush holders
to serve as a daily reminder. (Votes: 317 of 1,236)
From Johnson & Johnson, REACH is available in an unwaxed,
unflavored floss. It is accepted by the American Dental
Association (ADA). Daily flossing has been clinically proven to
remove plaque between teeth to help prevent gum disease. For more information,
visit www.jnj.com. (Votes: 366 of 1,236)
11
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LISTERINE SMART RINSE
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Use all pr
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re
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*Data on file, McNEIL-PPC, Inc.
Fluoride
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tca 2010 dental hygiene
In-Office Sensitivity Products (non-fluoride varnish)
GC America, Inc.: MI Paste/MI Paste Plus
In-Office Topical Fluoride: Foam
Oral-B: Minute-Foam, Neutra-Foam
GC America’s MI Paste and MI Paste Plus (with 900ppm fluoride), with Recaldent (CPP-ACP), created
the calcium phosphate treatment category
– a breakthrough in the science of remineralization. GC America is on the forefront
in the development of preventive products
for the dental hygiene professional. Visit
www.gcamerica.com. (Votes: 279 of 1,236)
Oral-B Minute-Foam is a leading fluoride topical
available to dental offices. Its light, airy foam
consistency provides unsurpassed coverage and
clears easily and quickly from the mouth. Oral-B
Minute-Foam’s low pH (3.5) ensures a fast, effective
fluoride uptake in 60 seconds. Available in seven flavors. Visit www.oralbprofessional.com.
(Votes: 299 of 1,236)
In-Office Topical Fluoride: Gel
Oral-B: Minute-Gel
In-Office Topical Fluoride: Rinse
Oral-B
Oral-B Minute-Gel offers your patients a treatment to fit their
individual requirements and personal tastes. Fast, effective fluoride uptake (12,000ppm in one minute) shortens treatment time
and reduces potential for gagging or gel ingestion. Available
in four flavors to encourage patient compliance. Visit
www.oralbprofessional.com
for more information.
(Votes: 155 of 1,236)
Oral-B Fluorinse is an alcohol-free rinse containing 0.2 percent
sodium fluoride. Used once a week, Fluorinse makes patient
compliance easy. Available in two flavors, mint and cinnamon.
For more information, visit www.oralbprofessional.com.
(Votes: 154 of 1,236)
In-Office Topical Fluoride:
Varnish
3M ESPE:
Vanish 5% NaF White Varnish
Interdental Devices: Brushes
Sunstar Americas, Inc.:
GUM Proxabrush
Proxabrush products are for people with orthoVanish White Varnish virtually disappears
dontic appliances, implants or galvanic sensitivity.
The antibacterial bristles inhibit bacterial growth so
after application, so there is no trace of the
your brush stays cleaner between uses. It is available in a
ugly yellow color you see with traditional varnishes. Vanish
White Varnish safely delivers 22,600ppm fluoride and contains travel-size brush or handle and refill system and can come tapered
xylitol. It takes just seconds to paint on and sets rapidly in the or cylindered with five handle sizes. Visit www.gumbrand.com
presence of saliva. Visit www.3mespe.com/preventivecare. for more information. (Votes: 348 of 1,236)
(Votes: 299 of 1,236)
Interdental Devices: Sticks/Piks
Johnson & Johnson Healthcare Products: Stim-U-Dent
Mouthrinses: Alcohol-Free
GlaxoSmithKline: Biotene Dry Mouth Mouthwash
Stim-U-Dent is clinically proven to fight gum disease by removing
plaque from between teeth. Just firm enough to
clean and polish without abrasion. Just soft enough
to invigorate tissue gently and safely with its
unique shape which conforms to spaces between
teeth. Convenient for use when away from home,
anytime, anywhere. Visit www.jnj.com.
(Votes: 284 of 1,236)
Unlike some harsh mouthwashes that can leave you wincing,
Biotene Dry Mouth Mouthwash gently cleans and
moisturizes minor irritation in the mouth and
freshens breath. Biotene Mouthwash is alcoholfree and uses the LP3 salivary enzyme-protein
system. Plus, its moisturizing polymers offer oral
comfort and help strengthen saliva’s natural properties. (Votes: 266 of 1,236)
13
dental hygiene tca 2010
Mouthrinses
Johnson & Johnson Healthcare Products: Listerine Antiseptic
Listerine kills the germs that cause bad breath,
plaque and the gum disease gingivitis. Listerine
offers 24-hour protection against plaque and
gingivitis germs and has the American Dental
Association (ADA) Seal of Acceptance for helping to prevent and reduce gingivitis and plaque.
For more information, visit www.listerine.com.
(Votes: 589 of 1,236)
Oral Cancer Screening
Zila Pharmaceuticals, Inc.: ViziLite Plus with TBlue
ViziLite Plus, the only adjunct oral cancer screening system
with TBlue, is a simple, three-step examination system to help dental practices
identify potentially cancerous lesions in
the oral cavity. For more information or
to place an order, please call 800228-5595 or visit www.zila.com.
(Votes: 170 of 1,236)
Oral Irrigators
Water Pik, Inc.
Pit & Fissure Sealants
Ultradent Products, Inc.: UltraSeal XT Plus
The Waterpik dental water jet is the only brand
clinically proven to be an effective alternative to
traditional dental floss for removing plaque and
reducing gingival bleeding and inflammation.
The Waterpik dental water jet removes plaque
biofilm both subgingivally and interproximally,
and massages and stimulates gingival tissue.
(Votes: 498 of 1,236)
UltraSeal XT plus is a light-cured, radiopaque, pit and fissure
sealant, making it stronger and more wear-resistant. Because it
is a 58 percent filled resin, UltraSeal XT plus has less polymerization shrinkage than competitive products. When used in
conjunction with Ultradent’s PrimaDry (the priming
and drying agent) microleakage is virtually eliminated.
(Votes: 348 of 1,236)
Prescription Fluoride: Daily Use
Colgate-Palmolive Co.:
PreviDent 5000 Booster/Dry Mouth/Sensitive (Rx)
PreviDent 5000 Booster/DryMouth/Sensitive
all contain 1.1 percent NaF (5000ppm) for caries
protection. PreviDent 5000 Booster provides
general caries protection, while PreviDent 5000
Sensitive contains 5 percent KNO3 for sensitivity
relief and PreviDent 5000 Dry Mouth is an SLS-free formula for dry
mouth. (Votes: 792 of 1,236)
Prophylaxis: Handpieces
DENTSPLY Professional: MIDWEST
Midwest RDH hygiene handpiece was designed with
one specific goal in mind: a hygienist’s comfort. The
lightweight, ergonomic design provides a balance of
weight, equilibrium and size for reduced hand and wrist
fatigue. A smooth finger-tip swivel provides free-flowing access, greater maneuverability and control and less
paste splatter. (Votes: 457 of 1,236)
Prophylaxis: Prophy Angles
Young Dental
Prophylaxis: Prophy Paste
DENTSPLY Professional: NUPRO
Young Disposable Prophy Angles are manufactured with a screwtype cup, giving hygienists reliability and a smooth polishing
experience. Young’s leading line of angles
is available in the Classic or Contra body
and features a variety of prophy cup
options, ranging from traditional web to
Elite cup; latex-free choices are available.
(Votes: 211 of 1,236)
The leading prophy paste, NUPRO brand provides everything
you need for excellent stain removal and polishing. With a
truly splatter-free formula, it rinses cleanly and easily. Choose
from four grits and 10 great tasting flavors with 1.23 percent
fluoride ion. Select flavors are also
available without fluoride. Visit
www.denstply.com.
(Votes: 404 of 1,236)
14
tca 2010 dental hygiene
Tongue Cleaners
Discus Dental, Inc.: BreathRx
Toothbrushes: Manual
Oral-B
The simple, easy action of tongue scraping has shown to significantly reduce oral
malodor as a regular part of patient’s daily
hygiene. BreathRx tongue scrapers have a gagreducing slim profile to lift and remove odorcausing bacteria and food debris off the tongue’s
surface for fresh breath all day.
(Votes: 239 of 1,236)
Oral-B Pulsar redefines the manual toothbrush category. It is clinically proven to
remove more plaque than the leading manual and battery brushes and uses technologies
protected by more than 15 patents. The brush
has soft, flexible MicroPulse bristles and a new
innovative split brush head. Visit www.oralbprofessional.com for
more information. (Votes: 478 of 1,236)
Toothbrushes: Power
Philips Oral Healthcare: Sonicare/Sonicare FlexCare
Toothpaste: Desensitizing
GlaxoSmithKline: Sensodyne
The Philips Sonicare elite e9000 Custom Care System comes
with two brush head sizes, allowing patients
to reach posterior teeth and interproximal
spaces. The new compact brush head is clinically proven to remove more plaque than the
standard brush head in posterior areas.
Exclusive offer for dental professionals, visit
www.sonicare.com. (Votes: 626 of 1,236)
One in every three adults has suffered from dentin hypersensitivity, yet few patients bring the issue to the attention of their
dentist. Sensodyne provides the unsurpassed relief from dentinal
hypersensitivity that comes with
KNO3, helping relieve
hypersensitivity in as
few as two weeks.
(Votes: 762 of 1,236)
Toothpaste
Colgate-Palmolive Co.: Colgate Total
Toothpaste: Whitening
Proctor & Gamble: Crest
Colgate Total Advanced Clean toothpaste has a unique
Triclosan plus Copolymer formula that delivers 12-hour antibacterial protection, even after eating and drinking. It contains
micro-particles for enhanced cleaning, and has been proven
effective over a range of patient benefits in more than 60 wellcontrolled clinical studies with more than 15,000 patients.
(Votes: 516 of 1,236)
Crest Whitening Toothpaste includes the bad breath fighting
power of Scope, all in one product. Crest tooth whitening
provides cleaning action to help prevent calculus buildup and
remove surface stains. The added Scope provides icy, fresh
breath while fighting tooth decay and calculus. Visit
www.crest.com for more information.
(Votes: 211 of 1,236)
Xerostomia Products
GlaxoSmithKline: Biotène Products (Oral Balance)
The Biotène family of products offers more options to better
meet specific patient needs. There are products that relieve and
moisturize, products for ongoing hygiene and products for saliva
stimulation. Biotène helps manage dry mouth while
supplementing some of
saliva’s natural enzymes.
(Votes: 871 of 1,236)
15
Share Hygienetown
Share with your hygienists
the Web site that was created
just for them. A site where they
can obtain online CE, participate in peer learning and get
more out of their careers –
www.hygienetown.com
infection control tca 2010
Gloves: Latex
Glove Club
Gloves: Non-Latex
Glove Club
The Glove Club offers a comprehensive line of high-quality
gloves with unique features to meet the needs of the entire office.
All Glove Club brand gloves have been designed specifically to
address the concerns of health care
workers, such as latex sensitivity,
powder levels, and inconsistent
sizing and fit. Visit www.glove
club.com. (Votes: 114 of 1,000)
The Glove Club offers a comprehensive line of high-quality
gloves with unique features to meet the needs of the entire office.
All Glove Club brand gloves have been
designed specifically to address the concerns of health care workers, such as latex
sensitivity, powder levels, and inconsistent sizing and fit. Visit www.glove
club.com. (Votes: 111 of 1,000)
Gloves: Powder-free
Glove Club
Masks
Crosstex International
The Glove Club offers a comprehensive line of high-quality Crosstex masks exceed ASTM barrier specifications for low,
gloves with unique features to meet the needs of the entire office. moderate and high exposure. They provide submicron filtration and fluid resistance, are latexAll Glove Club brand gloves have been designed specifically
free, odorless and comfortable –
to address the concerns of health care workeverything you want in a mask and
ers, such as latex sensitivity, powmore! Visit www.crosstex.com for
der levels, and inconsistent sizing
vital mask selection guidelines and
and fit. Visit www.gloveclub.com.
information. (Votes: 302 of 1,000)
(Votes: 112 of 1,000)
Pre-Sterilization: Ultrasonic Units
Coltène/Whaledent, Inc.: BioSonic
Protective Eyewear
Gargoyles
The BioSonic UC125 Ultrasonic Cleaner
is equipped with a programmable LCD
display, a degas mode, a digital solution
usage timer, easier/faster draining and
customizable operation. An exclusive feature automatically
adjusts the power in the tank based upon load requirements.
Visit www.coltenewhaledent.com or call 800-221-3046.
(Votes: 393 of 1,000)
Gargoyles Safety Glasses Classic/85s,
are optically correct protective safety
glasses. ANSI Z87.1 and NATO
approved. Unique wrapback design
provides 210 degrees of peripheral protection, exceeding OSHA
requirements for splash and splatter. Side shields are also available with every model. 100 percent UV protection lifetime warranty. (Votes: 84 of 1,000)
Sterilization Pouches
DUX Dental: PeelVue+
Sterilizers
MIDMARK
PeelVue+ Sterilization Pouches offer the highest quality dental
pouch. When you use PeelVue you are meeting CDC recommendations. The pouch features builtin internal and external indicators
and user friendly color identification that makes ordering and
grabbing the right size pouch easy.
(Votes: 181 of 1,000)
The Midmark family of sterilizers is an all-inclusive solution for
your sterilization needs. Combine
the capacity of the Midmark M11
and M9 UltraClave Automatic
Sterilizers with the simplicity and
speed of the M3 UltraFast to create the most efficient workflow for
your office. (Votes: 349 of 1,000)
16
periodontics tca 2010
tca 2010 infection control
Surface Disinfectants
Kerr TotalCare: CaviCide Spray/Wipes
Unit Waterline Treatments
A-dec, Inc.: ICX
CaviCide and CaviWipes are tuberculocidal, bactericidal, virucidal and fungicidal surface disinfectants. CaviCide is ideal for
dental operatories, instrument-processing
rooms and dental labs. Also effective
against HIV, HBV and HCV and a reliable means of preventing cross contamination. Visit www.kerrtotalcare.com.
(Votes: 388 of 1,000)
A-dec’s ICX waterline treatment tablets offer a unique and effective
way to maintain clean dental unit waterlines. As the tablet dissolves,
it releases ingredients that help prevent deposits and contaminant
buildup. ICX continues working after
each treatment to help protect waterlines
against contamination. For more information, call 800-547-1883 or visit
www.a-dec.com. (Votes: 139 of 1,000)
Hand Instruments: Curettes & Scalers
Hu-Friedy: NEVI 4
Instrument Sharpening Devices
Hu-Friedy: Sidekick Sharpener
Hu-Friedy’s Nevi 4 posterior sickle scaler features tapered, dual
cutting blades that provide effective removal of burnished, heavy
and tenacious deposits and precise access for effective deposit
removal – made with revolutionary EverEdge technology, which
allows the edge to stay sharper longer. Increased shank rigidity
provides powerfully effective stokes with less effort
and fatigue for the clinician.
(Votes: 291 of 1,049)
Hu-Friedy’s Sidekick Sharpener helps you maintain sharper
instruments with less effort. Our easy-to-use Guide Channels
and Vertical Backstop guide you and your scaler to sharp, consistent results time after time. This routine maintenance will actually extend the life of your
instruments and protect your investment. The
Sidekick is compact, cordless and requires minimal counter space. (Votes: 165 of 1,049)
The New Standard for Dental Isolation
Now with Two Solutions!
Both the original Isolite™ with 5 levels of brilliant
Lightless but brilliant!
intra-oral lighting and the new lightless IsodryTi™
systems provide continuous adjustable suction,
tongue and cheek retraction, throat protection, and
a comfort bite block. Professionals using this awardwinning isolation technology are experiencing:
U
30% Faster Procedures
UÊ I mproved
UÊ Reduced
Patient Comfort
Ergonomic Strain
To Learn More about Isolite, Call 800-560-6066
OR VISIT I S O L I T E S Y S T E M S . C O M
DTN2010
17
Superior intra-oral lighting
periodontics tca 2010
Periodontal Charting
Henry Schein Practice Solutions: DENTRIX
The DENTRIX Perio Chart is widely recognized as one of the
most comprehensive periodontal charting software programs
available enabling you to record standard perio measurements.
Data can be compared from multiple
visits and viewed and printed numerically or graphically using the graphic
chart. Visit www.dentrix.com.
(Votes: 245 of 1,049)
Periodontal Chemotherapeutics: Local Drug Delivery
OraPharma, Inc.:
ARESTIN (Minocycline Hydrochloride) Microspheres, 1mg.
ARESTIN (minocycline hydrochloride) Microspheres, 1mg. is
indicated as an adjunct to scaling and root planing procedures
for reduction of pocket depth in patients with adult periodontitis. ARESTIN may be used as part of a
periodontal maintenance program which
includes good oral hygiene, scaling and
root planing. (Votes: 519 of 1,049)
Periodontal Probes
Hu-Friedy: Colorvue
Piezo Tips
Parkell, Inc.
Hu-Friedy’s Colorvue Probe provides faster and more consistent
results. The vivid yellow tip and black markings provide increased
intraoral visibility and instant readability. The flexible, rounded tip is safe for use around implants
and ensures greater patient comfort and acceptability. The convenient twist-on design allows you
to use the clinician-friendly ergonomic handle to easily replace worn tips. (Votes: 246 of 1,049)
Parkell’s Piezo Tips are precision-crafted and built to last. They’re
available in four models, including the Perio, Universal Straight,
Universal Arched and popular Burnett Power-Tip, to cover
everything from low-power procedures up through serious calculus blasting. Parkell’s Piezo Tips are
easy to work with and compatible
with most EMS-brand scalers.
(Votes: 105 of 1,049)
Power Scalers:
Ultrasonic Magnetostrictive
DENTSPLY Professional: Cavitron
Power Scalers: Sonic
DentalEZ Group: StarDental Titan
The newly launched
StarDental Titan BlisSonic
Ergonomic Sonic Scalers
are portable, air-powered
sonic scalers available in 4-line swivel and fixed backend configurations. The scalers come equipped with five exclusive
StarDental-patented scaling tips. For more information, call
866-383-4636 or visit www.dentalez.com. (Votes: 80 of 1,049)
Cavitron Sustained Power System (SPS)
technology provides scaling efficiency
and patient comfort by maintaining power
when the insert tip encounters tenacious deposits. The
Cavitron JET Plus scaler/air polishing unit and Cavitron Plus
scaler offer a 360-degree wireless foot control with hands-free
boost. Visit www.dentsply.com. (Votes: 516 of 1,049)
Power Scalers: Ultrasonic Piezo
Electro Medical Systems SA: miniMaster/Piezon Master 600
Ultrasonic Inserts
DENTSPLY Professional
Parkell’s TurboPIEZO scaler includes many features of its popular Turbo-SENSOR magnetostrictive scaler, but incorporates
European-style piezo technology. The
ultrasonic vibration is provided by oscillating crystalline plates within the handpiece, so the TurboPIEZO scaler generates
less heat. Call 800-243-7446 or visit
www.parkell.com. (Votes: 71 of 1,049)
Increase productivity with Cavitron Inserts for better access and
adaptation during subgingival and supragingival scaling.
Cavitron Bellissima Inserts have a soft grip for clinician
comfort and reduced hand fatigue. Water delivery with Cavitron Focused Spray Inserts
enhances clinician visibility and patient
comfort. Visit www.dentsply.com.
(Votes: 367 of 1,049)
18
tca 2010 practice management
Dental Marketing
Demandforce, Inc.: Demandforce D3
Equipment Finance
Wells Fargo Practice Finance (formerly Matsco)
Demandforce D3 is a software-as-a-service application used by
thousands of customers to grow revenue, keep patients coming
back and manage operations using e-mail, text messaging,
online appointment scheduling, reputation management tools
and third-party Internet services. Demandforce D3 integrates
seamlessly with existing practice management systems to
deliver unparalleled results. www.demandforce.com.
(Votes: 113 of 1,060)
Wells Fargo Practice Finance provides customized financing
solutions supported by business planning tools and resources to
help dentists acquire, start and expand their practices. We’re here
to help you achieve your goals and are the
only practice lender endorsed by ADA
Business Resources. Call 888-937-2321
or visit wellsfargo.com/practicefinance.
(Votes: 66 of 1,060)
Internet Marketing & Web Services
Patient Finance
CareCredit
(Votes: 113 of 1,060)
Eight-time Townie Choice Award Winner! For more than 23
years, CareCredit has provided patient financing to the Townie
community, helping more patients accept needed care. Call for a
special offer to get started with the program offered by over
85,000 of your colleagues. Call 800-300-3046, x4519 or visit
carecredit.com/dental. If already enrolled, call 800-859-9975.
(Votes: 736 of 1,060)
Practice Finance
Wells Fargo Practice Finance
(formerly Matsco)
Practice Management
Consultants
Scheduling Institute:
Jay Geier
Wells Fargo Practice Finance provides customized financing solutions supported by
business planning tools and resources to
help dentists acquire, start and expand their practices. We’re here
to help you achieve your goals and are the only practice lender
endorsed by ADA Business Resources. Call 888-937-2321 or
visit wellsfargo.com/practicefinance. (Votes: 73 of 1,060)
The Scheduling Institute is a results-focused program that will help
you grow your practice by leveraging your existing resources. We
begin with training your staff to more effectively handle new
patient phone calls; significantly increasing the number of new
patients your practice sees. For a special Townie offer call 866-4707203 or go to www.schedulinginstitute.com. (Votes: 117 of 1,060)
Software: Patient Communication Systems
Software: Patient Education
Patterson Dental: CAESY Education Systems
(Votes: 147 of 1,345)
CAESY Education Systems content is distributed via video and
computer networks or DVD players throughout the clinical
and reception areas of dental practices. The CAESY product
family includes CAESY DVD, Smile
Channel DVD, CAESY Pediatrics and
CAESY Enterprise, which includes
Smile Channel and ShowCase. Visit
www.caesy.com. (Votes: 357 of 1,344)
19
tca 2010 practice management
radiology tca 2010
Software: Practice Management
Henry Schein Practice Solutions: DENTRIX
Software: Practice Management Enhancements
National Electronic Attachment, Inc.: NEA FastAttach
Dentrix is the leader in dental practice management systems with
more than 30,000 customers. With the release of Dentrix Mobile,
dentists can now use their smart phones and mobile devices to
access current information about patients, appointments, medical
alerts and prescriptions. Dentrix also provides
powerful new tools to increase profitability
with Practice Advisor and Profitability
Coaching. (Votes: 400 of 1,344)
NEA’s FastAttach offers dental providers a cost effective and reliable
method of transmitting supporting documents for electronic
claims. The unparalleled flexibility
of FastAttach is ideal for single,
multiple or large clinic practices.
Whatever your size, FastAttach will
improve your revenue cycle.
(Votes: 156 of 1,344)
X-Ray Equipment: 3D Imaging Software
Nobel Biocare: NobelGuide
X-Ray Equipment: Conebeam CT Scanner
Imaging Sciences International, Inc.: i-CAT
NobelGuide is a complete treatment concept that can be used The i-CAT leads with enhanced features for effective treatment
for all indications. NobelGuide offers dental professionals full
planning and predictability. These features
flexibility in surgical access, loading timing and
include the fastest scan and reconstruction
prosthetic solutions. Clinical procedures to use
rates, an Amorphous Silicon Sensor that capNobelGuide with mini- and full-flap surgical
tures multiple-sized scans, full skull to single
access are also available. Coming in 2011, the
arch, included and shareable i-CATVision,
new face of NobelGuide will be launched
plus compatibility with major 3D planning
as NobelClinician. (Votes: 26 of 1,027)
programs. (Votes: 53 of 1,027)
X-Ray Equipment: Digital Image
Management Software
DEXIS, LLC:
DEXIS Digital Imaging Software
The user-friendly DEXIS software provides easy integration with major practice management programs, digital panoramic systems, cameras
and scanners to create a true dental “Imaging Hub” where the
practitioner can capture, store and access all intra- and extra-oral
clinical images for maximum productivity. (Votes: 221 of 1,281)
X-Ray Equipment: Intraoral Machines
Gendex Dental Systems: GX-770, expert DC, 765DC
The expert DC provides reliable consistency in imaging while
offering unique features for flexibility in
workflow, such as Quickset controls on the
tubehead. Compatible with digital sensors,
PSP and film, the unit has a 0.4mm focal
spot (the smallest in the market) for
maximum image resolution.
(Votes: 222 of 1,027)
X-Ray Equipment:
Digital X-Ray Sensors
DEXIS, LLC: DEXIS Intra-oral Sensors
The gold standard in digital imaging
goes platinum with the new DEXIS
Platinum intra-oral sensor. This new version of the PerfectSize
sensor achieves direct USB connectivity without docking stations
or controllers for maximum portability, TrueComfort design for
precise placement and optimum patient comfort, and PureImage
technology for remarkably clear images. (Votes: 240 of 1,281)
X-Ray Equipment:
Panoramic/Cephalometric Machines (Digital)
Planmeca: ProMax/ProOne
The ProMax Digital Panoramic/Cephalometric X-ray has all the
great features of the ProMax Digital Pan, plus the added benefits and
imaging programs of a ceph. These are available as a single transportable sensor system or dual-fixed sensor system, and utilize the latest in CCD
technology. Visit www.planmecausa.com
or call 630-529-2300. (Votes: 100 of 1,027)
20
hygienetown short commentary
by Cindy Kleiman, RDH, BS
Since 2001 the wars in the Middle
East have killed more than 5,300 U.S.
soldiers, and 35,000 American soldiers
have been injured.1 According to one
study at Walter Reed Army Medical
Bob Woodruff
Center, 62 percent of troops returning
from Iraq have suffered head trauma,
often due to IEDs (improvised explosive devices).2
The phrase traumatic brain injury (TBI) has
increased in use during these years and has led to a
growth in medical knowledge in this area. Lives that
could not be saved before are now saved; some
threatened with lifelong disability are returning to
the life they knew before. ABC’s Bob Woodruff was
a reporter who became one of these statistics.
Oral complications are intertwined with these
injuries and are significant. They must be addressed
by our profession. Many patients will be permanently
in the Veterans Administration system, yet there will
be those who want to return to their home-based private dental practice. The following is just a short sample of some of the issues we might be presented with.
TBI patients who are in critical care are often
placed on a ventilator to assist with breathing. There is
no area in medicine where oral hygiene plays a more
important role. Poor oral hygiene has an evidencebased connection to ventilator-associated pneumonia.3
This disease has a high morbidity and mortality rate. If
the patient survives this first round of challenges, they
will be moved to rehabilitation care.
Oral care is an important activity of daily living that
is sometimes necessary to relearn. If the patient has a
knowledgeable and experienced occupational therapist,
21
this challenge will often be met. If not, he or she might
return home needing to start at the very beginning.
When providing care on a TBI patient, much
homework should be done prior to their appointment.
Establish their level of independence and cognitive
function. Does he need to be treated in the wheel chair,
or is he able-bodied and treatable in the dental chair?
How long has it been since the injury? Take time prior
to the appointment to completely review the medical
history. Is there a shunt or metal plate in the head? Does
he need premedication or a medical consultation? Prior
to the appointment review all of the medications listed.
Most will be on anticonvulsive medications due to the
fact that TBI patients are usually left with a seizure disorder. What type of seizures does he have and how often
does he experience them? Is he on a medication that
produces gingival hyperplasia?
Oral hygiene treatment should be provided with
the family member or attendant present if that is the
comfort level of the patient. Remember, there is a
huge range of levels of injury and return of function.
You might be seeing someone that is the same person
you knew before, or an entirely new personality could
be waiting for you.
If there is a family member or assistant accompanying the patient, always speak directly to the patient. Have
patience! The appointment could be tiring and frustrating for both of you, yet with a multitude of rewards. Your
clinical goals might need to be compromised or achieved
in increments. It might be appropriate to complete clinical care in two or three appointments.
There are so many wonderful oral hygiene products
available to our patients. We no longer need to make
short commentary hygienetown
flossing our number-one mantra,
as companies have created many
interproximal cleaning options,
such as water irrigators and disposable flossers. Powered toothbrushes
like the Sonicare Flexcare can lead
to increased ease of use for both
the patient as well as for the attendant if needed. Utilizing the twominute timer is a must to keep
on track. Well considered choices
of toothpaste, fluoride and
remineralizing products can
all lead to improved prevention
for these patients. How wonderful that we can partner
with them to minimize oral complications and to
increase their overall health. They have been through
enough already.
With the treatment of TBI patients, hygienists
have the opportunity to augment their reputation for
caring and compassion. It is important to take the
time to study this medical condition prior to treatment. We hope that all patients who have suffered a
TBI have the comeback potential and success experienced by ABC’s reporter Bob Woodruff. Returning
to lead a full and productive life is a reachable goal
for many. ■
References
1. Unknown News, http://www.unknownnews.net/casualties.html [Accessed
April 2010]
2. Patoine, Brenda, The Dana Foundation, Head Injury Increase in
Military Highlights Limited Treatment Options: New Research Seeks
Answers, http://www.dana.org/media/detail.aspx?id=14054 [Accessed
April 2010]
3. Fields, Lorraine, 2008, Oral Care Intervention to Reduce Incidence of
Ventilator-Associated Pneumonia in the Neurologic Intensive Care Unit,
The Journal of Neuroscience Nursing, 40 (5) 291-298.
Author’s Bio
Cindy Kleiman graduated from the University of Pennsylvania and has worked with medically compromised patients for
more than 25 years. She provides CE programs internationally and can be reached at [email protected].
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hygienetown message board
MI Paste or Fluoride for Ortho Patients
Patients going through orthodontic treatment are at risk for caries around the brackets and along the gingival margin. A variety of preventive
protocols are suggested for these cases. This message board has 31 replies and 945 views.
mudehy
Posted: 5/19/2010 ■ Post: 1 of 32
Total Posts: 168
23
Which do you recommend? Currently the dentist has all ortho patients on
OMNI Gel. I usually put them on MI Paste with fluoride as well. What does everyone else do? ■
lindadouglas
Posted: 5/19/2010
Post: 2 of 32
Total Posts: 3,536
MI Paste and fluoride work well together, in the correct ratio. I
think that if you are using fluoride, MI Paste Plus is not necessary. MI
Paste without fluoride would be better. Tim Ives is really up to date on
this; perhaps he will have some more info for you. ■
rdh1982
Posted: 5/19/2010
Post: 3 of 32
Total Posts: 1,243
Very timely topic! I just treated a 16-year-old male ortho patient
with extensive decalcification, demineralization and acid erosion
throughout his entire mouth! When I questioned him about his dietary
acid influences I found out he was drinking 30oz of Gatorade daily plus
other fruit-flavored boutique waters like Propel and energy drinks like
Monster. Then to top it off, he ate sour candy!
Without any hesitation he was prescribed 3M Clinpro 5000 with tri-calcium
phosphate for daily home use. I love this product! The calcium and phosphates help
rebuild the damaged enamel/root surfaces while the supercharged fluoride helps
reharden the enamel. All dietary acids remove calcium and phosphates from the hard
tooth structure while Clinpro 5000 helps replenish these essential ingredients. ■
timothyives
Posted: 5/20/2010
Posts: 4 & 7 of 32
Total Posts: 258
Thanks for the “big up” Linda. There are a couple of really important points here regarding remineralization and GC probably won’t like
me for it!
Providing there is no xerostomia and no malfunction of the salivary
glands in terms of their mineral output, then CPP-ACP is a waste of
time. Saliva is supersaturated with calcium and phosphate and will provide the minerals for remineralization. The only way to find this out is to do a buffering test and
a stimulated flow and resting flow rate.
If the patient has a low resting flow rate, they need to drink more, which is
much cheaper than CPP-ACP! If they have a low stimulated flow rate or buffering
problems, they need a lot of CPP-ACP.
The key to this whole equation is the pH of the mouth. No matter how much
CPP-ACP someone uses, minerals (calcium and phosphate) will not be taken into
the teeth unless the pH is at least 5.5 and ideally 7 to 8 where a maximum uptake
occurs. Fluoride will be taken into the teeth down to a pH of 4. Below this all the
minerals are lost.
So to summarize, before deciding which products are appropriate, you need
to look at the saliva and (critically) ensure the pH is correct before using them.
message board hygienetown
I recommend all my caries-prone patients with the above issues to use CloSYS
(stabilized chlorine dioxide) as a prebrush rinse. This ensures the optimum pH and
therefore the right environment for remineralization prior to brushing with a high
fluoride toothpaste or further rinsing with a fluoride rinse.
[Posted: 5/20/2010]
Incidentally, another avenue that you could go down is CariFree. All of their
products are aimed at neutralization and remineralization at the correct pH. Check
out the Web site. I love the CariFree products aimed at babies and toddlers. ■
Fascinating. Saliva flow rate “buffering” testing. This is the first I’ve
heard of this test. How do you do it, how much does it cost, and who
sells the kit to do it in office? ■
skr RDH
Posted: 5/20/2010
Post: 8 of 32
Total Posts: 1,282
In addition to GC America Saliva Check, there is another buffer
test made by Orion Diagnostica. These test saliva’s ability to buffer an
acid challenge. I also mention these briefly in my Hygienetown online
CE course on xerostomia (a shameless plug here). ■
Lindadouglas
Posted: 1/23/2010
Post: 11 of 25
Total Posts: 3,429
I have a few more questions. I am familiar with CloSYS II, but I’m ashamed to
admit that I did not realize its full purpose or benefit, so thanks for that info. I am
curious as to whether you incorporate xylitol into this situation. Wouldn’t that be
beneficial for creating an environment for remineralization? I am familiar with the
saliva check tests, but I doubt my doctor will ever go for that in our office. ■
JJW, RDH
Posted: 5/21/2010
Post: 14 of 32
Total Posts: 2
JJW, Xylitol, yes, yes, yes. It makes me want to believe in God! The
cure for caries is sugar, how ironic is that? In my opinion, everyone should
recommend it to all their patients from the age of zero.
Come visit www.dentalvillage.co.uk (with your DDS) as we have a lot
of links to various MI sites and downloads with recent articles we have
written on the subject, and protocols to use in the clinic. ■
timothyives
Posted: 5/21/2010
Post: 15 of 32
Total Posts: 258
MI Paste is as close to a neutral pH as you can get – most products have a very low
pH because of preservatives. Take litmus paper and test PreviDent and Clinpro – you
will be amazed!
Also, test your patients’ saliva with litmus paper (or GC saliva check buffer). If you
see a patient with acidic saliva, give them a pea size bit of MI paste and test their pH
right after. You will see it will change from acidic to neutral. (We did this at a Dr. Ngo
seminar – really amazing!) ■
DSanzeri
Posted: 8/6/2010
Post: 21 of 32
Total Posts: 10
Fluoride for Ortho
Find it online at
www.hygienetown.com
24

MI Paste or Fluoride for Ortho Patients

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