Technique Touch-Ups 2024

By Sara Kuckhoff, DMD

As patient expectations for the esthetic appeal and functional longevity of restorations rise, clinicians’ techniques, protocols, and the materials used to achieve these outcomes leave no margin for error. More and more patients are leaning toward less invasive treatment options to achieve their esthetic goals. In many instances the utilization of composite offers the clinician an opportunity to make significant esthetic and functional changes with minimal, if any, removal of tooth structure. These largely additive treatment plans ensure the clinician is bonding primarily to enamel—which, when paired with appropriate isolation and the manufacturer’s recommended adhesive protocols, can increase the longevity and quality of the esthetic restorations, often exceeding patient expectations.

Different brands of composites, derived from subtle differences in composite chemistry, can and will handle differently. Often handleability is a leading property affecting a clinician’s preference and eventual brand loyalty, all other factors being equal. To mimic the optical properties of natural dentition, multiple layers as well as a variety of composite shades and tints are often required. Regardless of how smooth or stiff a composite feels to the clinician, creating a seamless interface with the natural, unrestored dentition is a challenge not to be taken lightly.

In the past, bonding resin was used to improve the handleability of composites. However, employing bonding resin as a wetting agent can weaken the strength of the enamel bond and lead to staining of the restoration over time. Using wetting resin gives a significant advantage and lacks the disadvantages of bonding resin applied in this manner. Wetting resin’s lubrication properties enable consistent handleability of composites. This facilitates homogeneous blending and more precise sculpting of the composite. With a seamless blend and a defined natural shape, this refined composite restoration gives both patients and clinicians confidence in a long-lasting and beautiful result.

When seeking commercially available wetting resins, low to medium viscosity wetting resins increase ease of use of composite and do not overpower the composite. Providing lubrication without becoming tacky gives clinicians the ability to move the composite easily while sculpting the composite into just the right form. BISCO’s Modeling Resin (Figure 1), when placed onto a paint brush or instrument, enables the creation of a well-defined restoration with seamless transition from composite into the adjacent tooth structure (Figure 2).

Figure 1: BISCO Modeling Resin is available in a syringe delivery system.

Figure 2: The wetting resin can be applied directly to dentition with a brush.

Figure 3: The wetting resin is transparent and does not influence restoration shade.

As seasoned clinicians, we take great pains to ensure the most accurate shade for our patients. For example, verifying the teeth are properly hydrated prior to shade selection is essential, as the shade is as important as the shape in the acceptance of the final restoration by patients.1 Once the shade has been selected, it is important to consider the impact of the wetting resin on the final shade of the restoration. BISCO Modeling Resin is clear and does not influence the final shade or surface properties of the final composite restoration (Figure 3).2 Given its shade-neutral property, Modeling Resin can also dilute intense tints by placement onto an instrument or brush along with some tint to build lifelike characteristics into the final restoration.

Wetting resin plays an important role in building beautiful and long-lived restorations. Patients not only appreciate the confidence in their smile but rest easy knowing that their restoration is of the highest quality. A seamless interface with the natural unrestored dentition is the foundation for this caliber of result. Crafting a properly blended and shade-matched restoration is a complex process, and BISCO’s Modeling Resin enhances a clinician’s ability to consistently deliver beautiful restorations, no matter the height of the patient’s expectation.

References

1. Notarantonio, A. E., & McClintock, D. (2022). The Effect of Isolation and Dehydration on Shade Matching. Compendium, 43(5), E9-eE12. https://www.aegisdentalnetwork.com/cced/2022/05/the-effect-of-isolation-and-dehydration-on-shade-matching
2. Pereira PL, Pereira R, Silva BG, Lins RB, Lima DA, Aguiar FH. Effect of wetting agent coverage on the surface properties of resin composite submitted to brushing and staining cycles. J Clin Exp Dent. 2021 Aug 1;13(8):e795-e801. doi: 10.4317/jced.58311. PMID: 34512919; PMCID: PMC8412808.

By Christian Yaste, DDS

Over the past 20 years, dental materials have come a very long way. We have seen the introduction of nanoceramics, nanocomposites, and zirconia as well as improved dental bonding systems and cements. One of the materials used throughout the world in dentistry that continues to look the same is cold cure acrylic. The same cold cure bottle and powder systems available when I graduated from dental school in 1996 are still available today. Even the packaging hasn’t changed.

I have used cold cure acrylic for various applications in my implant practice, including splinting dental implant copings together, pickups for overdentures and fixed full-arch appliances, repairing prostheses, and welding together implant verification models. Dental cold cure acrylic is quite strong and has excellent dimensional stability, but it is messy, smells terrible, is hard to clean up, is difficult to manipulate, and relies on self-curing.

However, there is a new alternative that just may cause the obsolescence of traditional cold cure acrylic. TAUB Products has introduced Stellar DC Acrylic, and it is a significant advancement in polymethyl methacrylate (PMMA) technology (Figure 1).

Stellar DC provides a much better experience for dentists and our patients than traditional cold cure acrylic. First, it has all the strength and dimensional stability but also offers a dual cure component that allows you to tack cure the material in 5 to 8 seconds. This keeps the material from running all over and makes handling so much more pleasant. My team loves that you can easily train newer assistants to use it, and it doesn’t require the practice it takes to master the “salt and pepper” technique required with cold cure acrylic. The dual cure aspect also provides a much more efficient workflow as it sets completely in less than half the time of traditional cold cure acrylic. In addition, Stellar DC has little to no odor, so patients don’t scrunch up their noses and wince when we apply the product directly in the oral cavity (Figure 2). Finally, it is more conveniently packaged and easily dispensed from a dual-barrel cartridge.

Figure 1: Stellar DC Acrylic Resin from TAUB Products is a dual-cure PMMA material.

Figure 2: With little to no odor, the material can be placed intraorally with minimal patient discomfort.

Figure 3: With the ability to adhere to PMMA appliances, Stellar DC Acrylic is a great option for a variety of removable appliance applications.

My team and I can pick up a fixed full-arch implant conversion in a fraction of the time and with much more confidence using Stellar DC, and it has proven to be very reliable and fracture resistant over time. Even in a bloody environment, the product will adhere to PMMA through chemical adhesion and without a bonding agent (Figure 3). Another bonus with the material is that you can increase the strength by placing it under pressure and heat. This is especially useful in fixed full-arch provisional appliances and comes in very handy when repairing or relining a broken denture.

Stellar DC Acrylic has become my go-to product whenever I need to use an acrylic product for any of the aforementioned procedures in my practice, and I always keep extra on hand to share with dentists who attend courses in my practice.

By Kevin Brown, DDS

With the advent of single-shade composite systems, direct composite restorations in the esthetic zone are easier. These materials simplified the layering process, but most anterior teeth have a broad range of internal characterizations that are hard to replicate with a single-shade system. Colored resin tints can be used in conjunction with a single-shade composite system such as OMNICHROMA from Tokuyama Dental to produce highly esthetic results.

A common case of peg lateral incisors is shown in Figure 1. Ideally the peg laterals should be centered within the space, which makes it easier to control the composite emergence profile on the mesial and distal surfaces. If the peg lateral is all the way mesial or distal, it becomes very esthetically and periodontally challenging to achieve correct contours. Some single-shade composites, like OMNICHROMA, continue to shade-match post bleaching, but teeth whitening should be discussed prior to restoration. Gingival contours should also be evaluated. Any gingival zeniths requiring alteration can be addressed before or during the restoration. In this case we improved the zenith heights of teeth # 9 and #10 to match with teeth #7 and #8. Care must be taken not to violate the biologic width.

Figure 1: Preoperative view of peg lateral incisors after orthodontics was completed.

Figure 2: OMNICHROMA BLOCKER was used to replicate the dentin layer.

Figure 3: OMNICHROMA was sculpted to just shy of the final facial contour.

The primary advantage of direct composite bonding is the noninvasive technique. Tooth preparation was completed with pumice and prophy cup, air particle abrasion, phosphoric acid etch, and Tokuyama Universal Bond. A diagnostic wax-up and silicone putty index were fabricated prior to the appointment, and the putty index was used to facilitate the establishment of the lingual shelf with a thin layer of OMNICHROMA. This lingual shelf is exceedingly important as it forms the foundation for all subsequent layers. OMNICHROMA BLOCKER is then layered to replicate where the dentin would be (Figure 2). Next a layer of OMNICHROMA is applied, but it is left just shy of the final facial contour so there will be room to apply the colored resin tints with Estelite Color from Tokuyama Dental (Figure 3). This is followed by a final topcoat of OMNICHROMA, which will seal the tints internally (Figures 4 and 5).

Figure 4: Estelite Color was used with a sable brush to replicate internal characterization. Colors used were a 50/50 mix of gray/blue, medium chroma opaque, and white.

Figure 5: Final layer of OMNICHROMA.

In this case the tints used were a 50/50 mix of gray/blue to accentuate incisal translucency,medium chroma opaque to accentuate incisal dentin and mamelon effects, and white to replicate subtle surface calcifications. The colors are strong, so care must be taken to avoid overuse. It is helpful to have preoperative photographs visible during the appointment as a reference because the teeth dehydrate during the procedure. After shaping and polishing, the tints will be subtly visible and transform what would be a good single-shade composite restoration to a piece of art that blends with the surrounding teeth and smile (Figure 6).

Figure 6: Final postoperative view after shaping and polishing.

Figure 7: Final postoperative view right lateral full smile.

Achieving highly esthetic direct resin restorations on anterior teeth can be challenging. However, using this modified layering approach with a single-shade system and tints can be effective and rewarding (Figure 7).

by Catherine Cabanzon, RDH, BASDH

As an RDH, I have witnessed this scenario time and time again: a patient comes in for their routine hygiene appointment and decay is detected. The decay is not deep enough to drill so the doctor places a ‘watch’ on the tooth. But let’s ask ourselves, what are we watching? Why are we waiting? Without intervention, the decay will continue to progress, causing more damage to the tooth. Today there is a way to stop caries from progressing as soon as it is detected; a game changer that we can use easily, inexpensively, and immediately.

That game changer is Silver Diamine Fluoride, aka SDF.

When SDF was first introduced, it was considered mainly for children, older patients, or patients with disabilities—patients who were not cooperative or who could not tolerate a typical restorative procedure. Many clinicians still believe SDF is only for these populations, but thankfully we are seeing a change. The truth is: SDF provides real benefits to patients of all ages, and SDF provides real benefits to the dental team as well. It buys the dentist time and the patient an extra margin of safety. However, many clinicians have not yet incorporated this valuable tool into their protocols to gain maximum benefit.

SilverSense SDF™ from Centrix comes in a dropper bottle for precise application. | Image Credit: © Centrix

The SDF procedure is fast, simple, and painless for the patient. It can easily be incorporated into the standard hygiene appointment when decay is discovered. For many offices today, there often is not enough time to perform the restorative work during the same appointment as when the lesion is discovered. The patient is reappointed, and, too often, does not come back for weeks, months, or possibly ever. The patient may not be emotionally or financially ready for restorative work, or may think that because the tooth doesn’t hurt, treatment isn’t needed. Regardless, with SDF I can treat the lesion in just 3 minutes and know I have stopped progression of the decay and avoided the need for the patient to undergo more invasive dental work. This leaves both me and the patient with peace of mind.

I like using the SilverSense SDF™ by Centrix. It’s the best-value SDF product I’ve found. SilverSense SDF comes in a dropper bottle with applicators included. The dropper is very precise so you can control exactly how many drops come out when you express the product. This eliminates waste.

When we treat a patient with SDF, the question of esthetics is often brought up. It’s common to hear that SDF will “turn the tooth black.” However, SDF will only turn the demineralized area or decayed lesion darker—and these areas are usually already dark on their own. Healthy tooth structure will remain unaffected. After the tooth is restored, the discoloration will be completely gone, and the tooth will be beautiful. I rarely come across patients who decline treatment with SDF when the process and benefits are clearly explained to them beforehand. I find that the hesitancy comes more from the dentist or the hygienist who might have only heard superficial information about SDF and are not aware of its value in everyday practice.

SDF is a fantastic tool that can make treatment more comfortable and flexible for both the patient and clinician. I recommend you incorporate it into your treatment protocols for patients of all ages. Let’s end the “watch & wait” and provide our patients with the treatment they deserve! And don’t forget to protect the other teeth with fluoride varnish, as patients with active decay are at high risk for further decay.

By Arash Hakhamian, DDS, Co-Founder and CEO of Dentulu, Inc.

Do your patients continue to be aggravated by sensitivity due to recession, bleaching, or with veneer or crown preps? Does it limit their dietary choices? Compromise their dental hygiene? Affect their quality of life? Are you still searching for a good solution to provide them?

image Credit: © GreenMark Biomedical Inc.

Dentulu, Inc., is partnering with GreenMark Biomedical Inc., an innovative company specializing in dental health technologies using nanotechnology derived from nature. Together they bring you the latest in preventative dental products. This partnership heralds the introduction of the first product, CrystLCare™ Biorestorative, Fluoride-Free, a treatment solution designed to combat dental sensitivity and promote dental health using advanced nanotechnology. GreenMark’s fluoride-free dental strips utilize guided bioresorbable particles to help mineralize teeth and reduce tooth sensitivity through patented technology.

Dental hypersensitivity is caused by loss of dentin’s natural cover, enamel or cementum, due to gingival recession, attrition, abrasion, erosion, caries, and other predisposing factors. This exposes dentinal tubules, canals that radiate outward from the pulp cavity, allowing stimuli such as temperature or pressure to be transmitted within the tubules to nerves connected to the pulp, causing pain. Other clinical scenarios where dentin can be exposed and be a pain-point (literally and figuratively) include scaling and root planing, placement of temporary and permanent crowns, veneers, bridge work, and deep restorations.

Whitening agents can also lead to severe sensitivity. In this clinical scenario, sensitivity is caused by the easy passage of the peroxide molecules through pores in the enamel and dentin, to reach the pulp cavity, irritating the nerves, and causing inflammation and pain.

Figure 1: CrystLCare™ dissolvable strips can be delivered directly onto the target dentition, or via a tray. | image Credit: © GreenMark Biomedical Inc.

The dissolvable CrystLCare dental strips are applied directly onto the teeth to which they instantly adhere, or they can be placed in a mouth tray (Figure 1). Electron Micrographs show before and after treatment, providing evidence for occlusion of dentinal tubules (Figure 2). The targeted deposition of minerals onto the surface, into the tubules of exposed dentinal tubules, and into the subsurface of enamel provides effective and long-lasting treatment of dental sensitivity.

Figure 2: Electron micrographs showing before and after treatment with CrystLCare™ dental strips, which reduces sensitivity through occlusion of dentinal tubules. | image Credit: © GreenMark Biomedical Inc.

Dental caries impacts almost everyone in the world. In the oral environment, teeth undergo a continuous dynamic of demineralization (due to bacterial acids) and remineralization (a reparative process due to the presence of mineral ions in saliva). Cavities form when there is a greater demineralization than remineralization. Providing additional support for tooth mineralization can positively alter this balance and help to prevent the consequences of demineralization: cavities.

Dentulu and GreenMark are dedicated to transforming dental care through scientific innovation and technological excellence. Nanotechnology derived from nature is at the core of the new CrystLCare dental strips, which utilize bioresorbable nano-starch particles to deliver calcium and phosphate directly to the surface and subsurface of teeth where they form hydroxyapatite—the main component of enamel and dentin—aiding in the natural repair process of these dental hard tissues. This technology not only provides rapid sensitivity relief but also enhances the long-term health of patients' teeth by providing remineralization support.

CrystLCare strips are easy to use. The dissolvable strips are designed for both professional dental settings and home use. Through the action of natural enzymes in saliva, calcium and phosphate ions are released from CrystLCare starch particles contained within the strips, resulting in formation of hydroxyapatite to occlude dentin and enamel porosities. This process mimics natural remineralization of teeth by filling porosities and creating a protective barrier, enhancing enamel strength and resilience against external stressors.

Research to develop CrystLCare dissovable dental strips has been supported through multiple grants from the National Institutes of Health which has led to the creation of this innovative state-of-the-art treatment that is made with natural ingredients, suitable for vegans, gluten-free, and free from artificial colors.

The CrystLCare dental strips are recommended for use in many clinical scenarios, including before and after teeth whitening procedures, to address sensitivity caused by gum recession, following scaling and root planing, and other causes of dentinal sensitivity experienced by millions of patients nationwide.

By Shelley Brown, RDH, MEd, BSDH

Antibiotics for periodontitis are out, and sulfonated phenolics are in. One big reason for this is antibiotic resistance is on the rise. According to the CDC, antimicrobial resistance is a concerning global public health threat that kills at least 1.27 million people worldwide and was associated with nearly 5 million deaths in 2019. In the U.S., more than 2.8 million antimicrobial-resistant infections occur each year.¹

In dentistry we should be looking for alternatives to antibiotics such as sulfonated phenolics, found in HybenX. It works to desiccate—or dehydrate—biofilm within 30 seconds, eradicating harmful red-complex bacteria and keeping them below detectable limits for 180 days in conjunction with periodontal therapy.² It works as well to reduce the inflammatory mediators that promote hard and soft tissue loss as collateral damage as the host is attempting to destroy the pathogens and prevent them from going systemically.³

The primary cause of periodontal diseases is biofilm. Hand instruments should be used to remove hard deposits, not biofilm. One study showed hand instrumenting removes 35% of cementum, precious tooth structure that is needed for healing, therefore they shouldn’t be used for biofilm disruption.⁴

Power scalers remove less cementum and more biofilm than a hand instrument. It works through cavitation and microstreaming beyond 1 mm of the tip, but it doesn’t completely remove all of the biofilm in the sulcus. That is where sulfonated phenolics are necessary. With instrumentation alone, we disrupt and dislodge biofilm but we don’t destroy the bacteria that could easily recolonize after therapy. Sulfonated phenolics do.

The area of placement must be completely isolated so as not to let any other tissues, such as the lip, touch the sulfonated phenolic material. Then thoroughly dry the area as it rapidly attracts water and can lose its efficacy before reaching the water surrounding the biofilm and in the necrotic tissues. This FDA-cleared material is then placed pre-procedurally into the pockets similar to gingival irrigation. Within 30 seconds, high-volume suction it off and then rinse with water. Perform mechanical removal through periodontal therapy and then following instrumentation, place the sulfonated phenolic one more time with the same workflow. One syringe can do a full arch pre- and post-therapy. As it works to desiccate it also slightly softens hard deposits, and aids in the hemostasis of the tissues making it a cost-effective alternative to expensive lasers, powder polishers, and antibiotics.

References

1. Where resistance spreads: Across the world. Centers for Disease Control and Prevention. https://www.cdc.gov/drugresistance/across-the-world.Accessed March 26, 2024.
2. Isola G, Matarese G, Williams RC, Siciliano VI, Alibrandi A, Cordasco G, Ramaglia L. The effects of a desiccant agent in the treatment of chronic periodontitis: a randomized, controlled clinical trial. Clin Oral Investig. 2018 Mar;22(2):791-800. doi: 10.1007/s00784-017-2154-7. Epub 2017 Jun 17. PMID: 28624914.
3. Bracke, Jim & Basara, M & Savord, E & Dunaway, A & Watkins, M. (2015). Pilot evaluation of a simple adjunctive method for improved removal of oral biofilm during conventional scaling and root planing therapy. Journal of Biological Regulators and Homeostatic Agents. 6. 6-9.
4. Bozbay, Esra & Dominici, F & Gokbuget, Aslan & Cintan, S & Guida, L & Aydin, Mehmet & Mariotti, A & Pilloni, Andrea. (2016). Preservation of root cementum: A comparative evaluation of power-driven versus hand instruments. International Journal of Dental Hygiene. 16. 10.1111/idh.12249.

By Jennifer Bell, DDS

Video Transcript

Hello Dental Products Report community. My name is Jennifer Bell and I am coming at you from just outside of Raleigh, North Carolina where I'm a practicing dentist.

I wanted to bring an update to you from the Technique Touch-Ups of 2024, to shed some light on a new lithium disilicate block that I think you have to give some time and attention to. So let's go back into my practice…We've been milling all kinds of porcelain restorations since 2015, and have tried a myriad of different products. Definitely, in our practice for a long time has been a lithium disilicate block and a zirconia block to sort of meet most of our clinical needs that we have.

Now I'm going to be honest, about 2 years ago, we started experiencing some real significant marginal integrity issues with our lithium disilicate blocks. We just felt like the deliverables that were coming out of the furnace just were not quite hitting the clinical acceptability that we had become quite used to, frankly, from using the products for many years. And as clinicians, we tend to take ownership of that, you know, and I have done that in my career for many occasions where you know, maybe I had a poor lab or product that wasn't working well in my hands. But I took ownership of that is it being me, the clinical dentist that wasn't able to provide the technique appropriately, when probably it was the material, the third party, you know, some other system that was in place that wasn't really working well with us.

So fast forward, we were having these lithium disilicate issues, we decided to give the GC LiSi blocks a whirl, and to be honest, we haven't gone back since.

In fairness, I was a little skeptical. When you've been using a product for a really long time you become fairly entrenched, believing it's the best one in the market; that there's not going to be another competitor that could come close. And so I maybe slightly, reluctantly, begrudgingly put the LiSi block in our milling machine. And to date it's the only lithium disilicate block I'm using now.

Why? Because the marginal integrity of this block coming right out of your milling machine to deliver to your patient has been exactly what I was used to for the last 10 years of milling. I can take a radiograph and feel really confident we've got a phenomenal seal for that patient.

Oh, and did I mention you don't have to put it in a furnace when you get done milling. So you're going straight from mill to delivery. Now you're scanning and delivering your crown in 20 minutes or less. That's real time in your clinical practice. To give you more time to watch YouTube videos or maybe more productivity in your practice, you choose how you want to use that extra 20 minutes of firing time you no longer have to calculate for.

So I can't say enough good things about the LiSi block. If you haven't tried it yet, from GC, you've got to at least get one in your hands and give it a whirl. The esthetics are knock out. we've been bonding them in with the GCEM One cement, which also if you haven't tried that, cleanup on this resin cement is superior to any other resin cement that I've used in clinical practice. I actually don't dread a full cure because I still think I can remove it relatively well. Unlike some cements I've used in the past where if we get to a full cure, it's a handpiece to get the residual cement out of the interproximal spaces, which then just becomes a big hassle and a mess for the patient.

So anyway, that's our current clinical protocol. It's the GC LiSi block with the GCEM One bonding all day long. And the patients are loving the end product, and I as a clinician, am really excited to see the postoperative bitewings. Six months, a year later, those margins are still holding up with fantastic integrity.

So if you haven't tried it, go get one today. Thanks so much for tuning in and we'll see you soon.

By Nancy Miller, RDH BA

For many years in my career as a hygienist I worked side by side with a dental hygiene assistant.Besides the many advantages that provided me in patient care helping with seating and greeting, radiographs and images, and polishing, and data collection, she also assisted when I needed high speed evacuation (HVE). Having that “third hand” made evacuation a breeze and also enabled me to hold a mirror in my non-dominate hand, enabling me to see where I was scaling. Indeed, dentists have worked this way with an assistant for years to increase efficiency and visibility of the field of operation. For the solo operator however, it is difficult to maneuver a mirror and the HVE together and that becomes a barrier to delivering great care.

There are several mirror HVE hose systems on the market, but most use mirrors exclusive to that system necessitating replacement of those specific mirrors and handles over time which can be especially frustrating if the mirrors are not high quality and diminish clear visibility and need replacement after only a few uses.

Image Credit: © HuFriedyGroup

A handy adjunct to HVE has been introduced by HuFriedy Group. The HVE-MC (High Volume Evacuation Mirror Connect) allows me to insert a standard autoclavable mouth mirror into a

disposable connector to the HVE hose. This set up enables me to hold both the HVE suction tip with the mirror right inside the opening of the patient’s mouth. The flow of air back into the suction device keeps the mirror clear of water droplets enabling me to see while scaling with the ultrasonic as well as evacuating the liquid. I also have the ability to use the combined mirror/suction tip to retract tissue and the tongue as with a traditional mirror.

The blue suction tip is designed to be discarded after one use after removing the mirror inside. The mirror head can then be autoclaved and reused again and again. The recommended mirror to use is the HuFriedy #5 double sided mirror as it has a bend in the shank that enables it to fit snugly into the HVE-MC and offers visibility on both sides. This mirror is a standard one that can be used in traditional handles and is readily available from all suppliers.

The blue HVE-MC is shorter than traditional HVE straws for better retraction and maneuverability by the solo clinician. It has a lacrosse stick type opening to capture fluids and evacuate them, and there is a cleverly embossed guideline on the side to assure proper placement of the mirror. The mirror is held snugly in place by a serrated channel, but it can easily be removed.

In my vast experience using and teaching HVE suction technique with power instrumentation, I have always recommended a lighter weight hose to assure better ergonomics for the solo operator. This lighter weight hose has an attachment that fits into the standard HVE adapter on the dental unit with the heavier HVE hose. The heavier hose stays on the bracket arm while the lighter hose is maneuvered by the clinician, easing the strain on the wrist and arm.

HuFriedy is on top of their game by also offering a HVE-MC kit that comes with a light weight hose as well as the HVE-MC disposable tips and one mirror head to get started. The HVE-MC hose is very flexible and lightweight, and its attachment to the dental unit HVE adapter is designed to prevent kinking and to hold the HVE when it’s not being used.

An additional fabulous feature is the finger area the HVE-MC inserts into revolves or swivels to enable ease of turning the HVE-MC while working intraorally. This HVE-MC kit comes with one #5 autoclavable mirror, a bag of 50 HVE-MC adaptors, and the hose system. This is everything you need to get started and I recommend you get a box of the #5 double sided mirror heads to enable using the system all clinical day.

By Rhonda Kalasho, DDS

In the dynamic world of modern dentistry, staying ahead of the curve is paramount to delivering unparalleled care to our patients. At TruGlo Modern Dental, located in the heart of Beverly Hills, Hollywood, and Calabasas, California, we are committed to providing comprehensive dental services that not only meet but exceed the expectations of our discerning clientele. As the visionary behind TruGlo, I’ve always championed innovation and cutting-edge technology in our practice. This is why we are introducing a groundbreaking tool: Oral Genome.

Image Credit: © Oral Genome

Oral Genome salivary testing represents a paradigm shift in dental diagnostics, offering us invaluable insights into our patients' susceptibility for diabetes and caries, oral microbiome composition, while also offering insights for prevention. As a forward-thinking dental practice, we recognize the immense potential of this technology to enhance the precision and efficacy of our treatment plans, ultimately leading to better outcomes and improved patient satisfaction. This data from these tests will empower dental hygienists to tailor treatment plans with greater precision, offering targeted therapies that address the unique biomarkers contributing to each patient's oral health challenges. By integrating Oral Genome into clinical practice, dental hygienists can deliver more effective and personalized care, ultimately improving patient outcomes and promoting long-term oral health.

One of the most compelling aspects of Oral Genome is its ability to personalize dental care like never before. By analyzing the genetic markers present in saliva samples, we can identify patients' unique risk factors for conditions such as periodontal disease, dental caries, and diabetes. Armed with this knowledge, we can tailor preventive strategies to address each individual's specific needs, effectively minimizing the likelihood of future oral health issues. We can also share the results with our patient’s primary care physicians. Our patients love the idea of our clinicians working hand-in-hand with their medical healthcare providers.

Oral Genome empowers us to adopt a proactive approach to dental care, rather than merely reacting to problems as they arise. By detecting potential issues at their earliest stages, we can intervene promptly, potentially saving our patients from unnecessary discomfort, expense, and complications down the line. This proactive mindset aligns perfectly with our ethos of providing holistic, patient-centered care that prioritizes long-term oral health and wellness.

At TruGlo Modern Dental, we understand that our patients lead busy lives and value convenience and efficiency. Because Oral Genome is a point-of-care test, it was easy to integrate into our practice workflow, ensuring a streamlined experience for our clients. The app provides in-depth patient education that can be reviewed at any time, allowing our patients to reap the benefits of this cutting-edge technology with minimal disruption to their schedules.

Oral Genome represents a game-changer in the realm of dental diagnostics, offering unprecedented opportunities for personalized, proactive care. At TruGlo Modern Dental, we are proud to embrace this innovative technology as part of our commitment to excellence and to delivering the best possible outcomes for our patients. We invite you to experience the transformative power of Oral Genome salivary testing and embark on a journey to optimal oral health and wellness for your patients.

By John Flucke, DDS

Trust me when I say that whether you’re a recent graduate or a seasoned dental professional, selecting the right whitening solution for your patients can be overwhelming. Due to a seemingly endless number of over-the-counter whitening toothpastes, strips, pens, trays, and LED kits on the market, it can be difficult to confidently recommend a solution that will both help patients achieve their smile goals and fit their lifestyle. Many patients are hesitant to explore professional-grade whitening treatments as they can be time-intensive, invasive, costly, and cause sensitivity. But by becoming well-versed in the latest whitening innovations, we as dental professionals can make tailored recommendations to patients and ensure more impactful results.

I’m sure many dental professionals would agree that teeth whitening is among the most requested treatments from patients. They’re trusting us by requesting our help in getting a smile they can feel confident about. That means it’s our job to really listen to them and identify how we can make their goals a reality while factoring in their budget, schedule, comfort, and sensitivity level.

When considering the best treatment options, I’m a big fan of sitting down with patients and asking them about their previous whitening experiences. I like to explore what they liked, what they didn’t like, how sensitive they were, and if they were satisfied with their results. By doing so, you will gain a greater understanding of their background, which is key in identifying the best product for them. It’s an important conversation to have and I’ve found patients really appreciate it when we take the time to actively listen. When discussing teeth whitening with my colleagues, I always tell them to take the time and get to know their patients' whitening goals over a few visits. The last thing you want to do is sit down with the patient for only 2-3 minutes, provide them with a recommendation that doesn't best align with their goals and have them come back unsatisfied with their results…or worse, tell you they discontinued the treatment due to sensitivity issues.

Helping our patients achieve their goals is at the heart of what we do, so I think it’s important to work with a trusted brand portfolio that you can feel confident recommending, such as Philips Oral Healthcare. I appreciate that the Philips whitening portfolio offers both in-office and at-home whitening solutions that vary in price, chairtime and effectiveness—so there really is something for everyone.

Image Credit: © Philips Sonicare

For patients who want rapid results, Philips Zoom! WhiteSpeed with 25% hydrogen peroxide is an effective in-office solution that whitens up to eight shades within 45 minutes. For those who are short on time but don’t want to sacrifice results, Philips Sonicare Teeth Whitening Kits allow patients to whiten their teeth in the comfort of their own home with a semi-customizable reusable tray that makes it a grab-and-go solution.

Philips Sonicare Teeth Whitening Kits are the newest addition to the portfolio. I love that patients can see clinically proven results after nine uses with minimal tooth sensitivity while maintaining an affordable price point compared to in-office treatments. The solution comes in two formulas, Advanced and Caring, both featuring the power of two important chemistries: Potassium Nitrate and Amorphous Calcium Phosphate. Where they differ is the amount of hydrogen peroxide, with the Advanced formula containing 9.5% and the Caring formula containing 6%. This allows us to recommend the best option to patients based on their anticipated tooth sensitivity. I can personally attest to this product because my wife has extremely sensitive teeth and I had her test the Philips Sonicare Teeth Whitening Kit solution. She experienced almost no sensitivity and seeing her not only enjoy the results but the experience, as well, has only made me feel more confident recommending this product to my patients.

Overall, the more you can have your pulse on the latest innovations, like Philips Sonicare Teeth Whitening Kits, the more prepared you’ll be to meet the ever-growing demand for whitening treatments. As patients come to their appointments with whitening goals, I encourage my colleagues to remain open-minded and collaborative in determining the best approach to take. It will not only benefit your patients but your practice, as well. For me, I never cease to get satisfaction from seeing my patients achieve the smile they have always dreamed of and know that, based on my knowledge and experience, I was able to help make it happen.

By India Chance, RDH, CDIPC

In the bustling environment of a dental practice, efficiency and cleanliness are paramount not just for the quality of care but also for the safety and well-being of patients and staff. As a dental hygienist, one of my deepest concerns has always centered around the challenge of effectively managing the aerosols I produce while delivering patient care. These aerosols don't just vanish; instead, research indicates they can linger in the air for up to 10 hours and travel as far as 10 feet, creating a bioburden cloud that I find myself working within day after day.

Image Credit: © Air Techniques

This unsettling realization propelled me on a mission to discover a solution capable of not only clearing out the unsightly debris clogging my evacuation lines but also preserving their functionality to ensure robust suction all day long. That's when I discovered the Air Techniques CleanStream System, a game-changer for maintaining suction line health and simplifying operatory cleaning processes. It was exactly what I needed to improve the air quality in my workspace. The system comprises a pair of innovative products—a line cleaner coupled with a dispenser—which together, have revolutionized my daily routine by enabling hands-free operation. What once was a daunting task has now become a seamless, efficient part of my workflow, significantly enhancing the cleanliness of the air quality during my workday.

Daily Cleaning Made Easy

The beauty of the CleanStream System lies in its unique formulation designed specifically for daily use. This system effectively removes buildup that can clog and slow down suction, improving performance which means less time waiting for the equipment to do its job and more time focusing on patient care.

Through integrating this cleaning solution into my daily operatory maintenance routine, I've experienced a noticeable uptick in appointment efficiency and a decline in patient complaints regarding water accumulation during treatments.

Hands-Free, Hassle-Free

One of the standout features about this system is the hands-free dispenser. It’s equipped with Vortex technology, which is a process of mixing air and the line cleaner to efficiently cleanse the entire inner tubing without manual effort or holding the dispenser. This significantly cuts down maintenance time, freeing me up to focus on other end-of-day tasks with ease.

Extending Equipment Life

I've also discovered that regularly undertaking tasks to maintain my operatory equipment not only keeps it functioning smoothly but also extends its lifespan. Any experienced dental healthcare provider understands that malfunctioning equipment can lead to a stressful day, raise the risk of workplace hazards, and even result in a "doctor-down" day, necessitating the cancellation of patient appointments due to critical equipment failure.

By maintaining optimal performance and cleanliness of my evacuation lines, I am investing in the longevity of my operatory equipment, and this not only saves money in the long run, it ensures that I can continue to provide reliable care without unexpected equipment failures.

Using the Air Techniques CleanStream System comes from a place of genuine appreciation. By addressing one of my most significant concerns—the management of aerosols—with an effective and user-friendly solution, this system has not only enhanced the quality of care I provide but also safeguarded the health and well-being of both me and my patients. It’s a testament to how the right solutions can make a substantial difference in the healthcare environment.

By Nikki Liles

The LunaLite Device has significantly enhanced our dental workflows, particularly in capturing more precise x-rays using the bisecting technique. Although paralleling techniques have traditionally been favored, manual aligners like Rinn Holders or XCPs aren't always suitable for every patient. With LunaLite, we can achieve greater accuracy in positioning the x-ray unit to capture bitewings and periapicals for procedures such as endodontics, implants, and other clinical situations requiring quick shots.

Using LunaLite is incredibly straightforward. After ensuring the patient is parallel to the ground, simply place the device on the positioning indicator device of the x-ray unit, activate the button, select the desired angle, position the x-ray unit, and locate the laser. The laser indicator confirms that the correct angle for a safe shot has been achieved. It's a seamless workflow for capturing precise bisecting shots.

We're absolutely thrilled with our LunaLite.

See the LunaLite in action in this short video:

By Belangie Perez-Torres, RDH

As of 2019, the American Dental Association requires oral cancer screenings to include the head and neck to better detect oropharyngeal cancer, as well.¹ This policy expansion is especially important given the rise in oral and oropharyngeal cancers over the past two decades.² Traditional risk factors such as alcohol use are still at play, but the prevalence of HPV infections, which are a leading cause of oropharyngeal cancers, has become more critical.³ Fortunately, HPV vaccination is available for children starting at age 9, and for adults up to age 45. HPV vaccines are extremely effective, with the ability to potentially prevent over 90% of cancers attributable to HPV infection.⁴ Additionally, tobacco use as a risk factor is no longer confined to cigarettes–a recent study found that vaping can induce the same cancer-causing damage as regular smoking.⁵

As a result, preventative dental exams are more important than ever. Clinicians are the first line of defense against oral and oropharyngeal cancers. Fortunately, the tools have vastly improved, making oral cancer detection easier for both providers and patients.

Uplevel Patient Exams

Traditional oral cancer screenings use a ‘see and touch’ approach–we conduct visual examinations and palpate the tissue. While this method can detect some oral cancers near the front of the mouth, it’s much more difficult to see the back of the throat, where oropharyngeal cancers hide.

Fluorescence technology uses a screening device equipped with a special lens to solve this problem by illuminating the posterior oropharynx and helping providers visualize mucosal abnormalities. These abnormal lesions, when illuminated with fluorescent light and observed through filtered lenses such as caps or goggles, distinguish themselves differently from healthy tissue. The light and the lens make abnormal lesions look different depending on the changes occurring with the tissue density, which can be indicative of cancerous and precancerous cells. Considering that you only have seconds to look at the back of a patient’s throat without causing major discomfort, having an efficient, reliable tool makes all the difference. Further, understanding the soft tissue abnormalities can guide providers on to next steps—whether that be referring the patient to a specialist or following up to check on tissue healing.

The VELscope VX (left) and the OralID (right) oral lesion screening devices

Fluorescence exams, using tools like OralID from Forward Science or VELscope from LED Dental, can be performed during regular oral health checkups, significantly streamlining the oral cancer screening process for both clinicians and patients. While fluorescence technology is not a diagnostic tool, it does enhance the field of view for clinicians in a significant and meaningful way.

Build Clinical Confidence

Using fluorescence technology makes oral cancer screenings more efficient and convenient. Given how the language and requirements around oral cancer have shifted to be more inclusive of oropharyngeal cancers, it’s crucial for clinicians to be able to easily inspect areas such as the throat, which is both sensitive and shadowed. With fluorescence technology, we can identify tissue abnormalities invisible to the naked eye in a way that easily fits into the regular workflow, which helps build our clinical confidence.

Now, routine hygiene exams can be oral cancer screening checkpoints as well, giving clinicians the opportunity to offer more comprehensive care and further educate patients about their oral health.

The oral and oropharyngeal cancer death rate has been increasing over the past fifteen years, but the survival rate is much higher when cancers are identified early.^2,6 Embracing fluorescence technology can have enormous benefits for both providers and patients alike. Providers can level up their patient exams in a simple, affordable, and efficient way. For patients, the benefits–besides convenience and affordability–are potentially lifesaving.

References

1. Glass S, Brown V, Carrico C, Madurantakam P. Head and neck exam practices of dental professionals. Clin Exp Dent Res. 2023;9(5):887-893. doi:10.1002/cre2.772
2. Key Statistics for Oral Cavity and Oropharyngeal Cancers.American Cancer Society.www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/about/key-statistics.html. Accessed March 31, 2024
3. Oral Cavity and Oropharyngeal Cancer Causes, Risk Factors, and Prevention. American Cancer Society. www.cancer.org/cancer/types/oral-cavity-and-oropharyngeal-cancer/causes-risks-prevention/risk-factors.html. Accessed March 31, 2024.
4. Human Papillomavirus (HPV) Vaccination: What Everyone Should Know.Centers for Disease Control and Prevention. November 16, 2021. www.cdc.gov/vaccines/vpd/hpv/public/index.html. Accessed March 31, 2024.
5. Herzog C, Jones A, Evans I, et al. Cigarette smoking and e-cigarette use induce shared DNA methylation changes linked to carcinogenesis. Cancer Res. Published online March 19, 2024. doi:10.1158/0008-5472.CAN-23-2957
6. Tranby EP, Heaton LJ, Tomar SL, et al. Oral Cancer Prevalence, Mortality, and Costs in Medicaid and Commercial Insurance Claims Data. Cancer Epidemiol Biomarkers Prev. 2022;31(9):1849-1857. doi:10.1158/1055-9965.EPI-22-0114

By Robert M. Stern, DMD, Orthodontist at Evenly

Debond day in the orthodontic office is one of the most exciting moments of treatment. It’s also a time that allows the orthodontist the opportunity to enhance the esthetic outcome with a little extra artistic flair through incisal edge recontouring known as enameloplasty. This touchup technique, also known as enamel recontouring, involves the selective removal of enamel and polishing to refine tooth contours and alignment of anterior teeth optimizing dental esthetics and functional harmony.

Clear aligner treatments have redefined today’s orthodontics by offering a discreet and patient-friendly alternative to conventional braces. These customized, transparent aligners progressively reposition teeth, providing a comfortable and esthetically pleasing path to achieving a well-aligned dentition. However, traditional braces and clear aligners may occasionally fall short in addressing certain minor dental imperfections, such as uneven tooth edges or subtle irregularities in tooth morphology.

An example of how a patient can benefit from the esthetic enhancements provided by combining enameloplasty with clear aligner treatment | Image Credit: © Robert M. Stern, DMD

Enameloplasty enables orthodontists and restorative dentists to complement the effects of clear aligner orthodontic therapy, creating a more seamless and balanced smile. This enamel recontouring enables precise adjustments to tooth size, shape and symmetry, to those teeth that tooth movement alone cannot achieve.

When coupled with enamel recontouring, clear aligners afford a minimally invasive pathway to smile refinement, culminating in outcomes characterized by natural esthetics and enduring longevity without resorting to invasive and expensive restorative dentistry procedures.

Furthermore, esthetic enameloplasty contributes to dental health and functionality. By smoothing irregular tooth surfaces, enamel recontouring optimizes tooth alignment, enhances occlusal stability and diminishes the likelihood of aberrant wear patterns, incisal edge fractures and other occlusal anomalies.

Another example of how a patient can benefit from the esthetic enhancements provided by combining enameloplasty with clear aligner treatment | Image Credit: © Robert M. Stern, DMD

Additionally, from a psychosocial perspective, esthetic enameloplasty and clear aligner treatment fosters significant improvements in patient self-esteem and confidence. Addressing both a patient’s functional and esthetic concerns, this easy and conservative approach enables the orthodontists to attain the patient’s treatment goals.

I have always found enameloplasty to be one of the most enjoyable parts of overall treatment. Despite all the effort that goes into tooth positioning and functional alignment, teeth that are misshapen for whatever reason, simply don’t look good and detract from the overall outcome. Prior to the final clear aligner revision, or at the conclusion of treatment, we confer with our patients about any final esthetic concerns they or we may have. Most concerns involve incisal edge issues of maxillary and mandibular teeth from canine to canine. Improving the shape of these teeth takes only a few moments and the final outcome and patient response are always gratifying.

The landscape of orthodontics and cosmetic dentistry continues to evolve. The combination of enameloplasty as an outstanding touchup technique combined with clear aligner orthodontic therapy is poised to remain a cornerstone of modern orthodontic care, especially as patients demand a more efficient less invasive approach to esthetic treatments.

By Marilyn Sandor, DDS, MS

As the owner of a pediatric dental practice for over 15 years, my priority has always been expanding access to quality dental care for children. However, traditional technologies often hindered rather than supported my mission of delivering convenience and comfort to patients. Digital x-ray systems, despite being in the market for over 15 years, hadn't evolved beyond the cumbersome wired sensors, which were distracting and time-consuming to use.

For years, my practice faced constant equipment damage and safety concerns due to the tripping hazard of wired sensors. Picture this: a patient seated in the dental chair, with the sensor cord stretched across the room to connect it to the USB port on the computer, knowing that one little accidental tug will force you to start over. Not only does this disrupt the examination process, but it also poses significant risks to the sensor, and shifts our attention away from the patient throughout the x-ray process.

The stress of damaging a sensor cable in such a situation is palpable. Dental sensors are expensive investments, and any damage can result in costly repairs or replacements, and worse yet, downtime. As dentists, we understand the importance of maintaining our equipment in optimal condition to provide the best possible care to our patients. However, the constant worry over potential damage adds an unnecessary burden to an already demanding profession.

Image Credit: © A2Z Imaging

That's why the transition to wireless technology like the Air2Zed system from A2Z Imaging was a game-changer for us. By eliminating the need for cumbersome cords, it alleviates the stress associated with sensor placement and movement. With the Air2Zed system, we seamlessly transition between exam rooms without the fear of damaging equipment or compromising patient care. The ability to focus solely on providing compassionate, high-quality care without the distraction of tangled wires is invaluable.

Moreover, besides reducing stress and potential equipment damage, the Air2Zed system significantly improves time and efficiency in our practice. We no longer waste valuable minutes navigating tangled wires or worrying about tripping hazards. Imagine having your sensor ready to take an X-ray after moving from room 1 to room 2, by simply pressing one button? Exams are streamlined, allowing us to see more patients without sacrificing quality of care.

The benefits of wireless technology extend beyond our clinical practice to our mobile care partners in the GoodCheckup network. With its seamless integration and portability, our partners can provide dental care in a patient's home without the extra inconvenience of wires and connections. Residential environments can be challenging, and by eliminating the wired connection, a care provider can easily send images to a laptop at a distant desk or another room. This not only improves the patient experience but also expands access to dental care for those who may have difficulty visiting a traditional dental office.

I would reiterate that the financial implications of damaged sensor cables cannot be overstated. By investing in wireless technology like the Air2Zed system, we not only enhance patient care but also protect our practice's bottom line. The peace of mind that comes with knowing our equipment is safe and reliable allows us to concentrate on what truly matters: improving patient outcomes and experiences.

In addition to revolutionizing patient care, Air2Zed has also had a positive impact on our business model. Through its seamless integration into our workflow, we've been able to enhance our technology-driven approach, further positioning ourselves as leaders in the industry.

As we continue to embrace innovative solutions like Air2Zed, we're not only improving patient outcomes but also setting new standards for dental care delivery. With wireless innovation at the forefront, the future of dentistry is brighter than ever.

By Bruce B. Baird, DDS

In the world of dentistry, one challenge continues to puzzle practitioners: how to increase patient acceptance of comprehensive treatment plans while eliminating financial barriers. AcceptCare, a cutting-edge platform developed by OrthoFi, steps in to address this challenge by simplifying the fee presentation process and providing tailored financing solutions that help both dental practices and patients achieve their goals.
AcceptCare integrates seamlessly with existing dental practice management software, allowing staff to present treatment plans and payment options efficiently and clearly. By leveraging AcceptCare’s multi-lender network and Compassionate Finance, patients of all credit backgrounds have access to funding of up to $50,000. This empowers practices to maximize revenue by providing essential care to patients while eliminating uncomfortable financial discussions.

The user-friendly interface displays various payment options on a single screen, so staff can quickly address patient questions about treatment costs. Automated follow-up reminders and a powerful analytics suite enable practices to identify and track acceptance trends while maintaining communication with patients beyond their office visit. This automation reduces staff workload and is showing an increase in case acceptance rates up to 76%.

AcceptCare puts patients first by providing open-choice payment options, so no recommended treatments are delayed due to financial concerns. By simplifying treatment presentation and payment options, the platform nurtures trust and collaboration between staff and patients. The automated reminders are personalized, offering a convenient way for patients to review and accept treatment plans from the comfort of their phones after leaving the office. Over 24% of patients agree to treatment following these automated recalls.

Image Credit: © OrthoFi

Clarksburg Dental, a Maryland-based practice, demonstrated the platform's impact by more than doubling its acceptance rate within two months. Their case acceptance jumped from 22% to 53%, filling their schedule and delivering the complete care patients needed.

Stephanie Walton of Walton Family Dentistry echoes this experience, citing the time saved reviewing unscheduled treatment and the ease of triaging barriers to treatment acceptance.

This transformative approach is reshaping dental care by allowing practices to focus on delivering excellent care, fostering trust, and tapping into untapped revenue streams. Dave Ternan, AcceptCare's CEO, states the platform, “significantly increases patient case acceptance while improving the overall financial experience for patients and dental practices. We’re also boosting elective treatment by 15%.”

AcceptCare stands as a comprehensive solution for dental practices aiming to increase treatment acceptance and productivity, and unlock new revenue streams. By eliminating financial barriers and simplifying the presentation process, the platform empowers patients to make informed decisions about their oral health and practices to deliver optimal care. With AcceptCare, the dental industry is well-positioned for a future focused on collaboration and patient-centered treatment.

By Jason A. Ford, DMD

As a dental professional, I've had the opportunity to work with various products and instruments, each claiming to offer superior precision and efficiency. However, very few have matched the transformative impact of the elvatome 2.0 from TBS Dental. This innovative dental instrument represents a significant leap forward in dentoalveolar surgery delivering unparalleled precision and handling.

Image Credit: © TBS Dental

The elvatome 2.0 boasts precision engineering that is evident from the moment you hold it in your hand. It offers the finesse of a periotome coupled with the strength of a luxating elevator. The patent-pending TWIST handle offers supreme ergonomics that fits comfortably in the palm, allowing for precise control and minimal hand fatigue during prolonged procedures. The instrument's lightweight but thicker construction enhances maneuverability and rigidity, enabling delicate atraumatic extractions while preserving alveolar bone. The spade tip provides ease of insertion into the periodontal ligament space.

The elvatome 2.0 sets a new standard for ease of operation, with intuitive controls that allow for seamless adjustments. The instrument construction allows for strength and durability with the stainless steel weight counterbalance. The recommended push and twist motion of the instrument allows for ease of elevation of teeth while preserving adjacent soft tissues to minimize trauma. This results in reduced postoperative pain and faster healing time for patients.

In addition to its benefits for dental professionals, the elvatome 2.0 prioritizes patient comfort throughout the surgical process. Patients appreciate the gentle touch of the instrument, which enhances their overall experience and promotes greater satisfaction with their dental and surgical procedures.

The elvatome 2.0 represents a game-changer in the field of surgical instrumentation. Its combination of precision engineering, enhanced visibility, effortless operation, and patient comfort sets a new standard for dental instruments. Whether you're a seasoned practitioner or a novice clinician, the elvatome 2.0 is sure to elevate your surgical procedures to new heights of excellence. I highly recommended for any dental practice seeking to deliver superior patient care and achieve outstanding clinical results.

By Dmitry Burshteyn

In the fast-paced world of dental practice management, staying ahead of the curve is essential for success. As co-founder and CEO of Progressive Dental Management, I've experienced firsthand the challenges of managing a dynamic network of general dentistry and multi-specialty practices. When it came to finding a practice management solution that could scale with our growing business while providing top-notch patient and employee experiences, we implemented a cloud-based practice management software. That’s why my number one tip is to take the time to invest in a future-looking, cloud-based practice management tool.

While transitioning to new technology can be a painful and time-consuming process, switching to a cloud-based practice management software will save everyone in your organization hours and hours in the long run.

Image Credit: © Planet DDS

Before implementing our chosen cloud-based solution—Denticon by Planet DDS—we grappled with the limitations of outdated servers that hindered our ability to support multiple locations effectively. Onsite servers are prone to data loss and lack the robust features necessary for modern practice management. Recognizing the need for a comprehensive, cloud-based solution, we made the switch, and this has been instrumental in our growth and success. Here’s how:

• Seamless Collaboration with Cloud-Based Infrastructure: Having a cloud-based practice management solution facilitates collaboration among multiple dental clinics. With ambitions to expand our network, we needed a solution that could keep pace with our growth objectives. Denticon's cloud-based platform eliminated the bottlenecks caused by onsite servers, enabling our providers, specialists, and administrators to access patient information from anywhere. This has streamlined workflows and improved communication, ultimately enhancing the overall patient experience.
• Customization for Unique Workflows: One of the key factors that drew us to Denticon is the commitment to customization. Dentistry is a highly personalized field, and we needed a solution that could adapt to our unique workflows and requirements. From appointment scheduling to billing, Denticon allows us to tailor our workflows to meet the specific needs of our practice. Its reporting modules provide valuable insights, enabling us to track performance metrics and identify areas for improvement. This is a level of customization and transparency that is unparalleled in the industry.
• Revolutionizing Patient Care: Having a cloud-based practice management solution has also revolutionized how we deliver patient care. With easy access to patient records across all locations, our patients can receive consistent and high-quality care, regardless of where they visit within our organization. Specialists can review patient information remotely, ensuring they're prepared for appointments and providing a seamless experience for our patients.
• Adapting to Changing Needs As Your Practice Grows: Perhaps most importantly, Denticon has adapted to our changing needs and challenges over time. The reporting has provided us with valuable insights into our practice trends and has given us the data we need to implement new best practices. Because of this, it’s allowed our COO to focus on growth and operational improvements, knowing that our practice management needs are in capable hands.

Denticon has been more than just a practice management solution for us—it's been our foundation that fuels our success, and the Planet DDS team has been our partner in growth. With its cloud-based infrastructure, collaborative tools, and customizable features, Denticon has empowered us to deliver exceptional patient care while driving efficiency and innovation across our organization. I wholeheartedly recommend Denticon to any dental practice looking to elevate their operations and patient experience. It is a solution that is not just keeping pace with change, but driving it forward.

Information is power, and Denticon has provided us with the data and tools to transform our dental practice and propel us into the future of dentistry. With Denticon, the amount of time we save and efficiencies we’ve realized across all tasks is immeasurable, making adopting a cloud-based management software my number one tip to save time and money.

By Alan Jurim, DDS

Image Credit: © DGSHAPE

Integrating the DGSHAPE DWX-42W chairside milling solution into our digital workflow has allowed us to create the most accurate and best-fitting restorations we’ve ever been able to produce for our patients. Combine that with the fact that we can provide them with a one-visit restoration, and our patients benefit from a timing perspective and from receiving a better product with a reduced opportunity for any future complications.

The DWX-42W offers both increased efficiency and a better end result and provides a huge advantage for us in our practice.

Our patients benefit from the tight integration between the elements of our digital workflow, which incorporates digital intraoral scanning along with digital design and manufacturing. We are also able to provide a more comfortable patient experience, and one where the patient actually sees their restoration being made. We have a camera that is pointed towards the milling machine, so while the patient is waiting, a screen in front of them shows their restoration being milled. Along with the convenience of having in-house milling, it brings the patient into the experience.

The DWX-52D is an incredible addition to our portfolio of digital tools. Our in-house lab allows us to produce a lot of different restorations from single unit to full-mouth prosthetics.

Overall, it’s enhanced the laboratory and the practice because it allows us to produce what we digitally design in a way that’s very consistent. We use that as a very powerful tool in our workflows.

For any dentist interested in growing their office with digital workflows and in-house capacities, the best place to start is by understanding that digital dentistry consists of three parts: how you input information (i.e., scan) how you process that information (i.e., create a design using AI or traditional CAD software) and then how you output or manufacture that design (using a milling machine or printer).

Where you start in that process should be focused either on how you capture that data or on how you manufacture that data. The middle part, the design, can be done remotely (outsourced) by people around the globe. We have a lot of workflows where an intraoral scan is done in-house, and a remote technician who is part of our team monitors the milling machine with web cameras and works with an assistant onsite to load the appropriate material into the machine. When milling is complete, the on-site assistant removes the material from the machine and either delivers it directly to the patient or, if needed, for processing.

When clinicians have integrated intraoral scanning technology to capture the information, or acquired the means to rapidly manufacture restorations—or both—they can grow their business by learning to process their own designs, either using artificial intelligence or by using design software.

The savings clinicians realize from digital workflows really come down to cost and time savings. When I talk about time savings, I mean both how long it takes a patient to receive a restoration and how much time it takes for us to receive that restoration or to manufacture it. When we outsource everyday basic single unit restorations to a dental laboratory, there are additional transit and production times as well as shipping costs involved. By integrating digital workflows in-house for basic everyday single-unit posterior crowns, the process is faster overall and there is a significant savings in turnaround time and lab fees, while maximizing production dollars per hour and increasing our return on investment.

Another benefit of in-house chairside or in-lab milling is the ability to accurately reproduce a restoration. As all clinicians know, no material works for every single patient, and sometimes a restoration can crack or even break. A hidden benefit of digital production is the ability to reproduce a restoration quickly and efficiently, rather than to try to repair it, and to get a new, accurate restoration to the patient with little or no turnaround time.

By David Janash, DMD

Implementing AirPay across all of our 13 locations has been one of the best decisions we’ve made for our organization.

Image Credit: © AirPay

AirPay automates multiple aspects of the front desk workflow around verifying patient benefits and calculating out-of-pocket costs for their appointments. The platform electronically pre-verifies the insurance for every patient on our schedule and generates a clear cost estimate for each appointment, before we have even had our coffee at the start of the day. AirPay is integrated with our Open Dental practice management platform (along with most other major practice management systems) allowing us to truly set our verification on autopilot.

Automating this workflow has significantly benefited our organization in several key ways:

• Time Savings: Manually verifying insurance is extremely time-consuming, requiring a staff member to navigate various insurance websites and often involving phone calls. Automation streamlines this process, allowing staff to focus on other more value-added tasks, thus increasing productivity. This not only improves job satisfaction by reducing the monotony of administrative tasks but also enhances the quality of care provided to patients.
• Accuracy and Reliability: Software-based platforms like AirPay reduce human error, ensuring that the insurance verification information is accurate. This is crucial to avoid billing issues and write-offs. This efficiency can be a crucial factor in maintaining productivity levels in the face of staffing shortages, ensuring that our practices continue to run smoothly.
• Improved Patient Experience: Quick and reliable insurance verification expedites the check-in process and reduces waiting times. Additionally, accurate verification helps in setting clear expectations regarding coverage and out-of-pocket costs, increasing trust in our brand. This positive patient experience leads to better retention and referrals, which are vital for a practice's growth.
• Enhanced Revenue Cycle Management: Accurate and timely verification of insurance benefits enables dental practices to better manage billing and collections processes. This results infewer denied claims due to coverage errors and improved cash flow.
• Scalability: As we acquire new locations, or our existing practices grow in size, the manual verification of insurance for an increasing number of patients becomes unsustainable. Automation allows for scaling without the need to proportionally increase staff dedicated to insurance verification.
• Cost Management: Staffing is a significant expense for any dental practice. Automation can help manage costs by reducing the need for additional staff to manage administrative tasks. By investing in automation, practices can allocate resources more efficiently, potentially saving on labor costs in the long term.
• Analytical Insights: By adopting a new platform that is completely dedicated to this workflow, we have visibility into common insurance issues, patient demographics, and benefit trends, allowing for better training and improved strategic planning.

Automation has become increasingly important in the dental industry, especially in the face of staffing shortages. These shortages can significantly impact the efficiency and quality of patient care. Automation offers a practical solution to these challenges, enabling dental practices to maintain or even improve their service levels with fewer staff members. This is particularly true for job functions like insurance verification, where there is an incredible amount of detail, nuance, and complexity.

As technology continues to advance, the role of automation in dentistry is likely to become even more significant, offering innovative ways to overcome staffing challenges and meet the evolving needs of patients. Solutions like AirPay allow us to reduce our reliance on team members by supercharging our staff – and allowing them to complete these critical tasks in a fraction of the time.

By John Flucke, DDS

As a profession, we know what is best for our patients. People visit a dental professional to receive the best care the profession can deliver as well as advice on the best way to care for themselves between professional appointments. However, healthcare is also a partnership between the treating professionals and the patient. This means that patient home care routines are as important as professional services, and some might feel that they are more important than the care professionals deliver. Simply put, we all know that the best care delivered and provided can be quickly rendered at risk without diligent home care routines.

Perhaps nowhere in dentistry is this premise truer than in the area of periodontal therapy and treatment. Periodontal disease is an opportunistic infection. Some patients are unlucky and have genetic predispositions that make them more susceptible. Some patients find flossing difficult due to arthritis. However, for a large percentage of the population, the disease can be attributed to a simple lack of proper home care. We all see patients who come in as new patients, go through perio therapy, and then fail the perio re-eval appointment and return 2 or 3 years later with problems having grown even worse.

Home care regimens can be taught and demonstrated, but in order to be effective, they need to be practiced at least twice daily during the normal oral hygiene care performed at home. We often joke with patients that we refer to it as “home care” for a reason. That seems to help make the point more understandable to them.

The profession is in need of a solution that can help patients at all points across the spectrum. Many patients are diligent and meticulous about their home care regimen, yet continue to break down. Some patients find home care difficult because of their declining dexterity due to age, while some patients simply want an easier process.

As a profession, for years we have prescribed chlorhexidine as an adjunctive therapy for a variety of reasons. Patients who have stubborn periodontal problems, trying to get moderate cases to improve after deep scaling, and patients who are showing early clinical signs of periodontal disease are but a few of the situations that has us turn to a chemical treatment. Yet the biggest reason for its use is simply that few alternatives exist.

While chlorhexidine does provide benefits,it also comes with many clinical drawbacks. Some of these include:

• Staining, especially in the cervical area
• Terrible taste
• Stimulates additional calculus buildup
• 2-week treatment duration
• Can only be used for gingivitis
• Bactericidal, but onlykills bacteria, not other pathogens

As a clinician, what if there was a way to provide more benefits and fewer deficiencies with a product that had a similar ease of delivery and ease of use?

Image Credit: © OraCare

Oracare is a mouth rinse that functions as a chlorhexidine alternative. It kills the same bacteria as chlorhexidine, but has several benefits over what has been the standard treatment rinse. These benefits include:

• Kills the same bacteria as chlorhexidine
• Kills viruses and fungi
• Breaks up biofilm
• Non-staining
• Not inactivated by blood and saliva
• Removes volatile sulfur compounds (VSCs) which are a major contributor to halitosis
• Pleasant taste

Oracare uses activated chlorine dioxide and xylitol to provide the benefits listed above. Due to its wide spectrum of uses, it can be used in a variety of applications. It not only has great benefits for patients who have periodontal issues, but also for treatment of dry mouth, fungal infections, and halitosis. This is especially true for halitosis which is mainly caused by VSCs which are inactivated by the chlorine dioxide.

The product comes in a two-bottle system and each bottle comes with a pump dispenser. The patient simply pumps 4 equal amounts of each bottle into the provided cup, allows 30 seconds for the product to activate, and then swishes vigorously and thoroughly for 30 seconds, then expectorates. This is repeated every day, two times per day for the best results.

Why two bottles? Simply put, mixing the components creates the chlorine dioxide that provides the majority of the benefits. If the components were available in a single bottle, the chlorine dioxide would escape, and the results would be extremely limited. A fresh mix ensures a consistent and reliable delivery

If you are looking for a way to change your soft tissue and periodontal therapy, OraCare health rinse is a product with many advantages over your current choice of rinses.