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Oral Irrigation - Yay or Nay? Part 3

Types of Oral Irrigators and Tips

Oral irrigators have become increasingly popular because of their effectiveness in disturbing plaque biofilm. In this blog, the types of irrigators and tips are discussed.

Types of Irrigators-

  • Electric or Cordless- the power source is a traditional electrical plug or a rechargeable battery.
  • Full size, Compact, or Travel- various sizes are available depending on the user’s lifestyle.
  • Removable or Fixed Reservoir- refers to whether the reservoir can be removed from the unit. Removable is best to allow for proper cleaning.
  • Pressure Control- most units allow the user to adjust the amount of water pressure.
  • Pulsed Flow- This is the most common unit on the market. The water is compressed and decompressed causing bacteria and debris to become disrupted and removed supra and subgingivally.
  • Steady Stream- The water comes out in a steady stream without the pulsation.
  • Magnetized- The water is charged thereby reducing the formation of calculus. However, studies suggest that this type of unit doesn’t decrease gingivitis and bleeding.
  • Oxygenized- The water is incorporated with air which produces bubbles to disturb plaque and anaerobic bacteria. This, in turn, reduces gingival inflammation and bleeding.

 Tip Styles and Usage-

  • Standard Tip- This tip is the most common and is used supragingivally daily to remove food particles and disrupt plaque biofilm. It allows the water to reach 50% of the pocket depth.
  • Periodontal Tip- This specialized tip is designed to allow access up to 90% of the depth of the pocket. It’s inserted subgingivally and has a soft rubber tip with a small opening that controls the amount and pressure of the water and antimicrobial entering the pocket. The patient must be instructed regarding use and must have sufficient dexterity.
  • Orthodontic Tip- Used around orthodontic appliances to effectively remove food particles and disturb plaque biofilm, this tip is also recommended for patients with sensitive gums.
  • Combination Sonic Toothbrush and Irrigation Tip- this hybrid tip is excellent for plaque removal and irrigation at the same time. It’s recommended for all patients but especially ones with limited dexterity.
  • Tongue Cleaning Tip- this tip assists with halitosis by reducing the number of bacteria on the tongue. Recommended for all patients but especially those with elongated papillae.
  • Restorative Tip- this tip is recommended for patients with implants or crown and bridge that may not respond to traditional methods of oral hygiene. Implants, crowns, and bridges may be difficult to access because of their shape and positioning.
  • Nasal Tip- Used for flushing the nasal passages.

In the next blog, we’ll delve into proper use and care of oral irrigators.

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Oral Irrigation - Yay or Nay? Part II

Antimicrobial Use

Oral irrigators have become increasingly popular because of their success in disturbing plaque biofilm. Furthermore, the addition of an antimicrobial to the water makes using an oral irrigator more effective. By disturbing the plaque biofilm and delivering an antimicrobial above and below the gumline, reduction in bleeding, inflammation, and periodontal pocket maintenance can be achieved. Today, we will focus on the use of antimicrobials in the water.

Types of Antimicrobials Used in an Oral Irrigator-

  • Phenolic Compounds- these over the counter rinses contain essential oils and varying other ingredients such as alcohol, hydrogen peroxide, and fluoride which have been proven to reduce the bacteria responsible for bleeding and inflammation especially when the rinse is used full strength.
  • Stannous Fluoride- stannous fluoride is excellent in decreasing bleeding and inflammation. It’s also great for decay and tooth sensitivity when used in toothpaste.
  • Hydrogen Peroxide- hydrogen peroxide is very efficient at targeting harmful anaerobic microorganisms that thrive in pockets because it introduces oxygen into the area.
  • Chlorohexidine- a one to one ratio of water and Chlorohexidine has been shown to diminish inflammation and bleeding significantly. Chlorohexidine is only available by prescription and is the most powerful antimicrobial rinse on the market. However, simply rinsing with this product doesn’t reach more than one or two millimeters below the gumline. Its effectiveness is increased when added to the irrigator because it goes deeper subgingivally.

Stay tuned for part 3 of this blog series as we’ll look at the types of irrigators and tips.

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Microcopy's NEW 330^2 Carbide Bur

NEW NB 330The New Definition of Strength

At this year’s Chicago Midwinter meeting, Microcopy, a leader in the design and development of innovative products for the dental industry, announces the release of its new NeoBurr 3302 blended neck® carbide. This new blended neck carbide follows suit with the 5572, the section of the bur between the cutting head and the shank is blended so there is no reduction in neck width. This design, coupled with the removal of the weld joint increases the strength of the bur. The new 3302 boasts unrivaled strength. This innovative design removes any weak points in the bur’s neck that might otherwise cause breakage.

“It is important for us to provide high-quality products that solve a problem. Carbide breakage is a well-known issue that exists in dentistry. By offering a stronger carbide line, we have made it our mission to make carbide breakage a thing of the past,” said Heather Siler, Microcopy’s core product marketing manager. 

Most of the top-selling NeoBurr shapes are available in blended neck and Microcopy plans to release additional blended neck shapes as they are designed and developed.

After a recent product evaluation of the NeoBurr 3302, Dr. Lawrence Cooper says, “Very fast, smooth cutting occlusal and distal preparations.”  The new 3302 has all the same great features as the original NeoBurr 330, but now it has a blended neck for increased durability.

Visit NeoBurr.com or call 800-235-1863 for more information.

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Oral Irrigation - Yay or Nay? Part I

Oral irrigator

Oral irrigators have been available for home use since the early sixties, and recently, they’re gaining in popularity. New research reports their effectiveness in disturbing plaque biofilm and as a result, reducing the host’s response to the microbes in the plaque.

When oral irrigators were first developed, studies revealed that their use reduced gingivitis, but they didn’t remove troublesome plaque. Therefore, it was thought that daily oral irrigation wasn’t effective. Water flossing was mainly recommended for patients with orthodontia, crowding, and patients dealing with food impaction. Another concern was that daily use could cause bacteria in the mouth to enter the bloodstream and cause an infection, but research shows that using a water irrigator poses no more threat to infection than any other oral cleaning device.

New findings reveal that oral irrigators alter plaque formation rather than remove it altogether. Disturbing plaque formation dilutes toxins and disrupts bacterial colonies thereby lessening the patient’s immune response. In other words, even though the plaque isn’t removed, the bacteria within the plaque is disorganized, and in turn, inflammation, bleeding, pocket depths, and the patient’s immune response is repressed. Also with the correct tip and instruction, periodontal pathogens deep within the pocket are compromised.

Brushing, flossing, and rinsing with an antimicrobial product doesn’t go underneath the gumline more than one or two millimeters. By incorporating the use of a water flosser, patients remove not only food debris, but also disturb plaque formation from around the entire tooth beyond two millimeters.

Today, oral irrigators are beneficial for all patients, but especially those with orthodontic appliances, implants, crown and bridge, diabetes, periodontal disease, gingivitis, and those whose oral health is less than ideal.

In part two of this blog, we’ll discuss the types of irrigators and the different tips used for specific purposes.

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Get Outta There! The Effects of Unnecessary Radiation Exposure

iStock 000073708857 Small

If you’ve been in Dentistry for many years, you’ve probably held a film or sensor in a patient’s mouth during radiographic exposure. Children, patients with a small mouth or tori, severe gaggers, or uncooperative patients can make it seem like there’s no other way to get the perfect shot without compromising your health.

Because radiation is cumulative, it builds over time and can cause significant damage to the body. Exposure has lessened dramatically since the introduction of digital technology, and harmful effects are rare today, but that doesn’t mean that it’s ok to stay in the operatory during exposure. Following are some things to consider while taking x-rays:

  • Use appropriately sized film. Unfortunately, there aren’t many options for film or sensor sizes. However, a pediatric size is a must because it can be used for an adult with a small mouth, sensitive gag reflex, or tori.
  • Have the patient hold the film. If there’s no other way to get a decent shot, the patient can be instructed to hold the film. It’s a bit risky because the film or film holder must be held firmly, but it’s better than exposing yourself. It also may or may not work with a child. But again, it’s worth a try.
  • OSHA mandates that employers provide a safe workplace which includes limiting radiation exposure. Therefore, dosimeters and barrier shields (lead aprons and lead lined walls) should be in place anywhere x-rays are taken. A dosimeter is a scientific instrument (usually a badge that the clinician wears) used to measure exposure to radiation. The badge is monitored by the company from which it’s purchased.
  • Employees must be educated and take a course in radiation protection, and anyone who takes x-rays must be certified by the state.
  • The maximum annual dose of radiation for healthcare employees is 50 millisieverts (mSv). The maximum allowable lifetime dose is ten mSv multiplied by your age.
  • Pregnant clinicians can expose x-rays, but they must wear their dosimeter and a lead apron every time and never remain in the room during exposures. While this may seem like overkill, it’s prudent to have team members who are pregnant stay far from any radiation. Many pregnant practitioners refuse being exposed to any radiation, and their decision should be respected.
  • Continued exposure to dental X-rays is linked with an increased risk of cancer. Again, most clinicians today aren’t overexposed because of advances in technology that require far less radiation and precise and focused beams, but it certainly can happen. Specific types of cancer such as thyroid and tumors involving the hands or fingers are linked to the dental profession.

Dental offices are busy places and staying on schedule is a must. It’s easy to justify getting a diagnostic x-ray by holding the film in the patient's mouth, but it shouldn’t occur. Perhaps it’s time to find a course that teaches alternative ways to get a readable x-ray without exposing yourself. Always remember that radiation is cumulative and dangerous when not respected.

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