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Going to a dentist is, to many, a dreaded experience that they try to avoid as long as possible, even at the cost of suffering numbing pain. Odontophobia is a prevalent condition and it's very easy to jump on the “dentists are scary” bandwagon. Getting out of it is usually a little more difficult, especially if you are constantly hearing stories of “butcher dentists” and such.

In order to do his job with success, a dentist will need the cooperation of his patients. He can't just put people to sleep the moment they waltz into his office and start drilling and pulling. He has to use tact and he has to calmly explain what he intends to do with the patient's teeth. Of course, when a nervous patient walks into the dentist's office (most likely kicking and screaming), explaining the dental procedure proves to be a little more complicated. However, not impossible. Here is how you can talk with your edgy patients about dental procedures.

Explaining the Fillings

Most people sitting in the dentist's chair are there because of cavities. This is probably the most simple procedure in dentistry and most dentists have done it a billion times by now. Still, many people, when they see a needle used for numbing the mouth before they can administer a filling, start to have “second thoughts” and remember “prior engagements”. If you don't want your patent to jump out of his chair when he sees a needle in your hand, talk to him and calmly, but in a firm voice, explain what you are doing next. For instance, you could say something along the lines of “this will help you offset the pain”. Also, a lot of people feel the need for a distraction, so if they feel more relaxed listening to music on an iPod while you work, let them.

Explaining Tooth Extractions

extractions are the most feared dental procedure of all. Most good dentists try everything in their power to heal the tooth and only pull it out as the last resort and if it threatens other teeth. The worst first words you can utter as a dentist is “we'll have to extract this”. Try treating the tooth for a few days, at least, and only when you see that it doesn't work, start preparing the patient for the tooth extraction. This is where patients are won or lost forever, so give your patient a day or two to mentally prepare for the procedure. Once the patient finally arrives in his chair, having an assistant with you can work wonders for soothing him or her.

Finally, don't forget to talk while you work with your patient. If you show that you are relaxed, the patient is likely to be more composed as well. If you know of a good joke or an anecdote, tell them to the patient.

It can be hard to find the time to get individuals into the dentist for that annual cleaning, but you’d be surprised how your practice can capture the attention of possible patients when you promote a discounted holiday cleaning opportunity! This is one of the best ways to build up your dental practice’s credibility in the local community! While it might appear you’re losing by offering lower cost cleanings for the Christmas season, you have to look to the long term benefits this is going to award your practice! You can stand out above your local dental practice competition and show you care about the well being of people, rather than just about building your practice!

Offer That Christmas Day Special To Show Your Dental Team Cares

Show you care! This time of year gives your practice an excellent opportunity to reach out to the community and make a dramatic impact that illustrates, as a dental provider, you really do care! This is also an ideal way to market your practice most effectively. For example, amazing dental discounts can enable patients with hectic schedules to come in during the holiday season rather than waiting to try to fit in time between work and possible school schedules. You can diminish the stress and time constraints. You can also offer exclusive discounts for families with children!

If you market and offer a promotion for children to have a discounted check-up and cleaning before classes take back in, parents will take advantage of this! There is nothing better for a youngster than to start the New Year out with a beautiful, healthy smile! A special cleaning for children who might have ingested a little bit too much Christmas candy can end the holiday season with perfect contentment! For most, nothing is better than having a cavity free smile and clean teeth! You can also offer some holiday discounts for others as well, such as those more mature in life.

More mature adults need dental services just as anyone else does, and they get just as excited to receive a wonderful dental discount as well. For older adults, candy eating might cause a crack in dentures, or possibly even loosen teeth placed in a partial. Some adults have problems with gum irritation that might require dental care. All in all, you want to show those in the local community your practice cares about their dental health needs, no matter what age. Also, you should set an example and illustrate you don’t mind offering discounted services, or possibly even free cleanings at different times of the year.

You can also offer patients Christmas goody bags that are holiday gift bagged

Holiday Promotions Only Stop When You Lose Creativity: Give Christmas Gift Bags

People love goody bags, it is a common fact. For younger people, goody bags from the dentist are a treat, but it can be a nice treat for parents too. This holiday season; take a little extra time with those patient goody bags. Fill these with a brand new toothbrush, wrapped in a bow and dental floss that is peppermint in flavor. You can add to the fun by placing sugar free peppermints in the goody bags! If anything, your practice can represent good cheer and put patients at ease who decide to come in during the holiday season.

Just think, when you set up a great, friendly environment all year long, word-of-mouth can grow in a spectacular way. You can mention to your patients to not forget about mentioning your practice as you hand them their gift bag! You’ll find they’ll be more than happy to. Further, you can even offer a 20% discount for each patient referral you receive. While it might seem a bit pushy, the holiday is the perfect time to follow through with a marketing and promotion plan such as this.

Your gift bags can do all the promoting for your dental practice! When others find out about how generous a specific practice is, and the extras they can get for becoming a patient, they will stop by just to see how good the word really might be.

A dental practice should never lose sight of the fact that they are a business and they have to promote themselves above their competition. Doing this in a friendly and cheerful manner is one way to illustrate authenticity and originality as well. Try these tips and tactics on for size and watch your practice gain recognition within the community!

By Nicholas J.V. Hogg, MSc, DDS, and Archibald D. Morrison, DDS, MSc, FRCD(C)

Abstract

Objective: The transmission of pathogens from one patient to another via contaminated devices has been a high- profile issue in infection control. Although single-use devices have been promoted as a preventative strategy, resterilization of instruments has been a common practice in dentistry. The purpose of this study was to investigate the rate of bacterial contamination of instruments resterilized for use in oral and maxillofacial procedures in a hospital-based clinic.

Methods: The experiment was a prospective randomized controlled study. The test group consisted of burs that had been used in surgical procedures. These burs were grossly debrided before being cleaned and gas sterilized in the central sterilizing department of the hospital. The burs were transferred in a sterile fashion into a culture medium selected to grow oral bacteria. The control group comprised new unused instruments treated in an identical fashion before culturing. All burs were incubated and monitored daily for 72 h.

Results: The rate of bacterial contamination in the test groups was significantly higher than in the control group (p < 0.05).

Conclusions: Reuse of instruments can be cost-effective if the safety of patients can be assured; however, there is increasing evidence that the sterilization process may not be completely effective. Consideration should be given to the classification of certain types of dental burs as single-use devices if sterilization cannot be guaranteed.

MeSH Key Words: cross infection/prevention & control; dental instruments; disinfection methods; equipment reuse

Sterilization of instruments ensures that they are free of “all microbial life including microbial spores which¹ are the most difficult of micro-organisms to kill.” If the sterilization process is effective in killing bacterial spores, it will also be effective against mycobacteria and all viruses, including herpes simplex virus, hepatitis and HIV.¹

Resterilization is “the repeated application of a terminal process designed to remove or destroy all viable forms of microbial life, including bacterial spores, to an acceptable sterility assurance level.”² Resterilization of instruments used on one patient for reuse on another has been common practice in dentistry and oral and maxillofacial surgery. Some instruments used in oral and maxillofacial and orthopedic procedures, such as bone drills and saws, are Class I instruments as defined by the United States’ Food and Drug Administration and can be reused if sterility can be guaranteed.³ However, there is now evidence that the sterilization process is complex and that if strict adherence to an effective protocol is not followed, contamination of instruments may result.

In the past decade, single-use devices (SUDs) have been promoted in many dental and medical practices as a strategy to prevent the transmission of blood- and tissue- borne pathogens from patient to patient. This practice has also been influenced by high-profile legal cases that have brought the issue of SUDs to the attention of the media and the public.⁴ For example, in Toronto in 2002, a case involving a patient who contracted the hepatitis B virus via contaminated electroencephalogram electrodes resulted in a $27.5-million settlement against the neurologist and hospital.⁴ SUDs are convenient and their use has become widespread in hospitals around the world. However, the use of disposable instruments does not come without a significant cost to the health care system as well as environmental concern.⁵

Link to Article

by Archie Morrison, DDS, MS, FRCD(C), and Susan Conrod, DDS

Abstract

Purpose: The complex miniature architecture of dental burs and endodontic files makes precleaning and sterilization difficult. Devising a sterilization protocol for endodontic files and dental burs requires care, and some have suggested that these instruments be considered single-use devices. One purpose of this study was to determine the effectiveness of various sterilization techniques currently used in dentistry for the resterilization of dental burs and endodontic files. The second aim was to determine whether new dental burs and endodontic files, as supplied in packages from the manufacturer, are sterile.

Materials and Methods: The sterility of new (unused) and used dental burs and endodontic files before and after various sterilization procedures was analyzed. New burs and files were tested immediately after removal from manufacturers' packaging, with or without prior sterilization. Burs and files that had been used in various dental offices were precleaned, packaged, resterilized and then tested for various pathogens. Each item was individually removed from the sterilization packaging, transferred by sterile technique into Todd-Hewitt broth, incubated at 37°C for 72 hours and observed for bacterial growth.

Results: Sterilization procedures were 100% effective for unused burs and unused files but were less than 100% effective for all other test groups. Contamination rates following sterilization ranged from 15% for one group of used burs (p = 0.01) to 58% for one group of used files (p < 0.001).

Conclusions: Dental burs and endodontic files, as packaged by the manufacturer, are not sterile and should therefore be sterilized before first use. The resterilization procedures tested here were not adequate, and more rigorous sterilization procedures are needed. If such procedures cannot be devised, these instruments should perhaps be considered single-use devices.

Link to Article

A case for single use

By JT Walker, C Budge, M Vassey, JM Sutton, ND Raven, PD Marsh, P Bennett

This article considers the evidence underpinning the UK Health Department’s guidance that root canal instruments must be treated as single use as a precaution to reduce any risk of variant Creutzfeldt-Jakob disease (vCJD) transmission.

Summary

Some instruments such as endodontic files are inherently difficult to clean and may come into contact with peripheral nerves known to carry vCJD. Hence, the provision of clear and unambiguous advice to dentists from the Department of Health in a communication Advice for dentists on re-use of endodontic instruments and variant Creutzfeldt-Jakob Disease (vCJD) will ensure that endodontic reamers and files are treated as single use to further reduce any risk of vCJD transmission through dentistry.

Link to Article

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Developed for use with nanocomposites, Microcopy’s durable, single-patient-use polishers resist crumbling and retain their shape.

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Find out why Parag R. Kachalia, DDS, believes that Gazelle nanocomposite polishers

• Simplify restoration polishing with choice of a 1- or 2-step process with no polishing paste needed.
• Withstand anatomic variations for effective and efficient polishing of all areas of a restoration.

While the polishing system we were using at the UOP was adequate, we were always looking for something that would give us a better result with fewer steps. Additionally, we wanted something that performed consistently and would not leave debris on the restoration because it was easily breaking down. Gazelle was an easy choice to address these needs.

Choose the 1- or 2-Step Composite Polishing System

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Direct composite resins are usually the most common procedure in an average restorative practice. In a busy practice, it’s important to streamline your procedures to make them efficient and predictable. Having a systematic approach with complementary materials is a great way to accomplish consistent results. Many clinicians are focused only on the composite and matrix system and take for granted the importance of having a nicely polished restoration that will be less plaque retentive and last longer.  

Simplicity is very important and having a polishing system you can depend on with as few steps as possible is quite desirable. Fortunately, Microcopy, a Georgia based company near Atlanta, has a track record of creating high-quality burs and polishers for all your restorative needs. Their Gazelle nanocomposite polishing system is unique in that it offers clinicians the option of a 1- or 2-step system depending on your preferences. They are also available in 3 convenient shapes – points, cups and discs – to polish whatever anatomy is treated.

There are many composite polishers on the market with varying properties and steps. The Gazelle polishers are specially formulated for nanocomposites using a patented Siltec^TM process during development which infuses the polisher with strength to retain its shape and not crumble. This is a common problem with some of the other competitive systems. This durability also allows the polishers to stand up to multiple restorations during the same procedure, making it more convenient and cost effective. The fact that they are sterile wrapped in single-use packages allows clinicians to use and simply toss them out after all procedures are completed.