The Dental Equipment & Dental Office Blog

Does Color Matter whilst choosing dental equipment?

Surprisingly, the answer is yes. Many of you reading this will have noticed that there is a trend towards beige colored dental equipment in the marketplace. This isn’t simply a thoughtless manufacturing decision or decorating trend, although it does have its roots in aesthetics. It is actually a directed and thoughtful change to keep your office looking great, longer.

Dental Handpieces, a/w syringe, and suction tubings used to be almost universally gray or black. However, what happens over time is that as tubings are wiped with disinfectant they discolor and begin to look really bad. Through some experimentation, dental equipment manufacturers found that beige tubing (which will still discolor eventually) has a much less dramatic color shift, and therefore looks better longer.

Similarly, many older dental chairs had bases that were black. Dental equipment manufacturers found that powder from latex gloves would often cover the bases of the chairs and cause them to look dirty. Even when wiped, streaks would often be left behind, leaving patients with the impression that the office was unclean. The new beige colors are much closer to the color of the powder, and again, while it doesn’t solve the problem, it makes the problem less noticeable. This inspires confidence in your patients who have no reason to believe that your office is anything but clean and sanitary.

Offices with older equipment, or those that are buying used equipment, can also take advantage of this research. As your service person replaces damaged tubings in your office, instruct them to use beige tubings. With the exception of fiber optic handpiece tubings, most delivery system hoses are very inexpensive to replace. This is a low cost way to update your office.

In addition, many dentists will have older equipment repainted to freshen the look of the office without spending large sums of money. If you are doing this, or thinking of doing this, why not have the equipment repainted a neutral beige color? Not only will the equipment look more modern, it will appear cleaner.

It is true that color trends come and go in dental offices. Wood grain cabinets were standard equipment in the 1970s, and were rarely used in the 1990s. Now, wood grain is back in full force. However, I believe that the trend towards beige equipment is one that will stick around; the color is neutral and matches nearly any design scheme, and there are proven benefits in the equipment appearing cleaner. Beige is here to stay.

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Even with all of the advances in dental hygiene technology; air polishing, ultrasonic scalers, piezo scalers, and patient hygiene, the vast majority of dental hygienists still spend hours each day hand scaling teeth.

This short, repetitive motion causes wrist and joint problems in many hygienists. The best way to minimize this risk is to use instruments that are sharp, well balanced, and comfortable. Keeping instruments sharp is a discussion all of its own, and balance is self explanatory.

Comfort though, is subjective: Hu Friedy, one of the leading manufacturer’s of dental instruments, offers no less than six different handles for their instruments. Several characteristics combine to create the sensory experience we call comfort.

First is the material that the handle is made from. Metal handles are harder and less forgiving (but longer lasting and arguably easier to sterilize), while plastic handles tend to be more comfortable and lighter, but not as rugged. Some companies even offer cushioned rubber handles for a soft feel (though that soft feel doesn’t always transfer to comfort while actually being used).

Size is also an important factor in choosing a dental scaler handle. As the handle diameter increases, the stress on the fingers and hand are generally reduced. Small handles tend to be harder to hold and create more fatigue.

Finally, surface finish should also be taken into consideration. Smooth handles, ribbed handles, and knurled handles will all appeal to different users for a variety of personal reasons. Generally, smooth handles are the least comfortable over time.

If you are looking for a rule of thumb for buying instruments, here it is:

Buy the largest diameter metal handle with a ribbed finish that you can find. For the widest variety of people, this configuration will offer the most comfort. The best solution however, is still to let the user choose for themselves. Some hygienists actually prefer different handles for different types of scalers, and some scalers may be available in a limited number of handle configurations. Allowing the user to choose their own instruments ensures that they will make a choice they can live with.

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Dentsply’s newest Cavitron has been out on the market for a little while now, and by accounts it has been performing well. The Cavitron Plus by Dentsply International is simply the most advanced ultrasonic scaler on the market today. Most dental offices and all dental hygienists will be familiar with the name Cavitron, however most offices have an older version of the machine.

The Cavitron Plus is an improvement over the last generation Cavitron SPS in a number of ways. The display is now diagnostic, with a limited number of fault codes to help diagnose a problem or to verify proper operation.

Two important water control functions have also been added. First, an auto flush feature which will flush the handpiece water line for 2 minutes. The user simply has to place the handpiece in a sink, press the button, and walk away. The second is a rinse feature which cuts scaling power but keeps the water flowing so that the user can rinse away debris or cleanse a perio pocket.

However, the most welcome feature is the new foot control. No longer does the hygienist need to trip over a cord: the new foot control is wireless. The foot control is battery powered, and can move around anywhere in an operatory. The foot control does have a wire that can be attached in case of battery failure, but simply keeping some spare batteries in the office would also get around that issue.

The Dentsply Cavitron Plus still features a 330 degree swivel in the handpiece tubing for longer cord life and less strain on the wrist, as well as the SteriMate handpiece for easier infection control. The new unit runs at 30 kHz, so any tips you have from the SPS unit will still work as designed. Dentsply has not seen fit to incorporate 25 kHz tip support as some of their competitors have done, however, given that Cavitron tips rarely last longer than a year, any old 25 kHz tips in your office are probably worn beyond their useful life anyhow.

In addition to the changes to the regular Cavitron, Dentsply has also incorporated these new features into the Cavi-Jet model, calling it the Cavitron Jet Plus. This will be a welcome change for those dental offices that use air polishing to achieve high levels of dental hygiene. You can read more about the Cavitron Plus and Cavitron Jet Plus at http://www.dentsply.com.

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Dental Instrument washers are rapidly growing in popularity in dental offices. When they were first introduced a few years ago, many people (including myself) discounted them as another expensive piece of equipment that the dental companies were trying to get their customers to buy. Perception changes with time, and many dentists now consider an instrument washer to be a must have piece of equipment in a dental office.

Traditionally, dental instruments are cleaned first by scrubbing, then by immersing into an ultrasonic cleaner for a period of time. There are a few problems with this. Scrubbing is dangerous, and leaves the door open for a staff member to cut himself and potentially get sick. Ultrasonic cleaners aren’t really that efficient, and are almost always used improperly, with the lid off, aerating bacteria and germs into the air of the operatory.

Dental instrument washers change all of this. Essentially, they look like a dishwasher. Your instruments (hopefully in IMS cassettes) are placed into the racks, and when full the machine is run. The instruments come out sanitized (which is not the same as sterilized), and are ready to be wrapped and placed into the sterilizer.

Some dentists try to use a standard household dishwasher in place of these machines. I don’t recommend this, as there are many differences. For one, the dental machine superheats the water inside the machine at up to 200*F. Dishwashers are limited to 140*F, and that temperature variation makes a significant difference in the efficacy of the machine.

Dental Instrument Washers use specially formulated cleaners that won’t corrode or discolor your instruments, and are backed by warranties and trained service technicians for use in a dental office. Perhaps most importantly, these devices are registered and licensed as medical equipment and approved for use in a dental facility.

There are many brands of dental instrument washers on the market, with the SciCan Hydrim and the Miele G 7881 being the two most popular. Personally, I think that the Miele is a much better machine. In my opinion it is constructed better, easier to use, and has less problems in the field once installed. However, both are quite effective. You can learn more about these machines at http://www.scican.com and http://www.dentaldisinfector.com.

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Your service technician is paid to identify and solve problems, minimizing your downtime. No matter how good he or she is, there are steps that you can take to minimize the cost of that service by maximizing their time in your office.

A simple service needed checklist centrally located in your office is one of the best ways to do this.

Your staff writes down the problem, the location, and the name of the person the technician should talk to. When your technician comes, they can look at the list and fix all the problems on it, or let you know that they have to order a part. Without a list, items are often missed, meaning you pay an extra office call charge when the technician returns.

In addition, knowing all the repairs that you need done will allow the technician to multitask. The technician could be looking at your Assistina while the test cycle is running on your Statim, but only if they know it needs repair.

Similarly, simply keeping track of all of your dental handpiece repairs and the serial numbers and repair dates for them will ensure that you never pay for the repair of a handpiece that should be under warranty.

Finally, a simple maintenance checklist for the items in your mechanical room will help to minimize breakdowns. Running a compressor head dry and having it seize up is an expensive way to be reminded of the location of the oil sight glass.

Regularly checking this equipment helps to identify problems while they are still small, before they get big (and expensive).

These steps don’t all need to be done by the technician.

One of your staff members can be placed in charge of keeping these lists and forms up to date. That same person can check the compressor oil levels and track how long it has been since the Amalgam Separator has been changed. They can walk through your operatories once a week looking for broken hoses and items that need repair. That staff member becomes a single point of contact for service in your office, which reduces mis-communication errors and ensures that things get fixed right the first time.

This can ultimately save you valuable time and money.

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Instrument Management Systems (IMS) are a rapidly growing trend in Dentistry. Dental Instrument Management Systems, which some people simply call cassette systems, or instrument cassette systems change the way you handle, store, set-up, use, clean, and sterilize your instruments; a tall order for a simple acronym. Let’s take a closer look at how they work.

The basis of the IMS is the instrument cassette. Available in many different sizes, and usually customizable in terms of layout and color (for coding by procedure or operatory) the cassette becomes the new home of the instrument. In fact, except for when the instrument is used, it stays in the cassette permanently.

Here’s how it works. We’ll use a hygiene setup as an example. The hygienist selects a cassette based on the number of instruments she uses. The cassette will hold a full instrument set up, including scalers, A/W syringe tips, probes, ultrasonic tips, etc. The hygienist takes the cassette into the operatory, opens it and works with her patient. When finished, all of the instruments are carefully loaded back into the cassette, and the cassette is closed and locked.

Ordinarily, the hygienist would take the instruments loose on a tray back to the sterilization room, scrub each one and drop them into the ultrasonic cleaner. By having the instruments loose, there is a risk (slight, but present) that she could bump into someone, causing a stick injury, or simply drop a contaminated instrument on the floor, damaging it. During the cleaning phase, the hygienist is at risk for infecting herself when scrubbing instruments. With IMS, the locked cassette is simply placed in the ultrasonic or better yet, instrument washer, and left until clean. Simple, time saving, and safe.

When it is time to move the instruments into the sterilizer, the hygienist would traditionally dump all the instruments into a bag, or loose into a sterilizer tray or Statim cassette. The instruments are stacked on top of each other, with metal to metal contact which potentially leaves areas of the instrument which do not achieve sterilization. The sterilization cycle runs, and the instruments are again dumped onto a counter for sorting or reuse.

In an IMS office, the cassette can simply be inserted into the sterilizer (if they are to be reused right away), or wrapped and sterilized if they are going to be stored before use. Each instrument is held by a silicone pad, which ensures complete sterilization. There is no contact between instruments, and no chance for the instruments to be damaged.

At each step of the way, it is easy to see how the use of IMS systems simplify the process, reduce the risk of damage to the instruments, reduce the risk of injury to staff, and increase efficiency in the office. Many companies make some form of IMS, but Hu-Friedy is one of the leaders in the field. To learn more about IMS from Hu-Friedy, follow this link to their innovation page.

Here is where you can find current listings of Hu-Friedy dental instrument systems for sale on our site.

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Dentsply Professional has an interesting new high speed handpiece on the market under the Midwest brand. Called the Stylus ATC (Adaptive Torque Control), it is being marketed as a hybrid air/electric handpiece.

What does that mean - hybrid air/electric?

Midwest’s marketing material says that the handpiece combines the small size, speed, and light weight of a traditional air turbine handpiece, coupled with the torque and power of an electric.

How is this accomplished?

Make no mistake, the Stylus ATC is an air driven handpiece. It differs from a traditional air turbine powered handpiece in two ways. First, Midwest recommends that the handpiece air pressure be set at 75psi, instead of the traditional 39 to 45psi of traditional handpieces like a Kavo 635B or W&H TA98 (Midwest says the handpiece will work fine at 60psi). Obviously, you could dramatically increase the cutting power of any handpiece by doubling the drive pressure, but you would also seriously reduce the life of the turbine.

Midwest adds sensors to the handpiece that transmit speed sensors to an electronic control box. The control box continuously samples the speed of the bur (hundreds of times a second) and adjusts the power of the handpiece. In addition, the handpiece has the ability to idle the handpiece when not cutting to increase turbine life.

Will this idea take off?

It’s certainly a new technology in the dental marketplace. The key to success lies in two areas.

First, can you actually get 60psi – 75psi of pressure from your dental delivery system? Theoretically it’s possible, but many dental units run into a wall at around 50psi – 55psi. Increasing the pressure in the floor box could cause other problems, especially on older units. Newer delivery systems are more likely to be able to achieve higher pressures.

The second factor is the reliability and longevity of the dental handpiece and turbine. If the electronics prove reliable, and don’t seem to be negatively affected from being banged around and run through the sterilizer (no electrical items on electric dental handpieces actually go into a sterilizer, while the sensors in the ATC appear to be inside the handpiece itself) the product has great potential.

There are a lot of Dentists that could benefit from a technology like this. You can learn more at http://www.stylusatc.com

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Dental Instruments are the tools of trade for a dentist.

The category Dental Instruments covers a wide array of tools in use in a dental office. Often the term is generically applied to hygiene instruments; however, it also includes diagnostic, orthodontic, periodontal, restorative, operative, and even surgical instruments.

Most of the products in this category are long, thin handled instruments such as explorers, scalers, and composite tools. Many of the same criteria can be used to evaluate each of these to determine which brand and style best fit your needs.

The first and most important of these characteristics is the grip.

This is especially important in hygiene instruments where the practitioner spends the majority of his day using the instrument. Various sizes, types of materials, and styles of grip are used, but there are some common characteristics that you can look for when making a choice.

Generally the larger the shaft, the easier it is on the operator over a period of time. Smaller grips cause you to clench your fingers together tighter and can lead to wrist fatigue and repetitive strain injuries.

Weight is also a factor; however the goal isn’t to simply purchase the lightest instrument, but to choose a well balanced instrument. The style of grip is not as important as finding one that is comfortable and feels good in your hand.

Handles can be made of rubber, plastic, and metal with crosshatches or spirals engraved or molded into them. While it would generally be expected that the softer handles would be more comfortable, this is really a matter of personal preference.

The best thing to do is to try several different manufacturers and styles to see which works best for you. The handles of these types of instruments are generally available universally across a manufactures line. For example, if you prefer the Hu Friedy #6 handle, you can get most of their instruments in that handle.

Taking Care Of Dental Instruments

Dental Instruments are very easy to take care of. When you are done using them, lightly scrub most instruments under warm running water to remove bond, blood, composite, or other material from their surface. Sharp instruments should not be scrubbed due to the risk of the user cutting oneself and potential exposure to disease. Sharp instruments should be placed in an ultrasonic cleaner or instrument washer for cleaning before going into the sterilizer.

As a rule, instruments should be wrapped for sterilization. It is especially important to wrap hinged instruments such as forceps. The hinge pin in these tools is made from Carbon Steel, and when sterilized unwrapped can cause staining in the chambers of certain sterilizers.

Hygiene Instruments: Productivity Tools

Hygiene Instruments have special needs due to the nature of their use. They are under a significant amount of strain throughout their life, and the cutting edges wear at a rapid rate. A few things to consider with this class of instrument:

Sharpening – Aside from proper sterilization techniques, sharpening is the most important maintenance item for prolonging the life of your instruments and keeping the quality of the hygiene department high. Sharp instruments are more accurate, efficient, and provide better quality results. Rather than freehand sharpening the use of a guide or electric sharpening device is recommended as the angles involved are very precise and specific to the type of scaler. Sharpen frequently. When sharpening pay attention to the overall condition of the instrument, and the wear of the cutting edge. When 20 percent of the original edge of the tool has been lost it is time to replace the instrument.

Retipping –This is not a recommended practice. While many companies offer retipping services for dental instruments, no major manufacturer recommends doing it. When an instrument is retipped there is no guarantee that the quality of the metal will match that of the original. Also, the balance of the dental instrument can be thrown out, and especially for hollow handled instruments, there is no way to ensure that the new tips have been properly sealed for infection control. If your instrument was not specifically designed to be retipped, discard it when it is worn.

Implant Scalers – with the rise in popularity of dental implants in your patient’s mouths, it is wise to think about protecting these expensive restorations during hygiene procedures. One way to do this is to purchase dedicated implant scalers for the hygienist. These instruments are made out of a plastic or nonmetallic material so that they cannot damage the restorations. An office doesn’t need an entire tray full of these, but you should have a small selection available for when the need arises.

Ultrasonic Inserts – There are two things to consider when choosing ultrasonic inserts. The first consideration is the style of water delivery. Water can be delivered either directly at the tip, or at the base of the cutting edge. Styles which deliver the water to the tip are preferable for their superior water control. The second consideration is frequency. Ultrasonic inserts are generally available in 25 kHz and 30 kHz. It is important to choose the correct tip for your machine. These tips cannot be sharpened, but they do wear out. When checking and sharpening other hygiene instruments, compare these to the wear guide to make sure that they are still operating efficiently.

You can find new and used dental instrument for sale here.

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