Posted in Company on April 21, 2021

Spring is a time of new beginnings; days last longer, flowers start to bloom, and the leaves on the trees begin turning green. This new season also springs into action cleaning – referred to as Spring Cleaning.

 

“It is traditional to clean the house thoroughly either right before or during the first week of Great Lent, referred to as Clean Week. April 1st also corresponds with the Julian New Year.” (Source: https://en.wikipedia.org/wiki/Spring_cleaning)

 

Dental practices perform spring cleaning of the operatories every day no matter the season; thoroughly cleaning surfaces, instruments, and equipment. Primarily since the pandemic, stricter infection control protocols and guidelines have been implemented.

 

But what about the suction lines? Are they part of your cleaning and disinfecting procedures? If you haven’t implemented a daily cleaning routine for the evacuation lines, you may experience low suction, resulting in lower aerosol removal. Dental aerosols are generated when dental instruments are used during treatment, i.e., turbines or ultrasonic scalers. They can spread up to 6.6 feet and remain in the air for hours. These aerosols can contain harmful pathogens and could put you and your patients at risk. Using HVEs with a large opening, like Air Techniques HVE Air Protect XL Plus, remove 98% of aerosols1. However, for your HVE to effectively mitigate aerosols, the evacuation lines must be free of debris and build-up.

 

To ensure optimal suction performance and aerosol mitigation with your HVE, “spring clean” your evacuation lines with Monarch CleanStream. When CleanStream is used in tandem with the CleanStream Dispenser, integrated Vortex technology creates a mixture of air and liquid—atomizing the solution through the lines and cleaning the entire inner tubing walls. Atomizing the cleaning solution through the lines means less stress on the vacuum pump leading to a longer life than using a bucket. When holding the hoses into a bucket, the cleaner shoots through the lines with a speed of 30-40 mph, hitting the impeller of the vacuum, which could cause premature failure of your equipment.

 

It’s time, to begin with, a new cleaning routine for your suction lines, and as a reward, we’re offering a $10 Starbuck gift card for every $200 in CleanStream purchases until June 30th, 2021. Click here for details.

 

1 “Aerosol Reduction by means of an intraoral spray mist suction – first findings from an experimental pilot study”; Dr. Martin Koch, Duerr Dental

Posted in Company on February 26, 2021

by Michelle Strange, MSDH, RDH

With so many dental devices on the market, it is challenging to know what is right for your practice. It can be hard to determine the most important features and whether you want something reusable or disposable. Here are some factors to take into consideration when deciding what will work best for your practice.

 

Reusable tools

There is no question, dental professionals must have instruments clean, sterilized, and ready to go.^[1] We are all busy providing the best patient care, but we cannot compromise safety. To keep things clean and meet the required infection prevention standards, practices should have well-documented standard operating procedures (SOPs) in place for sterilization, especially if reusable items are used in the clinic. Depending on your practice, maintaining these standards for reusable instruments could become an issue since they require following proper instructions for cleaning/sterilization, ensuring they are not accidentally thrown in the trash, and confirming each team member is on board. A breakdown in the sterilization process could have catastrophic consequences for the patient and the practice.

Single-use tools

Although single-use instruments may appear wasteful on the surface, they could be safer. No two patients will use the same tool, eliminating most of the worry about cross-contamination. The CDC suggests that single-use items are the best for treating patients to avoid infection transmission.^[2]

 

Your team needs to know if a product is single or multiple-use because with reusable tools the risk for cross-contamination is slightly higher than with disposable. ^[3]

Environmental drawbacks

When it comes to single-use anything, there is a direct threat to the environment. Disposing of dental waste may seem small, but it does add up in the long run.^[4] Using disposable tools increases your footprint, not only because of the item you use on the patient, but also the packaging it comes in, the shipping to get it to the distributor and eventually to you.

 

The pro and con breakdown

Reusables reduce the amount of waste accumulated over time. They do not require replacement often, ensuring you have them on hand at all times. Costs can decrease with reusable products because reordering is less frequent, and single-use item’s expenses could fluctuate.

 

When people attend a healthcare practice, they want to leave infection-free. With reusable tools, the risk for cross-contamination is slightly higher than with disposable. For reusables to work, employees must receive proper training and closely follow the instructions for use for the reusable tools.

 

Whichever you decide to use in your practice, ensure that the necessary precautions, SOPs, and training are in place to reach the highest possible infection control standards, protecting your patients, employees, and your practice.

 

^[1] “Sterilisation in Dentistry: A Review of the Literature – NCBI.” 15 Jan. 2019, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6350571/. Accessed 8 Sep. 2020.

^[2] “Single-Use (Disposable) Devices | FAQs | Infection Control ….” https://www.cdc.gov/oralhealth/infectioncontrol/faqs/single-use-devices.html. Accessed 8 Sep. 2020.

^[3] “SINGLE-USE (DISPOSABLE) DEVICES | Registered Dental ….” 1 Jul. 2012, https://www.rdhmag.com/infection-control/disinfection/article/16405788/singleuse-disposable-devices. Accessed 8 Sep. 2020.

^[4] “The environmental impact of dentistry – ResearchGate.” https://www.researchgate.net/publication/6509267_The_environmental_impact_of_dentistry. Accessed 8 Sep. 2020.

Posted in Company on January 19, 2021

by Michelle Strange, MSDH, RDH

Recommendations on How to Maintain Your Vacuum System

Follow these steps to ensure your vacuum system is well maintained:

• Regularly change the traps in each unit
• Run the proper vacuum cleaner daily
• If you are doing surgical procedures or intense non-surgical procedures that may have more blood that is suctioned from the mouth, you may want to clean the lines after the procedure

The Monarch CleanStream Evacuation System Cleaner from Air Techniques has a unique formulation designed specifically for daily cleaning. It penetrates and removes line buildup while maintaining vacuum performance and suction.

 

Some Devices Require Special Care

Amalgam separators have become an essential tool in dental practices, required by the EPA in order to reduce the discharge of mercury into publicly owned treatment works to prevent seepage into rivers and oceans. However, when a new amalgam separator is installed, it can fill up quickly affecting the system’s functioning, possibly rendering them non-compliant with the new EPA rules. If the practice doesn’t follow a daily cleaning routine of the evacuation system lines, debris accumulates and build-ups in the lines over time. With a new amalgam separator installation, the buildup can be disrupted and clog up the system. You will need to do a deep clean of your evacuation lines a few weeks before installing a new amalgam separator. This will help prevent clogging and premature filling of the system. Inspect the separator regularly to see if a filter change is necessary.
It may be tempting to come into your office, flip on all the switches, and start seeing patients as soon as possible. However, the treatment that you can offer is only as good as the tools at your disposal, and it is vital to understand the maintenance that your equipment needs. We all know how important a reliable HVE system is in reducing aerosols in the dental office.

The current pandemic is the perfect time to give these vacuum systems, and all the other equipment in the ‘mechanical room’, the care and maintenance needed. The wellbeing of our team members and patients is the priority, making it essential to keep your tools in working order by checking and following the advice from the manufacturers of each system. If you have an Air Techniques vacuum system, you can find maintenance information on our website.

Posted in Company on October 15, 2020

---

by: Michelle Strange, MSDH, RDH

Different dental procedures require varying tools just as a contractor would not hammer a screw when building a home—it might do a similar job, but it is nowhere as effective. The same applies to the comparison between high-volume evacuators (HVE) and saliva ejectors. Saliva ejectors tend to be used during routine and straightforward procedures where fluid needs to be removed from the patient’s mouth, whereas HVEs are necessary during more extensive dental work because of their ability to quickly remove build-up of liquids and larger solids that the saliva ejector can’t evacuate. With the added benefit that HVEs can also reduce aerosol production by 90-98%. Understanding the appropriate and proper use of both tools is vital.

 

Flow Rate and Suction Volume 

Performing dental procedures can be challenging if a practice’s vacuum system/HVE is inadequate. Without a proper vacuum system, dental professionals could be making efforts to prevent aerosol contamination, without correctly judging the airflow level that produces adequate suction for clinical purposes. Many dental team members have walked into the office, flipped the switch on to the vacuum, compressor, and water without thinking about the system being fully capable. Most practices however do not have the ability to monitor or check air flow from the HVEs. This requires specific instruments which are only recently available through some manufacturers (such as Air Techniques). So, most practices would not be able to check this themselves or even through their dealers unless they had an AT Sales Rep or Technician do a special on-site visit. This has become even more important during the current pandemic. There is more to understand regarding the use of this great engineering control that is meant to reduce the risk of spreading aerosols including the required minimum airflow levels for producing adequate suction.

 

HVEs and Saliva ejectors perform two different functions

Saliva Ejectors are for removing saliva and pooling water during patient care, HVE’s are meant for specific uses during a procedure like crown preparation, extractions, and to help reduce the spatter and spray during dental hygiene procedures.
Although saliva ejectors are useful during routine dental procedures, they do not have the power needed to limit the spread of aerosols. After all, aerosols can remain in the air and travel throughout the dental practice, posing a risk to all staff, even after the infected patient has left the building. The use of a high-volume evacuator dramatically reduces the risk of these aerosols escaping from the patient’s mouth. Keep in mind this requires the dentist or hygienist to use their free hand always with the HVE, or it requires a second assistant to hold a free HVE specifically for this purpose.

 

HVE Tips without High-Performance Vacuum Systems 

Yes, we will need a saliva ejector to help the pooling of fluid in the patient’s mouth, but an HVE will be what is needed for most of our procedures in dentistry.  We create spatter, spray, and aerosols for most of what we do so becoming accustomed to using our HVE is incredibly important. However, we have to think past the HVE tip and consider the vacuum system that is really the workhorse in this situation.

 

To help eliminate infectious aerosols spreading throughout dental offices, the Mojave Dry Vacuum can “provide the highest operational performance” required. The higher-flow vacuum is consistent and provides an exceptional level of suction without the noise levels of older models. It can adjust speed to accommodate the number of users online without the performance suffering.

 

The system will always provide the right speed, suction, and flow to ensure a safe and reliable dental procedure for both the patient and the staff. With low maintenance and offering 85% energy savings compared to other systems, the Mojave can save dentists money.

 

HVE’s are amazing engineering controls and should be the choice for aerosol reduction during dental procedures.  We just have to remember they only work when we use them and only as good as the vacuum system to support their performance.

Posted in Company on September 24, 2020

---

by: Michelle Strange, MSDH, RDH

When we think about controlling exposures to occupational hazards in dentistry, the first thing that comes to our mind is often PPE (Personal Protective Equipment). Although the role of PPE is crucial in a dental practice, we should recognize that it only serves as the last control when all other measures fail to protect against possible contaminations.

 

To optimally protect any workplace, a hierarchy of controls needs to be determined. The concept behind this hierarchy is that the control methods at the top are the priority as they are much more effective than those at the bottom. By following this hierarchy, the risk of contamination, illness, or injury reduces substantially.

 

1. Elimination and Substitution

 

Elimination and substitution are the most effective strategies to reduce any risk in the workplace. Clearly, when we remove the original source of hazard, the accompanying risk will practically disappear or substantially be reduced. Unfortunately, these measurements are often the most difficult ones to establish. A dental practice is limited in the flexibility of its workplace, and some equipment or actions are just inevitable.

 

Examples

• Calling patient before they arrive at their appointment to confirm their health
• Asking employees who are feeling unwell or potentially contagious to stay home
• Choosing to handscale versus using an ultrasonic device on a patient with a contagious disease
• Using silver diamine fluoride on a patient with caries lesions instead of utilizing a dental handpiece

 

2. Engineering Controls

 

Less effective than elimination or substitution as engineering controls do not totally remove the risk from the workplace. However, thanks to smart engineering solutions, they try to remove the hazard at the source. The initial cost can be higher than administrative controls or PPE, but are more effective and in the long term could be more cost-effective.

 

Examples

• High Volume Evacuation to reduce spatter, spray, or aerosols to reach the clinician
• Sharps containers at point-of-use to reduce percutaneous injuries
• Instrument cassettes to hold dental instruments and prevent injuries when transporting
• Ultrasonic baths to remove bioburden during the cleaning process vs. hand scrubbing

 

3. Administrative Controls and PPE

 

As a last resort, administration controls and PPE protect when all other controls fail or where taking other measurements is not possible. Their protective role is still beneficial, particularly during a pandemic, but it is crucial to realize its priority on the hierarchy of controls.

 

Examples

• Not eating or drinking in clinical areas
• Using the engineering controls like the HVE for all aerosol generating procedures (AGP)
• Wearing utility gloves during instrument and operatory reprocessing
• Wearing protective eyewear when there is potential for chemical or infectious hazards

 

In dentistry, eliminating the source is not always possible. Engineering and work practice controls then become the highest priority. Therefore, training personnel with the correct safety procedures is essential.

 

Providing your dental practice with high-quality devices such as good HVE to reduce the aerosols during patient care can be essential to protect against infections too. Air Techniques Mojave Dry Vacuum System delivers more flow and the highest suction power of any dry vacuum system available resulting in effective aerosol capture with your HVE use. Administrative controls cover processes and standard operating procedures (SOPs) to reduce risk further.

 

Implementing a hierarchy of controls diminishes the risk of possible hazards in the workplace. However, although the controls at the top of the pyramid get the highest priority, it is the smart implementation of the right combination that will truly have the greatest impact.

Posted in Company on July 16, 2020

by, Amber Auger, RDH, MPH

 

The waterlines of a dental unit promote bacterial growth and the development of biofilms due to the dark, long narrow tubing, slow flow rates and periods of stagnation. According to OSAP (Organization for Safety, Asepsis, and Prevention), waterline contamination consists of slime-producing bacteria, fungi, and protozoans.¹ The microorganisms will begin to adhere to the walls of the tubing. As they grow, they develop a protective polysaccharide layer, which allows for the collection of even more microorganisms. Over time, they eventually break free and these heterotrophic microorganisms become planktonic-free floating microorganisms. They can find their way to areas of the tubing to grow another biofilm colony or into a patient’s mouth where they can potentially cause harm.

Monarch Lines Cleaner is a fast and effective way to shock and maintain waterlines in one single product. It gently removes biofilm from DUWL containing odor-causing bacteria in a non-corrosive solution. After the initial shock treatment, the lines only need to be treated once a week. Each treatment requires 2 oz. of the solution, which is poured directly into the water bottle undiluted.

Not all DUWL cleaners are treated equally. Monarch Lines Cleaner also meets the ADA and EPA guidelines. The product was tested in the Dental Advisor labs over a 3-month period. Bacterial concentrations met or were below 500 Colony Forming Units (CFU) per ml as recommended by the EPA. This level was observed just after a few days of treating the lines. The EPA established The Safe Drinking Water Act (SDWA). It is a federal law that protects public drinking water supplies. Under the SDWA, the acceptable CFU count is 500 CFU or less per milliliter of water.

When it comes to keeping ourselves, patients, and communities safe, cleaning DUWL should be a part of our infection control checklist and maintenance daily. Implementing the Monarch Lines Cleaner is a safe and cost-effective way to reduce biofilm contamination. Now, more than ever, our patients are aware of the importance of infection control. The Monarch line provides clinicians with the confidence of biofilm elimination our patients deserve.

Posted in Company on May 27, 2020

---

by Michelle Strange, MSDH, RDH

 

A healthcare environment is a stressful place. Years and years of medical school and training, long work days, time constraints, emotional stressors, negative patient outcomes, rapidly developing diseases, and high-pressure emergency situations make being a medical professional one of the most challenging jobs. In the wake of a pandemic, it seems anxiety has reached a new level. It’s no wonder that the stress of being a dental professional tends to have negative impacts on both their personal and professional lives.

 

You can define professional burnout as “a special type of work-related stress, or a state of physical or emotional exhaustion that also involves a sense of reduced accomplishment and loss of personal identity.” 

 

Unfortunately, dental workers are more prone to professional burnout, anxiety and depression because of the nature of their practice.1 These feelings can cause employees to experience lethargy and lowers their attention to detail, which can result in imperfect dental infection control and cause safety lapses for both clinicians and patients.

 

The problem with dental burnout is that it can harm patient safety. Health care professionals who feel emotionally exhausted raise the odds of unsafe care, unprofessional behavior, and low patient satisfaction. In fact, the odds for poor patient care double, and patients are three times more likely to give low satisfaction ratings when visiting healthcare professionals who suffer from burnout. 

 

Although this is a common issue that healthcare professionals have to deal with, there are solutions to make sure that your office is not compromised and that you are providing the safest dentist visits possible. Dentistry after COVID-19 may have dental professionals second-guessing their infection control procedures coupled with the anxiety of contracting this novel virus or any future ones. Establishing stress management programs would be advantageous to help dental professionals cope with any fears that are compounding with the already established burnout.  All dental offices should have stress management programs and do their best to accommodate the needs of their workers. Doing your best to promote the positive mental health of your dental staff is one of the best ways to ensure better health and safety for everyone. Though stress management programs may seem like fluff, in this systematic review of the literature, “courses based on mindfulness showed to be effective in improving healthcare workers’ well-being, increasing their quality of life and the productivity outcomes”.  After all, when you feel your best, you can be your best for your patients while adapting to new concerns that may arise!

 

1.  “Stress and Professional Burnout Among Newly Graduated Dentists.” Nov.-Dec. 2016.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5184387/. Accessed 5 Mar. 2020.
2.  “Job Burnout: How to Spot It and Take Action” https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/burnout/art-20046642. Accessed 5 Mar. 2020.
3.  “How Does Provider Burnout Impact Patient Care Quality, Care Access?” 6 Sep. 2018. https://patientengagementhit.com/news/how-does-provider-burnout-impact-patient-care-quality-care-access. Accessed 5 Mar. 2020
4.  “Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction”. 4 Sep. 2018 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2698144. Accessed 5 Mar. 2020
5.  “Work stress and occupational burnout among dental staff in a medical center”. Sep. 2019.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739458/. Accessed 5 Mar. 2020
6. “Stress management interventions among healthcare workers ….” 30 Jun. 2018, https://sensesandsciences.com/index.php/Senses/article/view/138. Accessed 13 Apr. 2020

Posted in Company on May 14, 2020

 

by Michelle Strange, MSDH, RDH

In any profession, it is not unusual to hear things like “I have done this for 17 years, and I haven’t had any problems. Why change now?” While relatable, it’s not a good mindset to have in the dental profession. Dentistry is always evolving, which means that we must also if we wish to offer patients the best care possible. 

In dentistry, infection control practices are not about us, but about the people who enter our facilities and sit in our chairs. Patient health must be the utmost concern, as it only takes one person catching an infection to put our practices and licenses at risk, nevermind the person’s suffering because of our mistake. 

The biggest dangers come from healthcare-associated infection, medication errors, and unsafe surgery. As documented in many studies, numerous infectious outbreaks are due to a lack of compliance with established guidelines for disinfection and sterilization. When incidents happen, patients can be affected by minor to life-threatening ways ranging from temporary to permanent injuries or even death. Patients often advocate for themselves, but at the end of the day, it’s still on us, the healthcare professionals to properly care for our patients. 

To improve the system and help prevent dental-related infections you can:12 

1. Develop relationships with your patients and embrace the importance of human connection. 
2. Avoid blaming when mistakes occur. Instead, question why the error happened and aim never to let it happen again.
3. Remember that Infection control isn’t about you or what you want to do. Do for your patients what you would want them to do for you if the roles were reversed.

Employ these strategies to improve the quality of your service and infection control to keep you, your practice, and your patients safer. 

 

1 “World Health Organization: Patient Safety” https://www.who.int/patientsafety/education/curriculum/course1_handout.pdf. Accessed 5 Mar. 2020.

2 “Disinfection and Sterilization” https://disinfectionandsterilization.org. Accessed 5 Mar. 2020.

Posted in Company on April 29, 2020

by Michelle Strange, MSDH, RDH

After working in one place for a long time, there is a human tendency to become somewhat complacent and move into an almost automated working process. However, as relaxing as this comfort is, it can cause problems because it means that you develop a particular set of responses that prevent you from being the most productive worker. Comfortable workers tend to be perceived as lazy, lack enthusiasm/passion, and settle for the bare minimum instead of going above and beyond. In the field of dentistry, this comfort can result in putting your patients’ well-being in danger.

 

One reason that people tend to become too comfortable in their working lives is because of a lack of accountability. Without accountability, unproductive behaviors are formed and can result in an environment where mistakes are the accepted norm rather than the exception.

 

In dental offices, professional mistakes often revolve around patient safety and can be something like forgetting to sterilize certain pieces of equipment. Errors like this can cause delays that upset patient satisfaction, but more seriously, they can be an indicator of lax safety rules. Many dental infection control safety guides have comprehensive directions to ensure as much as possible a reduction in healthcare-associated infections. If dental professionals lack accountability, it is all too easy for these tasks to get overlooked or done with complacency that fails to protect patients.

 

So, what can we do? Every dental practice needs to instill a sense of responsibility in their teams. The best way to increase accountability is to follow purposeful hiring practices, provide employees with clear deadlines, open clear lines of communication, have regular evaluations, and work tirelessly to have definitive expectations with clearly defined results. Accountability is the best way to build a high functioning team and limit the effects of accepted mediocrity because our patients deserve more than “just ok” when it comes to their care.

 

 

1 “4 Signs You’re Too Comfortable in Your Job”. https://www.themuse.com/advice/4-signs-youre-too-comfortable-in-your-job. Accessed 5 Mar. 2020.

2 “Accountability for your actions: Building a dental team culture that matures from its mistakes”. 1 May 2017. https://www.rdhmag.com/career-profession/personal-wellness/article/16409866/accountability-for-your-actions-building-a-dental-team-culture-that-matures-from-its-mistakes. Accessed 5 Mar. 2020.

 3 “Environmental Infection Prevention: Guidance for Continuously Maintaining a Safe Patient Care and Survey-Ready Environment” https://store.jcrinc.com/assets/1/7/nexclean_environinfectionprevention_%28002%29.pdf. Accessed 5 Mar. 2020.

4 “3 Ways to Hold Your Dental Team Accountable”. 21 Feb. 2019. https://www.dentistryiq.com/practice-management/staffing/article/16363712/3-ways-to-hold-your-dental-team-accountable. Accessed 5 Mar. 2020.