From Our Side of The Chair Issue 1

FrOomuOrSf TihdeeChair Product Spotlights Reading Your Patients Organized SYSTEM that WORKS Selecting the Right Bur System for your Practice Eye Injury Prevention in the Workplace The True Meaning of ProvisionalsSpotlightPam Kovar, EFDA

From Our Side of the ChairContinuing Education for the Chairside AssistantFREE Video, Workbooks and PDF’s to enhance the skills in every area of dental assisting.• Consultations • CAD CAM• Digital Photography • Anterior and Posterior Provisionals• Digital Radiography • Whitening• Alginate and PVS Impression Techniques • Bonding & Cementation• Infection Control Technique • Topical Fluoride, Varnish,• Chairside Charting• Rubber Dam Placement Foams and Gels• Cord Placement and Hemostatsis • Invisalign• Laboratory Communication • Inventory Control • MUCH MORE ! www.chairsideassisting.comWhat's In This Issue 16 S electing the Right Bur System for your Practice 18 E ye Injury Prevention in the Workplace 5 L ectures on the Road: 22 The True Meaning of Provisionals 6 S potlight: Pam Kovar, EFDA 24 R eading Your Patients 8 S afe and Effective Dentist- Dispensed 29 O rganized SYSTEM that WORKS 36 S treamline Inventory Control & Ordering Alternatives to OTC Whitening 13 P rocter & Gamble’s Crest Pro-Health [HD] 14 I Use Thiswww.chairsideassisting.com 2

From Our Side of the ChairEditor's NoteFor more than 25 years, I have had the pleasure and privilege to be a practicing dental assistant, lecturer, and educator within ourprofession. During that time, it has been exciting to witness all ofthe new and expanded roles and responsibilities that so many of mydental assistant colleagues have chosen to embrace. It has also beenamazing to experience the ways in which Henry Schein supports andvalues dental assistants as integral members of the dental team.Thatis why I am honored to introduce our first issue of “From Our Side ofThe Chair”, a newsletter exclusively for the dental assistant. It featurespractical and relevant content written specifically by, for, and about dental assistants, includingproducts and techniques that could help them to elevate their skills and professionalismthroughout their career. And it is all based on the experienced perspective of your peers.Thesynergy we hope to create through our newsletter is unprecedented, and it recognizes the manyways that dental assistants support dentists and their patients in achieving successful treatments,experiencing efficiency and comfort, and maintaining excellence in oral care. As dental assistantsour work sets the foundation for many treatments, and we are closely involved with patientcare. We consistently apply our skills and talents to properly and expertly prepare patientsand dentists for procedures and to ready the dental equipment and materials that enhance thetreatments we collectively help to provide. our work sets the foundation for many treatments,and we are closely involved with patient care.Therefore, it is not surprising that our duties inherently find us striving to stay abreast of productand material developments, in addition to tracking and ordering inventory. From Our Sideof The Chair is a timely resource designed to help you decide which products and resourceswould be best for your own practice based on the experiences and objective evaluations ofyour colleagues. It is also an educational medium for reinforcing or introducing proper clinicaltechniques.Forbes magazine recently identified dental assisting as the No. 1 best job for people under 25years old, it is more important than ever for dental assistants to continuously elevate their skillsand seek professional certification. Moving forward, each issue will remain dedicated to creatingsynergy among dental assisting professionals. We will strive to accomplish this by showcasingprofessional excellence and sharing information about products, techniques, and continuingeducation opportunities that enable dental assistants to enhance their skills and enjoy a fulfillingcareer. To share your thoughts and perspectives in an upcoming issue, please contact me [email protected] behalf of everyone from the Academy of Chairside Assisting, thank you for your continuedpursuit of dental assisting excellence. We hope you enjoy this first issue.With warm regards,Shannon Pace Brinker, CDA, CDDwww.chairsideassisting.com 3

It’s a new day...Revive your practice with the most effective ways to colorcode dental procedures for organization and efficiency. RESETstreamlines the training and setup time involved in implementingthe new products and techniques.The products and Efficiency Expert training on how to correctlyutilize a color code system is brought into your practice. The dentalteam will earn CE Credit while setting up the practice for optimalperformance and patient flow.THE PRODUCTSInteract with over 30 color coding products at your practiceand experience what the office would look like and howprocedures would flow through a hands-on demonstration.Learn the benefits of antimicrobial protection along with howZirc’s Safe-Lok® System and products comply to OSHA andCDC guidelines for proper infection control.THE EFFICIENCY EXPERTSAn Efficiency Expert will come into your office and demonstratehow the color code system works and assist you in implementingZirc’s organizational products into the treatment rooms andsterilization center. (Virtual consultations available)PERSONALIZED CONSULTING $1,500:Included in RESET: RESET• Each team member will earn 4 CE Credits A Fresh Start with Dental Efficiency• Complementary Workbook for Inventory Control and Supply Ordering• Custom Color Charting and Practice Logo on Supplies ordered• Free products and supplies donated by various manufacturers (valued at over $1000.00)• Free enrollment of our Academy of Chairside Assisting Online CE• Up to 2 hours of “One on One Training with our Efficiency Expert” after practice installation for further training or questionsPARTNERING FOR EFFICIENCY:Learn more about the services available and how to register: 800.328.3899

From Our Side of the ChairLectures on the Road: First half of the yearToday’s dental assistants are knowledgeable occlusion, record-taking to materials, and and efficient at performing and everything in between, CPS lectures, seminars,contributing to an increasing variety of and workshops raise your skills and preparetreatment procedures that require clinical you for what is next in cosmetic and restorativeacumen and wellrounded expertise in dentistry from your perspective.dental materials, products, and equipment.It is, therefore, essential that you activelyparticipate in clinically relevant and up-to-date continuing education programs thatdeliver instruction specifically focused onthe many roles and responsibilities of dentalassistants. Fortunately, our team of educatorsat understand this and delivers continuingeducation in a variety of formats to keepyou ahead of the game. From aesthetics toTopic Dates LocationFrom Our Side of the Chair and Be- March 8 and 8, 2018 Pacific Dental Conference in Van-coming the Whitening Specialist March 9, 2018 couver, BCTeams Role in Esthetics AACD Valley Dental Arts, MichiganWorking With You Is Killing Me March 23, 2018 Hinman Dental Atlanta, GA March 23, 2018 Hinman Dental Atlanta GAFrom Our Side of the ChairExcellence in Dental Assisting March 24, 2018 Hinman Dental Atlanta GAAestheticExcellence in Provisionals April 20, 2018 AACD Chicago, ILExcellence in Dental Materials April, 21, 2018 AACD Chicago, ILExcellence in Dental Assisting April 26, 2018 Star of the North Minn St PaulExcellence in Patient Coordinators April 27, 2018 Star of the North Minn St PaulExcellence in Ortho Essentials May 18, 2018 CDAWhitening to Restorative June 8, 2018 AGD in New OrleansTo register for any of the continuing education opportunities listed below, visit us at www.chairsideassisting.com or e-mail Shannon Pace Brinker at [email protected] 5

From Our Side of the Chair Dental Assistant SpotlightSpotlight Pam Kovar, EFDA Q. H ow long have you been a dental assistant? I've been a dental assistant for 15 years. Q. Where do you work? Before moving to Dallas, TX in 2016 I worked for Drs. Tony and Mary Gadbois in Columbia, MO for 11 years. I currently work for Dr. Kelli Slate in Dallas, TX. Q. W hat is your background and how did you get started in dentistry?  My childhood dentist got me started in dentistry. I was on summer break from the University of MO and he called looking for a dental assistant. I had no clue who or what that was! I just knew I loved going to the dentist! I had orthodontics as a child, and later had bonding on my peg laterals. I’ve spent plenty of time in the chair! I can vividly remember getting tooth shaped cookies on my 16th birthday from my dentist. In 2005, I moved to Cherry Hill Dental (Drs. Gad- bois) where I furthered my education in dental assisting. Within two years I completed every ex- panded function that existed in MO. Once direct re- storative came out for class II fillings, I was amongst the first in the state, licensed. In 2006, I started teaching our dental assisting course and helped develop the course with Drs. Gadbois. I discovered a new passion for education while teaching our sessions. Dr. Tony Gadbois started his accreditation for the AACD several years ago. I was his chairside assis- tant for each case. The dedication we all had for him to make this accomplishment was intense. I am proud to say he passed his accreditation this yearwww.chairsideassisting.com 6

From Our Side of the Chair Dental Assistant Spotlight(2018). I am honored to have been involved in Q. If there is one word to describe you whateach of those cases. would it be? I have been very fortunate to attend dozens of Grace. Learn to have it, always give the benefit of“doctor only” courses. Dr. Gadbois was a huge doubt.advocate for continuing education. We studiedmany new procedures at these courses. Because Q. W hat last words of inspiration would youof our continuing education, we were better give new dental assistants coming to theequipped to treat our patients with the latest profession?  and best dentistry. We continued our educa- Don’t forget your WHY. Why did you start in den-tion in sinus augmentation; implant placement, tistry? I started because I wanted to help people.Pinhole technique, CBCT scans, Invisalign, and For me, seeing someone cry because I have helpedmuch more! transform their smile, life, and outlook is what drivesCurrently, I am the practice Administrator for me and keeps me in the business. The day-to-dayDr. Slate in Dallas. Together, we have taken her grind can often bog us down. Don’t forget to stop,practice to new heights! We converted her prac- be still, and embrace the change you are making intice from paper charts to paperless. We have your patients lives. It is incredible what we can dogone fully digital with medical histories, upgrad- now to transform a smile. Changing lives by chang-ed equipment, and most recently, purchased ing smiles is WHY I stay in dentistry.our iTero scanner. I helped treat over 1100 In-visalign cases in my former practice, so Dr. Slateis confident we can bring her practice to thenext level! We have revamped her HR policiesand procedures. I have worked closely with oursupplier to lower supply costs, labs costs, etc. Iam excited about the potential for her practicein the Lakewood area of East Dallas. Dr. Slatehas been an advocate for “if we need it, buy it”,“whatever will make us more efficient, do it.” Ithas been an exciting times for her practice thelast year and half.www.chairsideassisting.com 7

From Our Side of the ChairSafe and Effective Dentist-Dispensed Alternatives toOTC Whitening Shannon Pace Brinker, CDD, CDAINTRODUCTION many patients are unaware of the risks (i.e., demineralization, gingival irritation, toothTooth whitening is a growing market, sensitivity, damage to the pulp, etc.) associated with more people investing their time with whitening without dental supervision.and resources into achieving whiter smiles. These potential side effects can causeHowever, with the wide availability of products, permanent trauma to otherwise healthy tooth structure. Therefore, it is the dental team’s responsibility to ensure patients are educated about tooth whitening and offered safe tooth whitening options that meet their clinical and lifestyle needs. When a whitening gel is applied to the surface of a tooth, the bleaching agent (i.e., hydrogen peroxide, carbamide peroxide, etc.) enters the enamel and dentin, producing a chemical oxidizing action with the discolored particles within the tooth structure.1-3 The low molecular weight of the bleaching agent (e.g., hydrogen peroxide) enables it to diffuse through the tooth’s organic matrix.1 Although the mechanism of action is still not fully understood, hydrogen peroxide and peroxide derivatives have been shown to safely and effectively treat stains and whiten enamel under dental supervision.4 However, without proper diagnosis, instructions, and monitoring by a dentist, the powerful chemicals can lead to permanent damage to the teeth and gingivae.5Figure 1. Pre Operative Full Facewww.chairsideassisting.com 8

From Our Side of the ChairFigure 2a. Pre Operative Smile Figure 2b. P re Operative A1Importance of Dental Supervision the staff at these kiosks may look like health care professionals, without formal regulations, they mayAlthough other types of whitening, such as over- have no proper dental training and no licenses tothe-counter (OTC) or whitening kiosks, use low provide health care services.5 By educating patientsconcentrations of active ingredients, they can still about the potential dangers from unsupervisedcause adverse side effects. Patient discomfort is a whitening, dental professionals can protect theirfrequent complaint associated with OTC whitening patients and offer the most appropriate alternativetreatments. Individuals experience discomfort (i.e., whitening options based on individual patientgel, tray, or strip movement) and improper coverage needs, type of discoloration, and overall oral healthfrom various OTC applications (i.e., trays, strips, gels, conditions.oral rinses, toothpastes, etc.). Ideal Whitening SolutionsAdditionally, a study completed by Potgieter etal. compared several different OTC treatments In-office whitening uses a high concentration hydro-and found that some OTC products had no gen peroxide bleaching agent for a single in-officesignificant bleaching effect at all.6 Some OTC treatment. Although effective in brightening teeth, itproducts have also been shown to decrease enamel is the most expensive treatment option. For patientsmicrohardness.7 Although many patients consider who desire a cost-effective alternative, dentist-dis-OTC treatments harmless, they can put patients at pensed at-home treatments are an ideal solution.risk for potentially damaging healthy tooth structure,increasing tooth sensitivity, and causing uneven Instead of a single office visit, patients can whiten atesthetic results. their convenience with a customized plan created by their dentist. Take-home treatments use customizedThe damaging effects of whitening kiosks are still or prefilled trays to apply the gel to the teeth. Somesomewhat unknown. However, the risks associated patients prefer pre-filled trays for more convenientwith OTC whitening are also potential side effects whitening. However, all types of whitening canfor kiosk whitening, including damage to hard and cause patient discomfort (i.e., ill-tasting material,soft tissues. According to the American Dental gel movement, tray displacement, difficult cleanup,Association, some states have chosen to ban these etc.) and sensitivity. Thus, new advanced whiteningwhitening kiosks for safety reasons.5 Although alternatives, such as dentist dispensed prefilled trays,www.chairsideassisting.com 9

From Our Side of the ChairFigure 3a. Post Operative Smile Figure 3b. Post Operative Shade W3 Figure 4. Post Operative Full Facehave been created to offer patients the convenience extrinsic, intrinsic, and internalized stains. Dent Update.of OTC treatments with the effectiveness and safety 2005;32(8):463-4, 466-8, 471.of dentist supervised whitening. 4. Viscio D, Gaffar A, Fakhry-Smith S. Present and future technologies of tooth whitening. Compend ContinConclusion Educ Dent Suppl. 2000;(28):S36-43; quiz 49. 5. American Dental Association. Tooth whitening whatDentist dispensed prefilled trays are an ideal you should know. JADA. 2009;140(3):384.option for on-the-go whitening. They combine the 6. Potgieter E. Grobler SR. Whitening efficacy of threeconvenience of OTC products (i.e., use right out of over-the-counter oral rinses. SADJ. 2011;66(3):128-31.the package, easy disposal, simple cleanup, etc.) 7. Majeed A, Grobler SR, Moola MH, et al. Effect of fourwith the benefits of dental supervision. The prefilled over-the-counter tooth-whitening products on enameltrays securely and comfortably mold to an individual’s microhardness. SADJ. 2011;69(9):412-5.teeth for appropriate contact of the active whitening 8. Wang Y, Gao J, Jiang T, et al. Evaluation of theingredients. They eliminate the need for impressions, efficacy of potassium nitrate and sodium fluoridemodels, and laboratory time. This gives patients a as desensitizing agents during tooth bleachingcustom-like fit with the out-of-the-box convenience treatment—a systematic review and meta-analysis. Jthey desire for a cost-effective, safe, easy-to-use at- Dent. 2015 Apr 22. Pi: S0300-5712(15)00083-4. [Epub ahead of print].home whitening option. • 9. Tam L. Effect of potassium nitrate and fluoride on carbamide peroxide bleaching. Quintessence Int.References 2001;32(10):766-70. 1. Goldberg M, Grootveld M, Lynch E. Undesirable and 10. Al-Qunaian TA. The effect of whitening agents on adverse effects of tooth-whitening products: a review. caries susceptibility of human enamel. Oper Dent. Clin Oral Investig. 2010;14(1):1-10. 2005;30(2):265-70. 11. Basting RT, Rodrigues AL Jr, Serra MC. The effects 2. Sarrett DC. Tooth whitening today. J Am Dent Assoc. of seven carbamide peroxide bleaching agents on 2002;133(11):1535-8; quiz 1541. enamel microhardness over time. J Am Dent Assoc. 3. Sulieman M. An overview of tooth discoloration: 2003;134(10):1335-42.www.chairsideassisting.com 10

THEAPPROACH TO HEMOSTASIS• SPECIALLY DESIGNED for the esthetic zone • TRANSPARENT GEL stays on the sulcus • LEAVES NO RESIDUE and rinses off easily • DOES NOT INTERFERE with bondingViscoStat®Clear 800.552.5512 U LT R A D E N T. C O M25% aluminum chloride

ViscoStat®Clear25% aluminum chloride ACHIEVE HEMOSTASIS . . . ESTHETICALLY This viscous yet spreadable 25% aluminum chloride gel quickly stops minor bleeding and sulcular fluid without the mess of a liquid or paste.Subgingival preparation and Rub hemostatic firmly against Press Ultrapak® cord into Remove cord. Firm air/waterbleeding sulcus. bleeding tissues. Achieve the gel in sulcus around tooth spray. Air dry. Rub gel into most rapid hemostasis with the preparations. the sulcus again. Metal Dento-Infusor® tip. The Leave 4–5 minutes. Leave 1 minute. clear gel allows easy visibility and rinses away quickly.Final rinse. Dry and make Finished restoration 2 weeks • SPECIALLY DESIGNED for the esthetic zoneimpression. Repeat above steps post-op. Facilitates great • TRANSPARENT GEL stays on the sulcusif needed. control in the esthetic zone • LEAVES NO RESIDUE and rinses off easily with no residue. • DOES NOT INTERFERE with bonding*6407 ViscoStat Clear Dento-Infusor IndiSpense Kit 6409 ViscoStat Clear Dento-Infusor Kit 1 x 30 ml IndiSpense syringe 4 x 1.2 ml syringes 20 x Metal Dento-Infusor tips 20 x Metal Dento-Infusor tips 20 x 1.2 ml empty syringes6408 ViscoStat Clear IndiSpense Refill 6410 ViscoStat Clear Econo Refill 1 x 30 ml IndiSpense syringe 20 x 1.2 ml syringes *Data on file Improving Oral Health Globally800.552.5512 U LT R A D E N T. C O M© 2017 Ultradent Products, Inc. All Rights Reserved.98035.13 110916

From Our Side of the ChairProcter & Gamble’s Crest Pro-Health [HD] Crest Pro-Health [HD] by Procter & Gamble, a two-step system that effectively treats gingivalContemporary Product Solutions presents its review on this inflammation and offers a new level of clean.two-step dentifrice and whitening gel system. Patients are attracted to Crest Pro-HealthUntil recently, there have been limited over-the-counter (OTC) treatment [HD] because they want a whiter smile. options for improving gingival inflammation. Conventional treatments However, we, as dental professionals, for patients with gingivitis often exhibit negative side effects (i.e., staining, understand that Crest Pro-Health [HD] isunpleasant taste, etc.), making it difficult for patient compliance and for dental also a necessary treatment for manyprofessionals to recommend them. Developed to deliver the next advanced patients to improve gingival inflammation,over-the-counter product for treating gingivitis, Procter & Gamble introduced plaque build-up, and overall oral health.Crest Pro-Health [HD], a two-step system that effectively treats gingival irrita-tion and offers a new level of clean that is noticeable by consumers. – Stacy Gagne, RDH, from Innovative Smiles at the ForumThe therapeutic ingredient is separated from the stain mitigation technology, thus each Everyone felt it was well worth thestep can be individually optimized, achieving superior cleaning and effective whitening. change in tooth paste.A recent evaluation conducted by Contemporary Product Solutions solicited the opinionsof 21 dental team members after they offered Crest Pro-Health [HD] in their practices. –The DentalTeam from Greenbrier Dental CareAll of those that responded to the evaluation stated that they offered chlorhexidine Being able to offer benefits comparableproducts to their patients, with 70% of them offering chlorhexidine for periodontal therapy. to chlorhexidine and with the addedHowever, 86% of survey respondents stated that their patients experienced a negative whitening definitely makes me excitedresponse to chlorhexidine because of staining, and 50% said their patients reported an about this product!unpleasant taste with use. The first step in Crest Pro-Health [HD] is an anti-plaque andanti-gingivitis dentifrice with stabilized stannous fluoride. This first step delivers optimized – Christie Mikolajczyk, CDA, EDDA, from Briarwood Dental Careantibacterial activity because the stannous fluoride is highly bioavailable. ConclusionThe anti-bacterial mechanism-of-action of stannous fluoride is not the same as other anti- Patient acceptance, compliance, andbacterial agents (e.g., Triclosan). Triclosan’s mechanism-of-action is killing bacteria, and results can be difficult to obtain with thealthough stannous fluoride does kill bacteria, its main mechanism-of-action is interfer- variety of OTC products available. Withing with the metabolic activities of bacteria. This in turn leads to a reduction in bacteria Crest Pro-Health [HD] patients receiveproliferation. effective plaque removal, gingival health benefits, and excellent whitening resultsOf those surveyed, 75% of respondents said that patients refused fluoride application all in one package. The unique two-stepbecause of financial reasons. With Crest Pro-Health [HD], patients receive daily fluoride system improves the efficacy of bothwithin the first step of application. After use, the majority of studies evaluating Crest components, maximizing the oral healthPro-Health [HD] showed a greater than 30% plaque reduction and significant improve- results that can be achieved. Overall,ment in gingival bleeding in as little as one week. Because of the enhanced anti-bacterial evaluators rated Crest Pro-Health [HD] aefficacy, users also notice a significant breath freshness. All of the dental professionals 4 on the 5-point diamond scale.who responded to the evaluation agreed that a product with fluoride, with comparableanti-gingivitis efficacy to chlorhexidine rinse, and whitening capabilities would be a valuabletreatment for their patients. Photographs courtesy of Greenbrier Dental Center, Chesapeake, Virginia.www.chairsideassisting.com 13

From Our Side of the ChairProduct SpotlightsI Use ThisChromaclone 5-Day AlginateManufactured by UltradentIn your busy dental office, every second counts. Every extra minuteyou save lets you breathe a little easier. With Chromaclone you’ll getmore than a few extra minutes–you’ll get a few extra days. That’s becauseChromaclone’s new formulation offers a full five days to pour your impressions,not just the few hours you’re used to.*And as always, Chromaclone 5-day offers the same dust-free formula andreliable set times you depend on. The Fast Set time (53 seconds) features aconvenient color-changing formula, while the Extra Fast Set time (45 seconds)is ideal for both young and sensitive patients. Both formulas are available in apleasant Bubble Gum flavor.• Dimensionally stable up to five days • Highly accurate• G reat Bubble Gum flavor • F ast Set changes color• Dust-free mixing • Extra Fast Set is ideal for• S ilicone-like consistency sensitive patients*Wrap the impression with a damp paper towel and store in a sealed plastic bag at room temperature (23°C/73°F) to ensure dimensional stabilityfor up to five days.Cranberry Carbon® Nitrile GlovesManufactured by CranberryCarbon® Nitrile gloves feature distinct black color to minimize visiblestains during use, enhanced fingertip texture for superior handling andincreased control.200-count Saver Pack reduces storage space and packaging waste. • D istinct black color minimizes the appearance of stains • F ingertip texture provides superior handling and increased control • 2 00 saver pack maximizes storage space and reduces waste • 200 pieces per box by weight. Available in sizes xs-xl • Black colorAvailable in sizes XS-XL • 3 237 (Medium) • 3 238 (Large) • 3235 (X-Small) • 3236 (Small) • 3 239 (X-Large)www.chairsideassisting.com 14

From Our Side of the Chair Product SpotlightsCocoflossManufactured by CocoflossKeeping our teeth for life is tricky (and rare) in our world full of piñacoladas and other sugary temptations. Floss the teeth you want to keep!Typical flosses are smooth and flat. They slip. They slide. ExperienceCocofloss – the loofah for your smile! Hundreds of filaments scrub awayplaque and grime to leave your gums purified. Coconut oil soothes yoursmile while tropical fruit fragrances exude delight. Made of 500+ strong,grime-catching filaments, Cocofloss scrubs like a loofah to leave yoursurfaces truly clean. • S ingle unit of Cocofloss (32 yds each), a super cleansing, soft, textured dental floss to refresh your smile • Infused with microcrystalline wax, coconut oil, fruit oils, and fragrancesCocofloss aromas are made from a combination of natural and syntheticingredients from a fragrance shop in Italy. If you’re interested in an allnatural fragrance, the mint variety is 100% naturally fragranced. Mint ingredients include spearmint oil, cornmint oil,anise camphor, and menthol.Ivory ReLeafManufactured by KulzerReLeaf has the ability to empower both the patient and the practitionerby allowing hands-free suction while providing continuous comfort.A new, innovative device that assists practitioners with evacuation,retraction, and maintaining a dry field during scaling, polishing, andrestorative procedures. It allows for hands free suction while enabling thepractitioner to work in all four quad-rants easily and efficiently. ReLeaf isthe solution for dental clinics that allows the patient and practitioner tofeel empowered. It ensures that every practitioner can continually providecomfort and efficiency to any dental appointment. With 280 degrees ofsuction, you never have to worry about suction location again.www.chairsideassisting.com 15

The Bu bur blo availab lid tha discardSSSSeyslyeetecsltmientfgoecrthytmeoiuRnrigPhfgrtaoBctutrircheyeMoRurigPhrtaBctuicr eShannon Pace Brinker, CDA, CDD odern dental practices are equipped to perform various treat- not move ments and procedures. These procedures consist of fillings, cording to inlays, onlays, veneers, crowns, bridges, implants, post and core, end- lid that ca odontics, provisionals, and various removable appliances. With these instrumen procedures the dental team bust be efficient and organized with ma- lid is fully terials, instruments and burs. All of these procedures require dental tools or burs that can consist of hundreds of sizes, shapes and grits.A Slahragnenaomn oPuancteoBfriunnkneer,cCesDsDar,yCtDimAe is spent Every dental professional has his or her favorite burs according to A recent e solicited tAin ldaerngtael parmactoicuens tevoefryudnany eoncehasnsdalirnyg tbiumrse itmshuespstrpboeceehdeunarte-t,stbeiurntilitzhededd,eeifnnttahltetyaeaalmrepfnaolrltaindtciospttohisceabcealete.sgPolearycivonfgeitberumyrss itdnhtaoat y on Shofu Denphabstanlreoodnrcickfdliieltzlehiissnnas.gtgT,oahabifednudssntriernoseedstrathionenecxgdkpisi,rtnofssgicl.fteeoesrssr.aiolfiTuzsnhitnioeqgruienn, geba,uenrdd exiimsnudtmisvidefuffoaiclirebnuacryb, lauoncdnksdiiiqnscsoiuduereaogfebsincsurtorurssm-bceonnltotcaamcssinketatteitsohnprcaoavutisdeeads ibmdyarxsei-- in the 99%) foun restocking.trieving burs from a common bur block during treatment. Burs are size was a comment a significant expense to dental offices, and such inefficient manage- are curren ment of burs increases this expense. A large amount of unnecessary ter placin time is spent in dental practices every day on handling burs and files. fall out. W the removModern dental practices are equipped to perTi-nhge, nsteeerdidliezxeiinsngts,tfaaonlrdaoruefnsftiioqccuekeisnb,ug,rabbnulotdcekasstuhyacttohaiiddisenninetiftfyhfiebcpyireuoscnientsgsmoafcasotnolorar- gement bur holes form various treatments and procedures. coordinaotedf sbysuterms.increases this expense. A large amount of blocks, al allowed s easier witvTeenhndeesoeedrops,nrocticrcoeswd, upnrsreo, svbicrsioidongnseaisslst,,oimafnpfdilllaivnnagtrssi,o,puinoslsarteymas,noodvnaclbaoylrtSTeeshhy,a,etsBhtoeulrmdBduasusnaatullelnytnrbheuobiaqcrynsteuSshsewehcosaufoaburnreruDlkdyyrelintnibnitmaplglloaCeccboekriuwsptiortshsrhapoatauieottnnndaduitismdfiainpslsieniildgisnce.ootnrnThesthpebaieulllprinpnbrgloreooacecucktedtsicesexosisfetssvtoeforr-yr from the and weigh operatoryappliances. With these procedures the dental teaofmthe blionckg. ,Thseteunriqliuzeinpgate,natenddhorleedsetsoigcnkwinitgh ,rebveurste efluatsinyg to identify stood updsbteurusntmtabelentotesofflaiscniodernbbtuuarrnss.dtAholalrgtoacfnatnihzeecsdoenwpsiirtsohtcomefdahutuerenrisdalrrsee,dqisnuhhsa-elieiolrrglotpehfwiootsnertgmhaabSenpndebiyzyruearreutsfsumostrtroeoiepnvsrratemgaalscyiostaiitfscnaetnhcptetelofasfhicibllceiouicaerwornsnth.cceiAyl.oewbvaadoisiloseraidbnmrlfeiekanctietnairnitaagelvodmarraaisekutyetyosscoftlofaervcmieonalgos..yrsTihntoe- clear lid w blocks we of each b comment helped tosdihtTbiaeuuhzresemrsBeisnuhs,,roiBnsbsutethhuloseaaertrctaputlhrsmheeoeebsauurlrlasodfbwtanleosvdbcntkoh.etegradirheltineetttsaealb.atculE-minsrvitcseiefaaarnryilctlloicdzimoneeixtrdnodan,tidantihmflgaetpthctrhcoeouaypfttetheaosegr1se0iopornrnyooacotTaemlenahfisdex-yBastohnuodrprlBTcwumtauconhsaiethtlnieceaahqhrnneouBkdbu.yubperuTeSturmhhopBedroo1afuvBub0uetutmbeliwlrsoueBniarptcurvshttkaieilblnieoldratngyobhagnlhl-eSaesoloaoihtsnrsetlaohcieaslnullfopolgruwdesliahdlsnbeDladuistnsnhrekdieaggbsunldlrionnltaeocabcnbklulwtlue.audtBClpiirtulcnoushorlgigsfnrssFariptectrGehheioac,vaevnCtureedaArtrrbooyte,silelooyncfilknui.stpTianlhagsecilei- comment and color als, nightgdisposable. Placing burs into individual bur blocks allows the burs to stay in place while disinfecting orinside of instrument cassettes provides maximum autoclaving. The high temperature resistant siliconeefficiency, and discourages cross-contamination base material makes for easy insertion and removalcaused by retrieving burs from a common bur block of the burs. Available in a variety of colors to helpduring treatment. Burs are a significant expense to organize for practice efficiency.www.chairsideassisting.com 16

The BurButler by Shofu Dental Corporation is a silicone From Our Side of the Chair The BbuurrBbluotclketrhbatyhSohldosfbuuDrsesnectuarleClyoirnppolaracetiaonndiasre a silicaovanielabbluerinbfliovcekastshoartehdoclodlosrbs.uTrhsesreecmuorvealybleinclear placelidanthdatacreanabveauilsaebdlaesibnafsieveduarisnsgoprrteocdedcuorelosrtso. bThaeserdedismucaroirnvdgaubspelerdocrcoleetadaruryrlieindsstttrhouamdteicnsatcsna.rbdeuusesedd as rotary instruments. The Bur Butler by Shofu is available in all shanks including FG, CA, and short shank. The BurButler also allows the dental clinician to mix and match up to 10 burs in one secure bur block. Burs are very easy to place andt- remove wnoithmlooven.gT-hleabsltoinckgs aarne davadiluabralebinlefipveluasgssortehdactodloors to sort ac-gs,d-Selecting the Right Bur Msea-System for your Practicealts.toatto i-e-ree-ryes. r-orckut cnBaosoultrboBmarussotetlveodelcliriinoddsu.shrotritdTrashiriunhnaftsmutggealaceltycabnpornctaelrvsuoobo,amteorcrocdirukcooelpissuavdnelvsadaaguacpbbraerretlsdeoleoebcstaaoeanvcvdtstdoealuaherdresieadlieuasoscriri.budsuiTnlreclisehgedadefppuroitBdrrnrrhoiuonecaurfagceiBtssdvepyueucerdtvroadleeiuacenrsewrsrtdheosobiuansotsedrga.eri.asrstTuc.yerhaEsedrimeeadncdo-huvsbaelbdoiolntbcedraklooaucntyalnarensomttrsa,isddycroeeisnnnsr,tlnapsatriydhodasev,nenividstteisaonwplinelrpieaaocrrlcsssoa,e,cnadcatniruecodgreweshvrsnea.aosrra,Tileobdthureeeikqssdrunerg,eieopmnpspw,rooeoimvidncnaepebtdgolluaeonrapaetfepfssrt,tpfephoclioorraemnsnptscbailevsanusta.dcrrWoisiconfouiwtgrfsheiol,tlttriehuhneneagledsdtse--, acoTDpbuAEsfsSbaAiotnotathafurhnelreraretmluoceraCnedddoacehrmncbtchmtcerraikanfibeslblagoescinolieonlyiyelnetm(ztroccennithstsi.atfsAeSsaa9obtafbcavkacstespaaerhnioiornalh9upleaPzlioesldllrl.ok,oeeslm.eo%drlmolalrgeeimvtiac,eedceppworcnfertowTeca,k)hmacwuciaweurhl9duoterarseatttonmvfeheltrAieaaoa,edhtoDen9cwuanulrdhiap.idsanertiueoetgBaednsy%einagcWsyhsnnaltttnvlnlnhaensbueomhgarhdstltap.ttwetedvntaoddliti)imiieloacloidsatpayootnroewrtiehtucfwhlcoreltttroBesefrhnhuoeunshktkeoieetcpeoeeiadjtetnfaucssae.auadeueinhhsrcastibdsnifttclbSrgsnrriaseiseullnjueftuutoiitthlel,eButotgul,oyeroothrBebnddovisewnrsoiCt.scnzesncu-dlneweltvhrinoSlacuooxkhttcnstgreDgydraiethtemeeoBohcabnokhptioBlirsthennvekoliunAoyuolsrape-fmiiceeeraeutnmcatredlsrBtnycu2mrhaub,paeiolsBreuettassut4sdsyktealseS.Cgatbnolaulylhecceiidrynsreoe9psd.det.AttsfaDueltervdbetosdeBlarixWioresc2hoveaeenleddacoslascsuiDunraylarmcit%cckiwrertihabtstaolsvrtbstntodrliwlhuktsehlielvenceyyaoiynoacaeagtnouearlbzaeaegoanheneott.slCnssysvleor.afTstoatelbtssAfiuotaoishoro.rebseobionSfhglussllkhTwrtsonrnemesuapnbmce,ieechtgeeealltthtltaactridkloitweadiieoaoteteoctlveoqednamemnhoitApsohsrhinmtebrcporneirtufeein,adipemooerttsiicialrwtpayfdnrcehonewoxemsonhvawlanlwke,padaarolttcitcean9Slrgpaasdthndssshsannohpbueehe2strdlaeaneeh,pfeedepfeutygea%tocurlrisdautodshcostlyeeitemaonahetPrtgfrssgueeudobaatfftoncrnwutenrrinhhunn2reyrvfbootsderituetteteeemeedc-thhoruad4ha-dtrrvr.eocrtsheuerueesoleaasubs.-ekbiancalverbbsrunuwntesireeelueqryadtoioocSavewritu-titbucwyofsoadnthhSEttmiTptmttacimekelornnlloerihroicoWcwbitwtwmftioogeeruwhuevewmsytntnsih-rassouuugdeoeorcooheon,eteastplihiogeieenbbh,t(slsmgiiklaagvceowrtrrhhtpatshvobaailmtunottuutoidseelyesintrr.hanlyrihphcsibcunneeeetiolrndeaeerrrbosideooefib,eerhdddsyy.eeeenodrssssg-fmekru,enruffcarssghiieumdfauecnpirsfeuiabibbthltbnamaeeuncetdsfeirelaeeuouutinzes.ittusnsvuxdurfnebrrarsrciatraotthtitnsWnrreusslutrkshtytsufhtheet-digcmvtiyertrhipfene,shhxstbrneh,yrelositeoeAFCawEDrbdptbeeae,oddttefcaeadaoosdlArlruieomanrlehmr.rairtnreoa,runefoCnDsrmitrtinetngletnBacdnctiliitDuecssicasgacistnhasfiajdtaadia.tenkzcpehtwisstueftaketaamrnaanulteeuoiseohtweeeelnodncarnlooasssdrtrahsdnscsdoplosteicoimrpdndet,cat,rtnuoesrhtiistePoimoetordeaqrtacfhaloi.lsrydatbhiofanndab’fniktlcaouomkietishmezuceiodd2NoslkshdtnuoiotnnehvlwDmtnir0aarqfheeeuinnoorsireiidabe0nsdeeboltcocresettaxnyth.au9snpoustcuogetcyigretscot,potosllteAofssu,iaperekehaaaeblfsea2faekcRtoaoStppISpSaorlbesiltbin.pnun0muDnnmtueeprlnphhswfharrsbihdAvoufs1txlfeepsaerooncaeassdSoosouceisesen0iaithmtnodvornneaScesttlforcrcfrbg,ncanhiaieoertuirarrnn.Ceernlofeod.aays2ektirl2ikutoleacvdoolssfoalnstAaEfroevf0Ihl0ftclhpst2nn,ayttndtomittvbrdstasic1mcco1ursi-ein5ena,cuhrteyeetauaion2yPtdlk1epceluoelecsottseiedaErhcotwnay.mnrta,rpoettrivemToetynadrrttwasootsacodmtdmonio2esnofhohgtaiaeeppletdmpriowavatdu0isltoeettetntwaouoaSoionistiv1larBcahdmtererpfhlcdvdarpncoruaooe3yonsraaimiishmhafdetenae.nnsnens’i,lezaciaecomsrsrsnetnadaeetifblsrneSdbhcsyaivrgeiiaijyzlksrkrenThthtennseuunowatnoCdlaneeteeePaoosvhtierodeidtteditahchseru4suisrfrpstaitnrrmeB.e,tnrelatdeetlyioi,bhoeitea2nnrtuaengsieotig3twetC1Phldsnouhsle0naeaiinwbftatoiaf0bnraDeuiatashldg1,6asotfacntdgrred0nanprhherpnylAcoim4uldnfsaoaotcioycotershprio,wrr.bfCt@aepncetoizeBtulroiooueraSnebwclCedSuDedooansntueehqsfitseobsnvdtchccrnitDmnauurfsdgemnithtiuhlulpDehuicseeteooiwvsDaanutieosdeieec.srensioisaeettbwreart,rwrsimrgnahyrflusmesaepwwnBiariaeeomocdersumoBenasiahmdiyanthiccnoodlNoautrntdlseonars.fdughtshaded.meihbfhumassAreotnontiassSmaucasdgro,ethynsoesepbfrczhhletasugomiieaftlniraltswabsanliaonaallthgtteaoryn.neiorlxetTdeetne-nnhhtorettareettedaroaSreissdsacsnooioyieer-----.rhtpcl..smeodloorc-Ehta.dlmonfa1ryernemyn0itbcnaknd0hti.ao,ntneennadeddlsng stood up to sterilization temperatures in the autoclave andTbhifelotBhcuekrsBuwtleerrebyhSehoaftusDteenrtialilzCeodr,potrhaetioren iws aa ssilnicoonseigbunrifbicloacnk tThe chccobloofleeommlaepcrakemmcdslhieewdnntboettwleeroeddpocruhkbtehleyvddaeehtyoncaschtwvtueairamnrnunigglsetietezntihdentodeegvtd,hdetoerrhnnaeobtiirnrutmehrhcweehbo.aaulbNesntuslngoeroeostrne.tisdnoAitghalhntelfhaitbofeevifroecstatoimtnhlovitecomeocrrdheno4eaeofn3nptb6tghataeielBsoiebaunn.usrsashohtstSrhbctbcelhiofeiBelshrgbahhloefvtlyuttpthlaoewhiesolaatonhiiorlehctcdszennnatoerdkersskatlbgmlgghdaealvoenhpeesnnicdenbiaekztriilugaelnna.lrpretblTfsumottteuharthhhroreoedsspeeevsrsursatetaienaldlssoscciyiiiodtsqurliitafaipurcnasceneteinrholnpoeyttepelnsfasfvifahicnibetelcceeoeiuicpnonearwblolnstetamcneh.accsdheirAyeslmu.ebvoehwbsaadoe.niistlitllosenieShanitbnotcmehdgleufkeeveeatdscteioiddetngbirruntnnoaiahomagclltwetvpohumctaiyirtonemrohaaigmwekmuberteotyeaosnrumvoncofetsrloffpreetasrsevi.ctdneliFeolhdnAiotalfnlegenolsluglot.yrldowthsTboiiornuhneutusogef-torn… n- to A,to and color for smaller procedures and laboratory burs for provbisuiornb- utler to have more options of size and colorry als, nightguards and removables. TfhoerBsumr Baultlleerr bpyrSohcoefudius raevasilaabnledinlaablloshraantkosriyncbluudrisngfoFGr ,pCrAo,-do mavniidxsiasohnondramt lssaht,cahnnkiug.phTthtoge1uB0uabrruBdrusstilnearnoandlesorseeacmlulorowevsbauthbrebleldosecnk.t.•aBl ucrlisnaicreiavnertoy aFTbniughdreusBmrienura:oBtnTucethhlseeerucBapulursetoroBbauu1lrlto0lbwelbosrcutakhrl.essodineanoltlanolewclssinetichciuearnedteobnmutiraxlbaclnoldicnmkic.aitacnh utpotmo 1ix0 easy to place and remove with long-lasting and durable plugs that do www.chairsideassisting.com 17

From Our Side of the ChairEye Injury Preventionin the Workplace Shannon Pace Brinker, CDD, CDAAccording to the Centers for Disease Control causing blunt force trauma to the eyeball or eye and Prevention (CDC), each day about 2,000 socket. Chemical and thermal burns to one or bothworkers in the United States experience a job-re- of the eyes are also common.lated eye injury that requires medical treatment.1About one third of these injuries are treated in hos- Dentistry is not immune to these eye-related inju-pital emergency departments, and more than 100 ries. In fact, dental staff members are prone to suchof these injuries result in one or more days of lost eye injuries as particles abrading the eye, chemicalwork.1 An estimate from the Occupational Safety and thermal burns, and ocular exposure as a resultand Health Administration (OSHA) states that in the of inadequate eye protection. In both the health-United States each year, thousands of people are care sector and society as a whole, ocular healthblinded from work-related eye injuries that could is becoming increasingly important because unde-have been prevented with the proper selection and tected and untreated ocular conditions and injuriesuse of eye and face protection.2 Eye injuries in the can lead to vision loss and blindness.3 Convention-United States alone cost more than $300 million ally, safety organizations such as Organization forper year in medical expenses, worker compensa- Safety, Asepsis and Prevention (OSAP) and OSHAtion, and lost production time.2 have judiciously focused on preventing the spread of infection, which has led to marginal educationData from the CDC indicates that the majority of regarding the eye-related injury risks associatedthese eye-related injuries result from small particles with dental practice.or objects striking or abrading the eye.1 Exam-ples of small particles include metal slivers, dust, Both OSHA and OSAP have specific guidelines forcement chips, and wood chips that are ejected eye protection to prevent the spread and infectionby tools, wind-blown, or fall from above a worker. of blood borne pathogens and diseases, but neitherLarger objects may also come in contact with the organization has standards acknowledging the riskeye or face, or a worker may run into an object, of eye injuries. Similarly, the CDC recommends the use of protective eyewear for dental and healthcarewww.chairsideassisting.com 18

From Our Side of the Chairprofessionals to protect the mucous membranes of required usage during restorative procedures.10 Allthe eyes from contact with microorganisms, but not dental professionals and patients are thus at risk foragainst other eye-related injuries.4 Further consid- eye injuries due to the activities involved in dentaleration is necessary to address eye injuries in dental treatments.practice and preventative measures to reduce thenumber of eye injury incidences. For example, any dental procedures involving high speed rotary instrumentation (180,000 rpmEye Injuries in Dental Practice to 500,000 rpm) generate debris that can travel at high speeds of up to 50 mph.11 Without protec-Dental professionals are considered one of the tive means, such debris, including amalgam, toothoccupational groups that are prone to experience enamel, calculus, pumice, and broken dental burs,ocular injuries and problems as they perform their may find its way into the eyes of the dental practi-daily dental work.5 A study completed by Arheiam tioner, team member, laboratory technician, or pa-et al. found that eye problems were the third most tient.11 If these small objects are projected and strikefrequently reported occupational health problems the orbit, injuries of varying severity can occur.12among dentists.6 In a study of Greek endodontists,73% reported ocular incidences, with amalgam and Drilling can significantly increase the probability ofsodium hypochlorite (NaOCl) as the most frequent- injuring the eyes of the operator as the foreign bodyly associated foreign bodies involved in ocular locates itself in the conjunctival sac or the cornea,accidents.7 Another study completed by Sims et causing lacrimation, reddening of the eyeball, andal. found that 43% of orthodontists in the United acute pain.13 More severely, if the debris deeplyKingdom reported instances of ocular injury in penetrates the eye, it may result in a perforation oftheir practices, with the majority occurring during the cornea and a consequent injury to the lens.13debonding or trimming acrylic.8 Depending on the type of material, drilling, polish-In addition to these generalists and specialists, ing, and finishing can also lead to foreign particlesdental laboratory procedures can result in traumat- entering the air and potentially the eye. Due to theic injuries due to projectiles or exposure to harsh complex nature of dental materials, these parti-chemicals or heat.9 Patients can also be susceptible cles can lead to chemical burns in the eye as well.to eye injuries during dental procedures. A 2006 In addition to debris contacting the eye, expo-study completed by Hill found that while 84% of sure to non-ionizing radiation has also become andental school restorative clinics in the United States increasing concern in dentistry because of the usehad safety glasses available for patients, only 77% of ultraviolet and blue light to cure or polymerize various dental materials, including composite resin, bonding agents, and sealants.14 Exposure to radi- ation can also occur during laser treatments and x-rays. Absorbed radiation can lead to phototoxic and photoallergic reactions in the eyes and skin of operators as well as patients’.15 Exposure to these wavelengths can damage the cornea, lens, and reti- na.16 Protective eyewear is necessary to safeguard the eye from debris, chemicals, radiation, and any other foreign bodies that can potentially injure the practitioner, team member, or patient. An Eye on Preventing Injuries The best practices for preventing eye injuries in the dental practice are safety shields and glasses wornwww.chairsideassisting.com 19

From Our Side of the Chaircorrectly.12 However, among dental professionals, dental mask and eyewear combination for protect-the use of protective eyewear varies. A study com- ing the eyes of the dental care provider is inade-pleted by Ajayi et al. revealed that the frequency quate protection.11of using protective eyewear among the dentalpersonnel was 36.7%.17 Another study surveyed Although some team members and practitionersgeneral dental practitioners and found that 48% may use their prescription glasses for protectivehad experienced ocular trauma or infection, which eyewear, these are not recommended due to theoccurred during a variety of procedures, and 75% many gaps that give way to potential debris, re-of these injuries resulted from not wearing eye pro- sulting in eye injury. Appropriate safety goggles ortection.18 Of those surveyed, 87% of practitioners glasses should fit comfortably over street eyewear,reported wearing eye protection routinely, but their providing satisfactory protection without impairingchoice of protection was not always adequate and the fit of the prescription glasses. Suitable safe-not worn for all procedures.18 ty goggles, glasses, or shields, should have thick frames that cover the side of the face and the topDebris enters the eye using one of three routes— and bottom of the glasses to ensure that debrisfrontal entry, sideways entry, or bottom gaps. Fron- cannot come in contact with the eye. Face shieldstal entry occurs when debris travels perpendicular are an alternative option that ensure completeto the practitioner’s face, and typically any type of protection and avoid the gap between the glasses/glasses protects the eyes from this route of entry.11 goggles and the mask.With sideways entry, debris travels tangential tothe face, and side shields on protective eyewear Additional protective glasses are necessary for anycan protect the patient and practitioner from this radiation exposure treatments. The practitioner,type of entry.11 Finally, debris travelling vertically or patient, and dental team members should weartangential to the face may contact the eye through glasses that filter UV light during light curing andbottom gap entry or the space between the glasses polymerization. Various colored plastic glasses andand the mask of the practitioner.11 Thus, the current hand shields are available that effectively protect the eyes from UV radiation.19 Glasses are also avail- able to protect the eyes from laser radiation (i.e., Holmium-YAG lasers, Diode 810nm lasers, etc.). Finally, safety glasses are necessary during radio- graphs to avoid radiation exposure during x-rays. It is important to notify the patient and dental team members when radiation-specific protective glass- es/goggles are necessary to ensure that the patient and dental professionals are adequately protected throughout the treatment.The practitioner, patient, and dental team members should wear Eye Injuries Prevention Checklistglasses that filter UV light during light curing and polymerization. Clean reusable eyewear between patients and disinfect whenever visibly soiled. Wear protective eyewear with solid side shields during any patient-care activities that can gen- erate debris, radiation, or splashes or sprays of blood or body fluids.20www.chairsideassisting.com 20

From Our Side of the Chair Educate your patients 9. 9. Palenik CJ. Eye protection in dental laboratories. J Dent Technol. 1997;14(7):22-6. about why protective eyewear is important and 10. 10. Hill EE. Eye safety practices in U.S. dental school require them to use it restorative clinics, 2006. J Dent Educ. 2006;70(12):1294-7. during any procedures that can generate debris, 11. 11. Arsenault P, Tayebi A. Eye safety in dentistry. Dentistry radiation, or splashes or IQ. 2015. Accessed via http://www.dentistryiq. com/ sprays of blood or body articles/2015/04/eye-safety-in-dentistry.html. fluids. 12. 12. Matsuzaki K, Aoki T, Oji T, et al. A rare case of broken Utilize radiation specif- dental bur perforating the medial orbital wall without damaging the eye. Quintessence Int. 2015. Doi: 10.3290/j. ic glasses (i.e., UV light, qi.z34806. [Epub ahead of print]. lasers, radiation) for the patient, practitioner, and 13. 13. Szymańska J. Work-related vision hazards in the dental team member. office. Ann Agric Environ Med. 2000;7(1):1-4.Conclusion 14. 14. Leggat PA, Kedjarune U, Smith DR. Occupational health problems in modern dentistry: a review. Ind Health.Although eye injuries occur every day, utilizing 2007;45(5):611-21.protective glasses, goggles, face shields, and radia-tion-specific eyewear can help to avoid most inju- 15. 15. Bruzell Roll EM, Jacobsen N, Hensten-Pettersen A. Healthries. Patients in the dental practice must be educat- hazards associated with curing light in the dental clinic. Clined about why protective eyewear is important and Oral Investig. 2004;8(3):113-7.when to use it. Team members and dental practi-tioners must be proactive in maintaining eye protec- 16. 16. Yengopal V, Naidoo S, Chikte UM. Infection control among dentists in private practice in Durban. SADJ.tion to avoid eye injuries and their complications. • 2001;56(12):580-4.References 17. 17. Ajayi YO, Ajayi EO. Prevalence of ocular injury and the use of protective eye wear among the dental personnel in a 1. 1. Centers for Disease Control and Prevention. Eye Safety. teaching hospital. Nig Q J Hosp Med. 2008;18(2):83-6. Accessed via www.cdc.gov/niosh/topics/eye. 18. 18. Farrier SL, Farrier JN, Gilmour AS. Eye safety in operative 2. 2. Occupational Safety and Health Administration. Eye and dentistry – a study in general dental practice. Br Dent J. Face Protection. Accessed via http://www.osha. gov/SLTC/ 2006;200(4):218-23; discussion 208. eyefaceprotection/index.html. 19. 19. Berry EA 3rd, Pitts DG, Francisco PR, et al. An evaluation 3. 3. Azodo CC, Ezeja EB. Ocular health practices by dental of lenses designed to block light emitted by light-curing units. surgeons in Southern Nigeria. BMC Oral Health. 2014;14:115. J Am Dent Assoc. 1986;112(1):70-2. 4. 4. Kelsch NB. Protecting eyes: What? RDH Magazine. 20. 20. Centers for Disease Control and Prevention. Guidelines 2012:32(8). for Infection Control. 5. 5. Kihara T. Dental care works and work-related complaints of dentists. Kurume Med J. 1995;42(4):251-7. 6. 6. Arheiam A, Ingafou M. Self-reported occupational health problems among Libyan dentists. J Contemp Dent Pract. 2015;16(1):31-5. 7. 7. Zarra T, Lambrianidis T. Occupational ocular accidents amongst Greek endodontists: a national questionnaire survey. Int Endod J. 2013;46(8):710-9. 8. 8. Sims AP, Roberts-Harry TJ, Roberts-Harry DP. The incidence and prevention of ocular injuries in orthodontic practice. Br J Orthod. 1993;20(4):339-43.www.chairsideassisting.com 21

TFrEoCmHONur ISQidUe oEf the ChairTechniqueTHE TRUE MEANINGOF PROVISIONALSSSTtEePp-B-Yb-yS-TSEPtePpROPVrIoSIvOisNioAnLSaUlSsINUGsingIINnTtEeGgRrITitYy®®fft-r,oDmENDTSePnLYtsCpAlUy LSKironaby Shannon Pace Brinker CDA, CDD, ACEP rovisional restorations provide an interim treatment option periodontal tissues, over strategic extraction sites, during grafting tech­ and a tool to ensure proper fit, occlusion, and patient comfort niques, furcation and endodontic treatment, and serve as a guide for the before final restorations are fabricated. Provisional restorations final restoration. Glnglval margins must beprecise and the cervicalcontour require a strong bond to avoid failure during the temporary correct so that the marginal gingiva willheal properly and be heldin place,trial period, however, they also require limited strength for easy removal. creating refined gingival zenith. A key point to remember is that dependingAlong with the introduction of provisionalrestorations more than80 years on the patient and treatment, provisionals can be worn for just a few days,ago came the development of provlslonal cements In attempt to meet the weeks, months, and In my own personal case, up to a year.needs of dentistsand create ideal bond strength. It is important to provideprotection for the teeth during these times, thus the provisional must be Conversations with the Patient Regarding Provisionalsproperly fabricated and cemented. The treatment performed reflects theentire dentalpractice, therefore when a provisionalis esthetically pleasing, Conversing with the patient about the steps during the restorative phaseremains Intact cemented, and Is comfortable, you have gained muchmore and giving reassurance that the provisional restorations are a blueprint forthan a well-fitting provisional. our final restorations is very important. Choosing a provisional material that blends with the natural shade of the teeth Is easy, but choosing a materialPurpose of the Provisional that mimics natural tooth structure, polishes well, and has an appearance of translucency and vitality are the hard parts. The selection of provisionalWith an accurate fit and adequate margination, the provisional is responsible material is the most important factor to ensure a happy patient. I have al­for maintaining space for the final restoration. The provisional must have ways said that patients are not sure of what they do not like until they seecontact with teeth on each side (meslal and distal) of the prepared tooth something, and unfortunately it Is usually cemented. I have heard dentistsas well as the opposing tooth. This contact will help reduce and hopefully and assistants say the provisional material is not that important since it'sprevent the adjacent teeth from moving. If the fabricated provisional does only \"temporary,\" but what I would ask is: Would you have this provisionalnot provide adequate contact, the adjacent teeth could migrate and shift, in your mouth? The use of a high-quality product will provide better easeand cause the final restorations to not seat correctly. Function is one of of use for the assistant, and that makes the process more efficient and lessthe most basic P\JrPoses of a provisional crown. The patient needs to be time-consuming.able to eat (on a modifie ddiet) during the period of time he/sheis waitingfor the penrnanent crown. Always make sure their bite is correct before Factors to Consider in the Choice of Provisional Productreleasing the patient to allow the pulp and periodontal ligament to healproperly after the procedure. There are many techniques available to provide provisional coverage for teeth while the permanent restorations are being fabricated. The type ofThese are Not Just Temporaries provisional needed, condition of the gingiva, desired outcome, and any special circumstances Influence thechosen technloue. Thedirect provlslonalRestorative procedures have changed dramatically in the past several technique is where a provisional restoration is made inside the patient'syears. These restorations are no longer regarded as temporary mouth and locked in with resin, cement or mechanical retention. The indi­restorations but rather as provisional restorations with distinct rect technique is when the provisional is fabricated outside of the patient'sfunctions and purposes. Provisional restorations have become a vital mouth and then cemented.diagnostic and assessment tool to evaluate function, color, shape,contour, occlusion, periodontal re­sponse, implant healing, and overall Things to consider:esthetics. The provisional restorations act as a \"blue print\" for the dentistand patient to discuss the appearance of the permanent restorations. • Shades the manufacturer offers: Not Just A2 but the lighter shades suchAfter wearing the provisional for some time, the patient may request as Bl and Bleach shades that truly mimic the Vita Guide you are using in the communication with the patient to choose the shade for the finalchanges to the final restorations based on the fabrication of your restoration.provisionals. Changes the patient may ask for Include color, shape,length, embrasure, and many others. Provisional restorations allow the • Strength of the material (Is it brittle? Does it break during fabricationpatient to have a trial smile simulation that they can look forward to in the and cementation?)new, final restorations. • setting Time (Does It set too fast. too slow or Just right with yaur skills:Tissue Conditioning and Healing it is easy to trim and polish?)Provisionals provide coverage and support during periodontal treatment. • Does it polish well? No matter what polishers you use, is the material isincluding implant therapy, in developing the morphology of perio-implant still flat and dull in appearance or does it look shiny and glazed?www.chairsideassisting.com 22

From Our TSiEdCe oHf NtheIQChUaiEr TechniqueProvisional of Choice Today for Most Dental Assistants ', 0 Prior to fabrication of the provisional, remove the cartridge cap and dispenseWhen asking dental assistants what provis ional materials they like, a small amount of base and catalyst onalmost all prefer bis-acryl materials. Bis. -acrylics provide greater strength the table top. Make sure both have beenand color stability, and they have no objectionable odor or taste duringfabrication, or the heat that is released from powder liquid acrylics. The dispensed.distinct advantage in using bis-acrylic materials is that the material willbond to Itself, which Is very Important If the provisional has bubbles or Begin dispensing Integrity Material by applying continuous light pressurevoids after it is removed from the matrix, and they help to avoid re-makes to the dispensing apparatus handle.and waste material. Some practitioners object to the increased cost of thebis-acrylic materials. However, if chair time is decreased because of the As the material comes out of the mixingmore \"user-friendly\" characteristics of these materials, then the products tip, inject it into the deepest portion ofare actually more cost-effective. the preliminary impression and then into the gingival areas, keeping the mixingStep by Step instructions: tip immersed in the material to preventFabrication of Esthetic Provisionals using Integrity* Multi-Cure TemporaryCrown and Bridge Material with Fluorescence - Complete Package bubbles.Integrity• Multi-Cure Temporary Crown & Bridge Material provides fast, Seat the putty matrix onto the patient's mouth within 45 seconds andstrong temporaries with great esthetics. It is anauto mixed, two-component leave in place for approximately 2-3 minutes from the start of the mix.material Intended for use for both short and long-tenrn temporary restor­ Remember, this is a lock-on technique. After removing the matrix, use aative procedures including provisional veneers, inl ays, onlays, crowns, or scaler to remove any excess material around the margins and polish withbridges. What makes Multi-Cure different from other provisional materials an Enhance CUP by DENTSPLY Caulk.is its ability to self cure and an option to light cure to a final set that helpsto reduce treatment time If needed. Pre Operative Cloce-up• Creates fast strong tempora ries with great esthetlcs Post-Op Provisional Visit• Less than 5° c temperature change in the mouth during setting, will not One of the most important visits is the postoperative provisional visit, or damage the pulp and offers great patient comfort the trial phaseof provisionals with allesthetic cases. The patient is always Instructed to return no sooner than three days after they've had the chance• Bonds to itself for easy repair to look, feel, and test out their esthetic provisionals. Patients will change their minds about color and shape, and it is important not to create the• Polishes to a natural luster for superb results finals without approval of the provisionals. At this appointment, I will gather photos of the provisionals and talk with the patient about any changes• Great consistency for easy handling and cleanup they would like to make. If the patient Is not sure about shade of the nnals, remember to always default to the lighter side. In my career of focusing• Available in shades Al, A2, A3.5, Bl and BW on cosmetics, I have never had a patient tell me their teeth are too white, but I have had patients say they wish they had chosen a lighter shade.• Allows the dental assistant to make a choice in procedure technioue (Dual or Light cure) ConclusionStep by Step Instructions for Direct Provisional Technique I have always said that If the patient likes the provisionals, then they will love the finals. I never want the patient to lose confidence in our practice. In the preoperative consultation, patient Dental assistants who are certified to place temporary restorations have a decided on a Bl shade provlslonal. valuable role in the dental office. In order to maximize this role, however, assistants must stay continually informed on the materials and technioues./� ,\"'- Prior to preparation, fabrication of available. With the right material and technloue, assistants can create a putty matrix was formed over the beautiful provisional restorations thatclosely resemble thefinal restoration ' in both esthetics and function, and that leads to a happy patient-and most ·-. . diagnostic wax up. importantly, to referrals for the practice.'• ' 11 After the putty set, the matrix was removed and relined with a light body wash to define the margins of the wax up.www.chairsideassisting.com 23

From Our Side of the ChairReading Your PatientsCommunication & Interaction Techniques toIncrease Case Acceptance Shannon Pace Brinker, CDA, CDDwww.chairsideassisting.com This is the second article of a three part se- ries about breaking down the components of interpersonal communication, including dental fear, non-verbal communication and cues, and verbal communication, word choice, and verbal cues Patients with dental fear can be anxious about being in situations in which they feel a lack of control, that present the potential for pain and drills, and cause embarrassment because of the current state of their dentition. Although dental fear is common among patients, making dental care possible for them is a mutual challenge…and it’s one that requires an interplay between dental staff and patients that involves verbal and non-verbal communication to convey respect, attention, and empathy. OK, so again, it’s not just what we say, but how we say, and that means we need to take a closer look at nonverbal communication. Non-verbal communication includes body language, hand gestures, posture, facial expressions, eye contact, and pauses in conversation. Even before any word is spoken, patients observe our body gestures and facial expressions. In the same way, before the patient speaks, we can perceive their willingness to complete treatment by paying attention to his or her non-verbal cues. And interestingly, most people assume that non-verbal messages do not lie and, therefore, they tend to believe the non- verbal cues when a verbal message contradicts it. For example, if the front desk team member says, “We’re glad you are here,” but has a frown on her face or is preoccupied doing something else and isn’t focused on the patient, which message should the patient believe? In the same way, if the patient says 24

From Our Side of the Chairyes to the treatment plan but has his arms crossed But before we talk more about patient interactions,and avoids eye contact, do you believe that he there are other non-verbal cues that are importantwill proceed with the recommended care? Among to discuss—like eye contact—which can influencethe non-verbal cues we’re talking about are hand case acceptance. Eye contact frequency can sug-gestures, a movement made with a limb—especially gest either interest or boredom and can even betraythe hands—to express, confirm, emphasize or back dishonesty, and eye level can affect whether or notup the speaker’s attitude or intention. Some hand a patient feels they’re being spoken down to orgestures, like a wave, have a universal meaning, inferior. That’s why I like to be eye to eye and kneewhile others are culturally conditioned, such as a to knee with my patients to connect with them andhigh-five. And there are times when hand gestures promote a relationship of equals, so it’s importantcan have slightly different meanings, such as when during patient consultations to be at the same chaira person brings his hand to his head—which can height to ensure an equivalent eye level. And finallyindicate interest. But if he brings his head to his pauses in conversation—either a brief suspension inhand, it can suggest boredom. And then we’ve all your voice like I just did to show the limits of sen-seen other hand gestures—pointing, putting your tences and their parts—or that can consist of a tem-hands in your pockets, and crossing your arms porary vocal inaction—something that reveals the speaker’s hesitation, uncertainty, or tension—alsoWhat does this mean for you and the patients you communication something. A pause in conversationinteract with? Well, imagine you’re sitting with can be judgmental and suggest favor or disapprovalyour arms crossed while the patient is reviewing and can have a positive or negative influence on thehis health and dental history. He may perceive you communication process.as apathetic and uninterested. But instead, pic-ture yourself sitting up straight, facing and leaning As dental professionals, it’s important for us to main-slightly towards him. He may now feel that you are tain a positive attitude when we’re communicatingvery interested in what he has to say. And of course, with patients and avoid any pauses that they mightour facial expressions show our interest in what perceive as judgmental. As listeners, we need toour patients have to say, as well as what our pa- look out for pauses in conversations as opportuni-tients are feeling, since the face is the reflection of ties to ease uncertainties through education, a moreemotions—whether we’re talking about happiness, comprehensive explanation, and perhaps by askingfear, worry, anger, sadness, or surprise. These emo- engaging and patient awareness questions.tions are represented by smiling, frowning, raisingan eyebrow, yawning, or sneering. As I suggested In the first scenario, the patient had a toothache; sheearlier, yawning or frowning while greeting a patient easily made an appointment with your friendly staff,can send mixed signals. Smiling while greeting the arrived at the calm and welcoming practice, andpatient, however, confirms that you’re glad they’re checked in smoothly. When the team member camethere. Likewise, paying attention to a patient’s facial to meet her, she was called by name and greetedexpressions can be helpful when gauging how re- with a warm smile, and walked back to the treatmentceptive they are to what you’re saying. If you’re ex- chair, making polite small talk along the way. Whenplaining a treatment option and they are frowning, she got to the treatment room, the team membersneering, or raising their eyebrow, they may need reviewed her medical and dental history before evenmore explanation or answers before they accept the placing a bib on her, and there wasn’t an instrumenttreatment plan. And in fact, if we look at each type in site. The steps of the evaluation were thoroughlyof emotion-based facial expression and look at what explained to her before the examination began, andcharacterizes them, you’ll see what makes them the dental assistant prompted her to ask questionsdifferent so you can begin to recognize them. And and listened attentively to everything she said andwhen you do, you can adjust how you’re communi- to all of her concerns. When it was time for thecating and interacting with the patient accordingly. dentist to discuss his findings and treatment rec- ommendations during the patient consultation, thewww.chairsideassisting.com 25

From Our Side of the Chair Product Spotlightspatient was receptive and agreed to treatment. I’m experience and why making them successful is im-sure we all know it doesn’t always go this way, and portant to patients, dental team, and the health ofthat’s why we’re here today. In many instances, there the practice…and in particular, what you can do tomight be a patient who is frustrated with a personal improve your case acceptance rate. Because thereproblem who also had a toothache who calls for an are many factors that have an impact on patient con-appointment, but when the receptionist answered sultation and case presentation success, and theythe phone, she was short with him and left him fall into two broad categories: interpersonal commu-feeling as if scheduling the appointment was a huge nication and overall patient experience/interaction/inconvenience. To make matters worse, the patient management. Fortunately, what’s important to knowwas running late, and the receptionist showed she is that increasing case acceptance becomes easierwas annoyed by rolling her eyes when he finally when we know: (1) what to do, when, and how, asarrived. The dental team member who came to get well as the affect it can have on a patient; (2) whathim called his name loudly, but didn’t wait for him to say, what questions to ask, and what responsesto get up from his chair in the waiting area and was to give to patients to help establish and maintain analready starting to walk back to the treatment room. open patient/practice relationship; and (3) how to in-Once he was in the treatment chair, the assistant put teract among ourselves—as members of the dentalthe bib on him and was looking inside his mouth team—and with the patient to orchestrate informa-before she even introduced herself or asked about tion gathering and scheduling of their care.what was bothering him. Already worried about howmuch this appointment was going to cost him, when Let’s begin by breaking down the components ofhe met with the dentist for the consultation, he interpersonal communication, including dental fear,had already determined that he wasn’t going to do non-verbal communication and cues, and verbalanything. Now from the two dentists’ perspectives, communication, word choice, and verbal cues. You’llboth of these cases presented with similar patient learn things to pay attention to in a patient’s bodycomplaints that could have been resolved with sim- language and verbal cues—as well as your own—ilar treatment options. But as I’m sure you can see, to grasp a better understanding of interpersonalso much more goes into creating an environment communication. Then we’ll move into discussingfor ideal patient consultations and increasing case the overall patient experience, interaction, andacceptance than scheduling an appointment, per- management, which essentially involves everythingforming an examination, and informing the patient from the first phone call to scheduling to check-in toof the diagnosis. the treatment room and beyond. So we’ll really be taking a look at how what we do and how we do it—In this article we will be discussing the components and the settings we do it in affect the conversationsof patient consultations and/or the new patient we have with patients during examinations, consul- tations, discussions about financing, and ultimately, case acceptance. Interpersonal communication is the process by which people exchange information, share feelings, and create meaning through verbal and non-verbal messages. In dentistry, communi- cation is the basis of a relationship between practi- tioner and patient. It is a relationship of equals, and patients should feel as though dental team members are partners in their care. In fact, according to the Dental Anxiety Network, a resource for dental professionals who treat patients with dental anxiety, “Communicationswww.chairsideassisting.com 26

From Our Side of the Chair Product Spotlightsmeans that you do things together with your den- tal fear can be anxious about being in situationstist, rather than your dentist doing things to you.” in which they feel a lack of control, that presentSo what does this mean for us? Well, as members of the potential for pain and drills, and cause em-the dental team, communication gives us an avenue barrassment because of the current state of theirto connect with our patients and show them we’re dentition. Although dental fear is common amongequals in when it comes to their care. And based patients, making dental care possible for them ison key communication research, it also means that a mutual challenge… and it’s one that requires anwhile what we say is important, what may be more interplay between dental staff and patients thatsignificant to your patients is how you say it. Two involves verbal and non-verbal communication toresearch studies completed in the late ‘60s by Meh- convey respect, attention, and empathy. That’srabian and Wiener, and Mehrabian and Ferris, broke according to a study by Bernson et al publisheddown the importance of communication and also in the European Journal of Oral Science in 2011.what constitutes communication. They determined OK, so again, it’s not just what we say, but how wethat 55% of communication is body language, 38% say, and that means we need to take a closer lookis tone of voice, and 7% is the actual words spo- at non-verbal communication. Non-verbal commu-ken. So for communication to be complete and nication includes body language, hand gestures,meaningful, we need to match what we say with posture, facial expressions, eye contact, and paus-non-verbal cues, like such as hand gestures, pos- es in conversation. Even before any word is spo-ture, and eye contact; and be mindful of our verbal ken, patients observe our body gestures and facialcues, such as word choice and tone of voice. And expressions. In the same way, before the patientthis is particularly important when we think about speaks, we can perceive their willingness to com-our patients’ apprehension and attitude toward plete treatment by paying attention to his or hertheir dental visit. According an article in the 2009 non-verbal cues. And interestingly, most peopleEuropean Journal of Oral Science, nearly 25% of assume that non-verbal messages do not lie and,people experience dental fear and, compared therefore, they tend to believe the non-verbal cuesto other subtypes of fears—for example heights, when a verbal message contradicts it. For exam-snakes, physical injuries, etc.—it was rated as more ple, if the front desk team member says, “We’resevere than any other fear. Another survey by the glad you are here,” but has a frown on her faceCenters for Disease and Control found that fear of or is preoccupied doing something else and isn’tthe dentist was the reason that one out of 10 adults focused on the patient, which message should thedid not visit the dentist for an oral health problem. patient believe? In the same way, if the patient saysNew York City dentist Dr. Louis Siegelman explains yes to the treatment plan but has his arms crossedthat the mechanism of dentistry- related fear is the and avoids eye contact, do you believe that he willfight or flight response. In an article taken from the proceed with the recommended care?Huffington Post, he says that phobias are causedby a multitude of things, including a previous trau- Among the non-verbal cues we’re talking about arematic experience at the dentist, feeling extreme hand gestures, a movement made with a limb—es-discomfort while undergoing a dental procedure, pecially the hands—to express, confirm, emphasizeand having an accident where a person needed or back up the speaker’s attitude or intention. Somestitches in or near the mouth. Patients with den- hand gestures, like a wave, have a universal mean-Communications means that you do things together withyour dentist, rather than your dentist doing things to you.www.chairsideassisting.com 27

From Our Side of the Chairing, while others are culturally conditioned, such as an eyebrow, yawning, or sneering. As I suggesteda high-five. And there are times when hand gestures earlier, yawning or frowning while greeting a patientcan have slightly different meanings, such as when can send mixed signals. Smiling while greeting thea person brings his hand to his head—which can in- patient, however, confirms that you’re glad they’redicate interest. But if he brings his head to his hand, there. Likewise, paying attention to a patient’s facialit can suggest boredom. And then we’ve all seen expressions can be helpful when gauging how re-other hand gestures—pointing, putting your hands ceptive they are to what you’re saying. If you’re ex-in your pockets, and crossing your arms. plaining a treatment option and they are frowning, sneering, or raising their eyebrow, they may needBut you know, posture—as I mentioned—is also a more explanation or answers before they accept theform of nonverbal communication, but it’s some- treatment plan. And in fact, if we look at each typething we might not think about even though it can of emotion-based facial expression and look at whattell us so much. Although posture typically conveys characterizes them, you’ll see what makes thema degree of formality or relaxation, it’s more stable different so you can begin to recognize them. Andthan hand or body gestures, and refers to the posi- when you do, you can adjust how you’re communi-tion of the speaker’s body. Sitting slouched in a chair cating and interacting with the patient accordingly.typically translates as someone being uninterested,while people sitting (or standing) up straight speaks But before we talk more about patient interactions,of confidence and control. there are other non-verbal cues that are important to discuss—like eye contact—which can influenceWhat does this mean for you and the patients you case acceptance. Eye contact frequency can sug-interact with? Well, imagine you’re sitting with gest either interest or boredom and can even betrayyour arms crossed while the patient is reviewing dishonesty, and eye level can affect whether or nothis health and dental history. He may perceive you a patient feels they’re being spoken down to oras apathetic and uninterested. But instead, pic- inferior. That’s why I like to be eye to eye and kneeture yourself sitting up straight, facing and leaning to knee with my patients to connect with them andslightly towards him. He may now feel that you are promote a relationship of equals, so it’s importantvery interested in what he has to say. And of course, during patient consultations to be at the same chairour facial expressions show our interest in what height to ensure an equivalent eye level. And finallyour patients have to say, as well as what our pa- pauses in conversation— either a brief suspension intients are feeling, since the face is the reflection of your voice like I just did to show the limits of sen-emotions—whether we’re talking about happiness, tences and their parts—or that can consist of a tem-fear, worry, anger, sadness, or surprise. These emo- porary vocal inaction—something that reveals thetions are represented by smiling, frowning, raising speaker’s hesitation, uncertainty, or tension—also communication something. A pause in conversation can be judgmental and suggest favor or disapproval and can have a positive or negative influence on the communication process. As dental professionals, it’s important for us to main- tain a positive attitude when we’re communicating with patients and avoid any pauses that they might perceive as judgmental. As listeners, we need to look out for pauses in conversations as opportuni- ties to ease uncertainties through education, a more comprehensive explanation, and perhaps by asking engaging and patient awareness questions. •www.chairsideassisting.com 28

From Our Side of the ChairOrganized SYSTEMthat WORKSReduced cost – eliminating the need forcabinetry in the ops has immediate financialbenefits. Reduced treatment room size –without side cabinetry you can build physicallysmaller ops that feel larger. Allowing you toget more ops in the same amount of spaceReduced time spent – time will besqueezed from every aspect of theoperative cycle, from setting up/breakingdown procedures, to reordering/restockingsupplies, to transitioning treatment rooms tounexpected procedures. This is the biggestbenefit, as this will ultimately allow you to domore procedures in the same amount of time,or do the same amount of procedures in lesstime.Scheduling flexibility – with each room setupidentically, as long as you have capacity (a topicfor another discussion) it won’t matter where yousee that new patient or that emergency case. Itwon’t matter when you schedule the proceduresthroughout the day (no more Rock, Paper,Scissor scheduling) and it won’t matter whatcombo of doctor/ assistant is in the room at thetime. These constraints are eliminated.A simpler system – everything is madesimpler, you set the system up once andthen you let it run. Inventory control is moremanageable and less time consuming. Stafftraining can be standardized and repeatable.“Here’s a picture of what it should look like.”Allowing you to judge a staff member’scapability by their chair side performance andnot by their ability to memorize & organizelists. Introducing new products into the systembecomes a common activity with measurableresults. Organized SYSTEM that WORKSwww.chairsideassisting.com 29

From Our Side of the ChairBenefits of Color-CodingW hile the task of organizing your dental office may seem daunting and overwhelming, the time youspend now will save you time, and money, in the longrun. With our complete color-code system, Zirc takesthe stress out of organization.Use our exclusive color-code system toachieve:EFFICIENCY – Improve the efficiency of yourstorage, sterilization, restocking, and operatory setupwith our streamlined color-coded solutions. Withall your materials easily accessible and organizedby procedure and practitioner, you’ll save time andenergy.PRODUCTIVITY – Increase productivity with a well-organized office. You’ll spend less time looking forinstruments or missing materials and experience lessstress and frustration. That leads to a more productivestaff and more time to focus on the patient.SIMPLICITY – Our system is easy to implement andmaintain. Once you assign a color to each procedureor practitioner, it’s simple to keep materials togetherand identify what’s needed. We offer three colorlines in Vibrant, Jewel, and Classic tones to createambiance and complement your practice.PROTECTION – Our products offer the highestlevel of protection against contamination andinfection. Product design allows for superior cleaningand protection against damage and injury duringsterilization and transportation.COMPLIANCE – Meet OSHA and CDC compliancerecommendations for safe transportation ofcontaminated materials from the operatoryto sterilization. perspective – Improve patientperspective. Your patient will appreciate the sleek,organized, and sanitary appearance at chairside.VALUE – Not only do we offer an economicallypriced product line, you’ll save in the future with lesstime wasted and fewer instruments lost or damaged.www.chairsideassisting.com 30

From Our Side of the ChairAssSigTnEinPg1C: oAlsosrigning ColorStartStbayrt absysaisgsniginnigngeeaacchhpprorcoecdeudreuirtes oiwtsnocowlonr.cYooulor irn.sYtroumurenitns,sitnrsutrmumeennttsh,olidnesrtsr,ubumr ehonldtehrso, aldndedrse,ntbalumrahteoriladlsewrisll,aallnbde denidteanltimfieadtbeyrtihaelssawmeillcoalollr bfoer eiadchenprtoifcieeddureb. y the same color for each procedure.sCaonoodlothsrpiCdnceoiagflfconeirrsaechelnatantnycvs.hoeealovraoes.fapZcpioroacwwlomefefrefrurwfsluietlhtfhfreeecfedftecoiofncfloetartromleinnonestsapthctomeorcelooo,msmrppsol.ehomZde,ierranecnt,daomnefymfoedoeortsnidotant,hl. paCrreonanedcvtiecceyeomwalnaoordmrtsiltpohinenacein.asdlCtyct.ooomncfvooertmyorpwalaesormmotehtinhngtasanenndsyecdoofemcnaltfmoalrwtpitohrarcatice VViibbrraanntt OuOr burrighbtr, ilgivehlyt,VilbivraenltycoVloibr lrinaenits perfect forcaoploedrialitnricepirsacpticeerofreacntyfooffricealooking to infpousfeefidceineaetrlrgoiycoakpndirnaagcsettinocseeinooffruexsaceinteyment. energy and a sense of excitement. JJeewweell oThffTdoeerhfyrianceohdau,rymmirncaoJhimcde,eiwcamrnanenotdolddnlbbieenosorledonlfdqootuufoqafrelnuiJtereyawtasloeitlaylninyteo deanntayl pdraectnictea. l practice. CCllaassssicic ThCTehslaoefstsstoiocnfetlsintooef onpuerrsColovasifsdioceulinare provide a ssuubbtlet,letr,adtirtaiodnaitlilooonka. Tlhleosoe kp.leasing, veTrshateilesecolporlsewaosriknwge,llvinerasnaytdielental office. colors work well in any dental office.www.chairsideassisting.com 31 web: www.zirc.com | p: +1 763.682.6636 | f: +1 763.682.6604 5

From Our Side of the ChairColor & OrganizationOrganize The Sterilization CenterAcentrally located Sterilization Center is the restocking of materials. Finally, remove the bulky ideal place to store your procedure setups and overstock of disposable products such as paperprocedure specific dental materials. Use the color- towels, patient napkins, gloves, cotton rolls, gauze,coded B-Lok Tray System to house your instrument saliva ejectors, etc. to create more storage spacesetups, and Procedure Tubs to hold your procedure if needed. These items can be moved to anotherspecific dental materials. Next, store your Trays/Tubs storage area or divided up amongst the treatmenton Zirc’s Multi- Mod racks or shelving, in cabinets, or rooms. If sufficient storage space is not available foron the counter. We recommend restocking all tubs Tubs in Central Sterilization, they may be stored in thesimultaneously once or twice per week. This allows Treatment rooms. Look to Zirc for a more organized,for easy access, optimal organization, and efficient efficient, attractive sterilization center. 4 1 3 21 Clean storage for instrument setups after being 3 Store completed Tray setups with instrumentation removed from autoclave. in racks.2 Counter space in the “clean area” of the 4 S tore Tubs in either Central Sterilization or Sterilization Center is ideal for preparing each treatment rooms, whichever best suits your procedure’s instrumentation ahead of time. practice.www.chairsideassisting.com 32

From Our Side of the Chair Product SpotlightsSet Up the Treatment RoomZ irc’s color-code products are designed for the procedure, simply close the cassette and return burs highest level of organization and efficiency for and any other instrumentation to the procedure tray.the dental practitioner. This, along with the inviting Secure the B-Lok Tray Cover back on the tray beforeappearance at chairside, will provide your patient with excusing the patient. This provides a great patienta positive, pleasing experience. experience with a quick room turnover.As part of the room prep, the designated B-Lok Tray Keep disposable products, such as gauze, cottonSystem & Procedure Tub is brought into the Operatory rolls, gloves, masks, paper towels, saliva ejectors,before the patient is seated. Keep your instruments etc. in the treatment room. This will allow for quickorganized by returning them to the correct space in and easy restocking of the dispensers and drawerthe cassette as you use them. Soiled gauze and cotton organizers. Keep the most used products withinrolls should be placed in a receptacle as you work to arms reach so you can easily retrieve more duringmaintain a clean working area. The compact size of the procedure if needed. Enjoy the benefits of anZirc’s Handi Hopper is ideal for conveniently mounting organized and efficient treatment room with Zirc’sto any counter or cabinet. Upon completion of the Color-Coding system. 4 3 121 Cotton roll and gauze dispensers within arms’ 3 Covered procedure tub for easy, safe transport. reach for easy access. Tub setup has all of the dental materials needed for the procedure.2 C overed tray with cassette and all other required instrumentation provides an organized work area 4 S tore tubs in either Central Sterilization or and is visibly pleasing to the patient. treatment rooms, whichever best suits your practice.www.chairsideassisting.com 33

From Our Side of the ChairOrganization SimplifiedIncorporate Procedure TraysOur selection of color-coded trays offers organization, efficiency, and, when used with our exclusive Safe-Lok®Tray Covers, a level of infection control and safety unlike anyother product:■ S et up procedure instrumentation on the tray ahead of time. Our E-Z Jett® Cassettes fit nicely and still leave room for other instrumentation. Secure the Safe-Lok® Tray Cover to keep items clean and for safe transportation to chairside. Remove the cover once the procedure begins.■ O nce the procedure is complete, the Safe-Lok® Tray Cover prevents crosscontamination, injury, or damaged instruments during transportation back to the sterilization area. Keep all contaminated items enclosed until you are ready for the cleaning and sterilization process. Ensure compliance with OSHA and CDC regulations with color-coded trays and Safe-Lok® Tray Coverswww.chairsideassisting.com 34

From Our Side of the ChairMaterial ManagementOrganize your materials by procedure withtMo-dMaMTayubaotspaeteatrnreadetiriaotrainkalsie.alMYtholeMuM’aslltrhaneaasvsnaenoageuavtgeeorgfymetyehominumegr dneyaeontyu-nttneed in one tub that can be easily transportedMMMaataeterteirarialialMlMMaanananagagegemememenentnttfOrorgmOanrOgizsaregntayoizoneruizayreomgyuoaerutmertramioatealsrtoeibarpylisapelbsryrobacpyertpdoorucoerrcedyeu.wdruiethrweTiwtuhbitThsuaTbnusdbastnaadknetdathktaektsehtretehsetsrseotrsuestsosufotyuotufoyrfodyuaoryu-drtaody-ad-tyao-y-todo-apdyeaoryapoteiporeantrsiao.tYniosnu. sY’l.olYhuoa’lulv’ehllaehvvaeevreyvtehvrineytrghyiytnhogiunygnoeyuoenudenienedoeidnneionnoeneNtuobtttuhebtau:ttbhcbathentaclbtaoecnawebnaesbaielryaeestrailasyeniltxsyrpaatnroamsrntpesopdprotlfeerodtsemfdr-osfrtmoormrsagtgoseartoatngoraeiogztpeeoetoryapotoeoprrueaytr.roaNrtToyo.urtyNeb.:oNbteo:tloeb:webloaerwloewaerxeaarmexpealxmeaspm-leposlreg-sao-nrogizaregnayizoneuizyreoTyuorbuTrtuoTbufitboytofiutfyritonyueoreundresn.eedesd. s.tOorgfOaintrgOizyaernogyiazouenuiryzreonmuyeraotumeerradimateslasr.itbaelyrsiapblrsyobpceyrodpcureordecuewrdeiuthwreTituwhbiTtshuabTnsudbatsnadaknetadtkhteeaktshetertehssetsresostursetososuftoyoufut yorofduyaroyud-traoyd--datoayy-tdoa-pydeaorypateoiorpanetsiro.anYtios.unY’slol.uhY’oallvuhe’lalevhveaeveryevteherivynetghryiyntohguinynogeuyeondueiendeoeindeoinneone tubttuhbatuthbcattnhcabatencaebnaesbeileyasterialysntilsryapntorsarptneosdrptfoerdrotmefrdosfmtroorsmatgoesrtaotgoreaogtpoeeotropateoorprayet.oraNrtyo.trNey:.obNteeo:ltobewe: lboaewrleoawerxeaemrexpaelmxeaspm-leopsrle-gsaonr-giozaerngyiazoenuiyzreoTuuyrobuTturobTfuittobyfotiotuyfriotnuyeroeundrese.ndese.ds.CrCoCrwornowwn&n&B&rBiBdrgirdiedggeTeuTbTuubb EnEdEnonddoTouTbTuubb For the best in dental practice organization, look to our line of color-coded material management products. Our easily implemented CaCpCasapupslesuulCeleoCmCoopmmopspoitosesitiTetueTbuTubbsystem will save you time – before, during, and after procedures and sterilization.ProPcrePodrcuoercdeudtruebrte,uttbuu,bbt,ulitnbueblrin,lietnure,brt,utbub ProPcrePodrcuoercdeudtruebrte,uttbuu,bbt,ulitnbueblrin,lietnure,brt,utbub ProPcerPodrcuoercdeeudtruuebrt,euttubub,btl,uintbuelbrin,lcienare,prcs,aucplaespusluele STEP 6: Manage MaterialsCdivrrCidodoiedvCrwriwdvsorie,ndndwroesirv,&wsnid&d,iedvnBdi&dvBrised&lidiedrdBdseigldBirstdlerigieadrdyteeTir,gdatauryeagTvb,ayaure,iTveabatuvyrTaioebrutfiyebtoyfof dEivnEidddiedvnEriodvsdnie,ddordTesirv,uosiTdTd,ibuedvuTdibdvbuisedldiebddselistdlrieadyter, atrroyat,ayrr,oyrtaofirtlaey rfyilefile 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From Our Side of the ChairStreamline Inventory Control & OrderingChallenges with Team Member IntegrationWhen implementing any new system into the dental practice, team member participation and support is very important to its success. However, challenges do exist. Many team members may not see a prob-lem with the current inventory and ordering process. Others may be upset if their ordering authorization isbeing revoked. By understanding the perspectives of many team members, dentists can better explain thebenefits of the new system and answer team member questions. Common Team Member Misunderstandings• Team members are afraid that the Do you utilize your own system in your operatory product(s) they love using won’t be because you are afraid of running out of supplies? available when they need it/them. ______________________________________________ ______________________________________________• So, they have their own tags in their ______________________________________________ operatories, not realizing that there is What reservations do you have toward a centralized enough working inventory. and streamlined inventory control and ordering system? _______________________________________ _______________________________________________ _______________________________________________• Team members believe they need their own Are there products that you feel are necessary to personal tag system because they are the only keep extra quantities of in your operatory? ________ ones that use something. ______________________________________________ ______________________________________________• Yet, with investigation, it’s realized that others What challenges exist from stockpiling supplies in in the practice sometimes use the same individual operatories? __________________________ product without them knowing it. ______________________________________________ ______________________________________________• Some products are only ordered and stocked Are there products that you feel are unnecessarily for one or two dentists and are not centrally ordered or stocked at your practice? _____________ located. ______________________________________________ ______________________________________________• If another dentist wanted to use the same item, Is it an easy process to try new materials within your it would not be available to them practice? ______________________________________ ______________________________________________ ______________________________________________What is your greatest concern about implementing a centralized and stringent inventory control and order-ing system into your practice? _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________www.chairsideassisting.com 36

From Our Side of the ChairThe Ordering ProcessIntroducing Technology & Inventory Control and Ordering SoftwareN ew technology and software can enhance inventory control, increasing productivity and reducing the time it takes to order and monitor new inventory. Fully integrated products harness the power of practicemanagement style software programs to track inventory and simplify the reordering process.Options for Placing Orders Simplifying the Ordering Process with Online or Scanner TechnologyThrough a Sales Representative • Advantages: One-on-one relationship with • Used in conjunction with online ordering purchasing assistant; tracks history; reduces or inventory control and ordering software, purchasing costs; available for questions about scanner technology provides a quick and products efficient way to reorder supplies. • D isadvantage: Diminishes opportunity to compare costs; time consuming to call for every • The Aruba eZScan scanner from Henry Schein order Dental is a portable key-chain-sized scanner that conveniently works with the website orCall Customer Service Aruba eZ software. • A dvantages: Convenient; available for questions about products • It automatically inputs product information • Disadvantage: Difficult to remember all of the into the online shopping cart, along with the product numbers and quantities previously reordered quantity.Online Purchases • W ith Aruba eZ, there is no guesswork or time • Advantages: Simple; straight forward spent deciding quantities of products to order, • D isadvantages: Requires research to compare when to order, or how long it will take for the costs; must input quantities and find product supplies to arrive. numbers • T he system’s customizability enables practicesSoftware Management to take control of the supply inventory and • A dvantages: Automated system; reduces create a systematic, functional, and efficient purchase costs; convenient approach to gain the ideal balance of • D isadvantage: Requires some time for supplies. installation and orientationInventory Control & Ordering in PracticeHelpful RemindersW ithout a system and protocol in place, there is no way to control the inventory process and minimize the impact on profit margins. Thus, it behooves dental practices to integrate and implement orderingprotocols and systems that ensure the appropriate quantities and supplies are consistently available.www.chairsideassisting.com 37

From Our Side of the ChairThe Ordering ProcessSetting Up Inventory Minimums and Reorder QuantitiesDetermining the minimum inventory quantities and ordering amounts can be challenging, since materials and supplies are used at different frequencies and have varied expiration dates. Theminimum inventory amount should ensure that the practice has enough of the product for about twoweeks, guaranteeing sufficient time for ordering, shipping, and stocking.Goal of Inventory Control Tips for Determining Appropriate Inventory QuantitiesTo achieve an ideal balance between maintainingnecessary inventory and curtailing overhead expenses. • M inimums should be based on your practice’s normal product consumption average and normal delivery timeframe. • S ome items may not need a minimum quantity in the supply area because you order them so frequently. • It can be helpful to label the shelves with the item number and description for easy restocking. • Inventory control software, such as Aruba eZ, can be helpful in determining your practice’s minimum inventory requirements and reorder quantities.Examples of How to Calculate Minimum Inventory Quantities and Reorder Amounts from Henry Schein DentalExample 1: • O ption A: Minimize inventory by setting reorder quantity • Used 60 cans of Caviwipes in 12 months to 5. • Average monthly use = 5 cans • Henry Schein has price rates on 1 can or 12 cans • O ption B: Maximize savings by setting reorder quantity • Metrex offers 1 can free with purchase of 12 to 12. • Set Minimum Stock = 2 cansExample 2: • O ption A: Minimize inventory by setting reorder quantity • U sed 260 boxes of Criterion small gloves in 12 months to 12. • Average monthly use = 21 boxes • Henry Schein price breaks on 1 box, 10 boxes, or 20 boxes • O ption B: Maximize savings by setting reorder quantity • Set Minimum Stock = 2 or 3 boxes to 20.Your Turn… Calculate Minimum Inventory Quantities and Reorder AmountsRepeat this technique for all of the items in your supply storage areas.Example 1: • O ption A: Minimize inventory by setting reorder quantity • Used 60 cans of Caviwipes in 12 months to ______. • Average monthly use = 5 cans • Henry Schein has price rates on 1 can or 12 cans • Option B: Maximize savings by setting reorder quantity • Metrex offers 1 can free with purchase of 12 to ______. • Set Minimum Stock = 2 cansExample 1: • O ption A: Minimize inventory by setting reorder quantity • Used 60 cans of Caviwipes in 12 months to ______. • Average monthly use = 5 cans • Henry Schein has price rates on 1 can or 12 cans • O ption B: Maximize savings by setting reorder quantity • Metrex offers 1 can free with purchase of 12 to ______. • Set Minimum Stock = 2 cansAnswers: Example 3—Option A (2) and Option B (10); Example 4—Option A (3) and Option B (6)www.chairsideassisting.com 38

Become a MemberAs clinical procedures in dentistry continue to expand and improve, the role ofthe dental assistant has continued to evolve as well. It requires us to learn newEvidence Based Models that result in “Responsible Esthetics”, learn to work withnew next generation nanotechnology materials and have a higher level of com-bined communication with the dental team and patients. If you feel as passion-ately as we do about dental assisting and continuing education, we urge you to consider becoming a member and join us on this journey.General & Students Corporate Various job descriptions for dental assis- Through networking opportunities, tants define their role as one that helps support and encouragement fromthe dental operator provide more efficient your professional peers, ACA candental treatment by overseeing necessary help you achieve your goal of clin-tasks and effectively becoming the opera- ical excellence. Receive discountstor’s extra hands. Today, this encompasses for dental materials and equipment much more than technical skills. and much more. Join Today Contact Uswww.chairsideassisting.com









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