Restore Access Openings - Cleanly and Quickly!

You asked for more handy chair-side tips so I'm giving you one of my favorites.  I was going to make my millions and somehow patent this technique, but I decided to be unselfish and share this with everyone. :)

This may seem very simple and silly but it streamlines the process and helps save time.  This picture shows red wax formed into the shape of a cone and placed securely onto the end of a PFI. The material is in the perfect shape to fill an access opening of an implant or as a temporary restoration for a root canal treated tooth, sedative filling, or palliative treatment. You can use any material that is appropriate for your situation such as a composite material like Systemp or a temporary filling material like Cavit. 

Fun Whitening Products To Try

Check these out!  Chic-Flic TOGO Teeth Whitening & Lip Gloss Plumper Pen.  The Chic-Flic TOGO Pen is a unique dual-sided tooth whitener and lip-gloss plumper all-in- one. It comes with a  built-in mirror and mini LED lights.

Whiter Image TOGO Teeth Whitening Pen

with a brush-on applicator, it is a convenient way to whiten your teeth without messy strips or trays. Our office has found these products very valuable for marketing, give-aways, fundraisers and for our personal use.

Check out their website or Facebook page for more info on these and other products at http://www.whiterimagedental.com/. 
     

Setting Up For Success

We recently sat down for a Q & A with our EFDA extern, Laine Watson.  Laine has been completing her 500 hours of  assisting and EFDA duties in our office since October of 2010, and will be finishing in January 2011.  It's been great having her as an extern at East Berlin Smiles.  We have seen her develop her assisting skills and increase her confidence through patient communication.  

Diva's: Laine, what attracted you to the dental field?

Laine: I think a person's smile is very important in the way they feel about themselves. So I want to help someone feel good about themselves.

Diva's: We agree. That is definitely a perk of dental assisting. Did you ever consider a career in dental hygiene? If so, why did you choose to become a dental assistant?

Laine: I initially considered going to school for hygiene but thought dental assisting would be a great opportunity to get the experience and knowledge of the dental field. In the future, I may go back to school for hygiene.

Diva's: We're not bias or anything, but we think you picked the right field! That is a great goal to have. Tell us more about your recent schooling.

Laine: My schooling was a full-time, 15 month EFDA program at Keystone Technical Institute in Harrisburg, PA. I learned all the basics of dental assisting like charting, chair side procedures, identifying different instruments and passing them.  Since it was an EFDA program, I also had training in placing and finishing amalgam and composite restorations. Everything I learned was very helpful, but I do wish there was a little more hands-on experience.

Diva's: Now that you are doing the extern portion of your training, how does the "real" office compare to what you did in school?

Laine: The "real" office is very different than school. First, I'm actually working on "real" patients not models which is a huge difference. Some of the materials used in Dr. Cockley's office are different from what we used in school and that makes procedure steps a little different from what I was taught. Digital x-ray sensors are placed differently in the patients mouth than traditional film.

Diva's: It certainly is easy to work without the distractions of a tongue and saliva! What has your extern experience been like?

Laine: My extern experience has been great! Everyone in the office is very knowledgeable and helpful. I have learned so much and I am very thankful to be at such a great office that is willing to work with me and explain things to me.

Diva's: What have you learned here that you will take with you and apply to your new job?

Laine: Everything that I have learned while on extern I will take with me and apply to my future career. You two are great at what you do-watching and listening to you interact with patients has taught me how to feel more comfortable talking and explaining things to patients.

Diva's: Thanks Laine. You are doing a great job. What would you like to see on our blog that may be helpful to other assistants?

Laine: I think it would be helpful for new assistants to read about what to expect in an office-knowing what to look for in a potential office, helpful interview tips, and what a doctor might expect from a brand new assistant. Tips on procedures and lab work would be nice, as well as tips that might make something easier or faster that you have figured out over your years assisting. Also, what doctors look for in a cover letter and resume that will make you stand out from the rest.

Diva's: Those are some great topic ideas and we will definitely include them in future posts. Now that you are almost finished your externship and are going to be looking for a job, what are some key things you will be looking for in an office?

Laine: I will be looking for a team that is very knowledgeable and that truly care about their patients. A practice that is up-to-date in procedures and equipment and that are consistent with continuing education.

Diva's: Thanks for sitting down with us. We know there are alot of assistants out there in your same position or someone who may be considering dental assisting as a career and your candid answers will be helpful to them.  

De-Stress Your Mess!

We recently had the opportunity to work at another dental office as temporary assistants.  We weren't sure what to expect from the office or the situation that we were walking into. But to our pleasant surprise, we were warmly greeted by a great dental team and a doctor who was appreciative that we were ready to help. 

One thing that immediately struck us was how different things were from East Berlin Smiles.  Different doesn't mean bad - this office just struggled with organizational systems.  We would like to think of ourselves as easy-going, totally flexible people who can be thrown into any given situation and come out victorious.  But we have to say, when it comes to our career and the position we hold as dental assistants, there are quite a few things that we are not willing to compromise on. 

Normally, someone who is "set in their ways," may not always be viewed in a good light.  But, what your office may need is an assistant who will uphold high standards, implement organized systems, and refuse to compromise on quality patient care.   We were reminded how critical it is to have organizational systems in place, and when they're not, it effects the practice in several ways:

*  Running behind in the schedule - It's important to your patients to stay on time and not make them wait to be seated.  Occasionally, you may run behind, but do not make your patients wait more than 5-10 minutes. Be courteous by having your front office associate communicate the reason for the delay.  It is also a good idea to meet with your clinical team to discuss a set amount of time needed for specific procedures in the schedule.

* Not reaching targeted production goals - Let's face it, hopefully everyone on your staff strives to be their best and cares about your patients, but at the end of the day, your dental office is a business.  You have to produce more than your overhead and the key to this is having a productive schedule that's effectively carried out by both the front and back offices. 

*  Stress levels - When stress is brought on by someone or something, there is a trickle-down effect that quickly takes place.  Before you know it, the whole office is feeling it and don't think for a second that your patients won't notice - they do.  The last place they want to be is in  your dental chair when you're under stress and your mood is affected. Clear communication between the front and back office is critical to keep the schedule flowing smoothly, to ensure your patients are seen on time, and to alleviate a stressful  environment. 

Your roll as an assistant to implement organization takes place in your operatories, sterilization room, and lab.  Not only do you need to know where items are located, and what specific items are necessary for procedures, but you need to implement a system for each area that is logical and consistent.  One way of beginning this process is to write SOPs (standard operating procedures) for each procedure.  The purpose for SOPs is to be able to easily train a new-hire in the set-ups and organizational systems that are specific to your office. 

Some other systems we implement in our office are procedure specific bins that contain all necessary materials for that procedure (i.e.crown/bridge,
composite,root canal and extractions). These bins can be carried from room to room as needed. We also have bur blocks prepared for composite and crown/bridge procedures that are sterilized after each patient. In our practice we have a restorative tray set-up that can be used for all restorative procedures and a basic set-up for emergencies. If your doctor uses more than one operatory, they should mirror each other in where items are located and stored. The overall idea is to keep things simple and organized so that items you need are readily available in each operatory eliminating the possibility of cross contamination and needless  "jump-ups" to retrieve materials.  Don't feel overwhlemed if your office is in need of an organizational make-over......start small and eventually you will reach your goal.  Your efforts will benefit you as an individual and your practice as a whole.

Our New Toy

Is the technology in your dental office up to date? Or are you stuck in the vacu-form dark ages?

 

We were, but no more! Our office now has a Drufomat scan-a high quality thermoforming unit. It features material recognition software with a built-in scanner that programs material related parameters such as the product name, strength, heating and cooling down times-automatically!

You no longer have to stand there waiting for your "bubble" to melt, so you can pull it down over your model and hope that there are no creases in the material after it is vacu-formed.  The Drufomat scan does practically all the work for you. Simply trim your model, spray with silicone spray to make the tray easier to remove, load and scan your material-the machine does the rest.  The Drufomat requires less time to fabricate appliances than other methods and produces a predictable outcome.  It's accuracy saves material cost and eliminates the lab fee.  

There is some trimming and polishing that will need done when your appliance is moved from the machine, but it is minimal. The result is lab quality whitening trays, essix retainers, night guards and sports guards just to name a few.

Check out http://www.essix.com/ to see the Drufomat and all the cool accessories and materials available.

We love their polishing brushes with Scotch-Brite material

How to Make a Great Provisional (AKA temporary crown)

We use bite registration material  and a 2x2 gauze to take a pre-op impression.  By using the bite registration instead of alginate, you will have the impression available if you would need to remake the patient's temporary crown before his or her scheduled delivery date.  Using this technique also saves on the inventory budget and scheduled "chair time" for re-makes. 

Steps:

1.) Dispense the bite registration onto the 2x2 gauze in the form of a thick line.  Keep in mind you will need enough material to cover at least one adjacent tooth on each side of the tooth that is being restored. 

2.) Quickly mold the material onto the three teeth you are going to capture in the impression.  Place it directly on the incisal/occlusal surfaces and evenly mold it to the buccal and lingual surfaces, creating an exaggerated "U" shape.  

3.) Allow the bite registration to fully set in the mouth. 

4.) After the tooth has been prepped for the veneer, crown, or onlay, dispense the acrylic temporization material (We like Protemp Plus) into the pre-op impression and place the impression in the mouth until nearly set. (For most materials, 1 min and 10 sec usually allows the material to be flexible enough to easily remove excess from the impression and adjacent teeth.)

5.) Place your temporary crown back onto the tooth until it has fully set.  Check the bite with articulating paper and adjust if necessary.

6.) Carefully trim the margins and contacts and taper towards the gingival margin.  Be careful not trim too much - you do not want a temporary without interproximal contacts.  (If you are temporizing more than one tooth, and your provisional crowns will be connected, you must trim the contact and embrasures properly to allow a "triangle" for the interdental papilla.  If you skip this important step, the tissue may be traumatized and become blunted.)

7.) "Rough" the inside surfaces of the temporary crown with a slow speed hand piece and a diamond bur.  By taking away the air-inhibited layer on the inside, the cement will adhere to the temporary better.  Again, be careful not to ream out the inside - you just want to gently remove a thin layer and rough the surface.

8.) If a build-up was placed, apply a glycerin gel (We like Ivoclar Vivadent's "Liquid Strip.") to the build-up only, before using temporary cement. This will prevent the cement from adhering to the build-up instead of the tooth. 

9.) Cement the temporary crown, remove marginal excess, and be sure the patient can floss between the interproximal contacts.  ( We like Dent Zar, Inc.'s "Olympian-M" temporary cement.)