Modern solutions to modern dental issues

Tomorrow’s patient called. They are ready for what’s next.

Just like most industries, there has been significant innovation in dentistry over the last few years. However, when thinking about technology that has made a real difference, most dental professionals point to bigger-ticket items like CEREC and Digital Radiography as solutions that have dramatically improved practice productivity and the patient experience. And although that is certainly true, there are innovations occurring at a more practical level in dentistry that might not get the limelight, but are making a big difference in advancing dental performance and patient outcomes. So, while there are some dental instruments used today that are not too different from what might have been used 20 years ago, there have absolutely been innovations in the core functions of dentistry that should be highlighted more.

Thus, what is more core than the overall prophylaxis process? How will you clear biofilm, remove calculus, and promote gingival health? How do you do all of this for the modern patient sitting in your dental chair with orthodontic braces or titanium implants? Sure, some things are reliable favorites. (Mirrors haven’t changed too much in concept, after all.) But twenty-first century problems like peri-implant mucositis call for twenty-first century solutions, like air polishing. But even air polishing has benefitted from major improvements and a new approach, such as the Hu-Friedy EMS AIR-FLOW line of devices, which we will discuss here.

The standard, semi-annual prophylaxis visit is predictable and familiar to patients and clinicians alike: The patient and hygienist go over medical conditions. The patient contorts their mouth to fit heavy, awkwardly shaped bitewing x-ray sensors. The patient leans back while the hygienist examines the teeth for any irregularities. The hygienist removes biofilm and calculus with scalers as the patient nervously wrings their hands. The hygienist reminds the patient to breathe every so often. The hygienist polishes the teeth with a polishing cup and paste. The patient comments how clean their teeth feel. The dentist examines the patient, reminds them (again) to floss, and they are sent home.

That's the way it's always been. There's comfort in familiarity. There's no need to change.

But sometimes change is exactly what is required in order to get a better result.

While the standard examination, scale, and polish may be adequate for many patients, it is not optimal for all patients. Just as other facets of dentistry have changed, your patient population has changed. Moreover, the science and the extent of what we know has changed, too.

New technology can be a bit intimidating, especially in a field like dentistry, where instruments can go many years without many changes to the essential concept. However, wouldn’t you be receptive to a product that improved treatment and prophylaxis for patients, including orthodontic patients, sensitive and anxious patients, and those with dental implants? The Hu-Friedy EMS AIR-FLOW system is an example of one such technology.

Air polishing and glycine powder represent a paradigm shift in general dentistry and periodontics. AIR-FLOW is not just a polisher; it is an advanced biofilm management system that yields thorough and more efficient biofilm removal. AIR-FLOW devices and Perio powder can be used on every patient. The Perio Powder is made of ultra-fine grain glycine (a naturally-occurring amino acid), which means that it can be used where other systems are not safe: on the most sensitive patients, for patients on reduced-sodium regimens, on exposed root surfaces, subgingivally, around restorations, as well as on and around implant surfaces. While glycine powder is effective in removing biofilm and stain, it is gentle enough to be used on implants or exposed roots without scratching or compromising the surface, and it does not irritate the gingiva, making it ideal for cleaning fragile gingival pockets.

Using a PERIO-FLOW handpiece with Perio Powder opens the doors of air polishing to a wider variety of use cases. The standard AIR-FLOW handpiece can be used for general supragingival biofilm removal and shallow subgingival removal. This is ideal for most patients, and particularly useful on orthodontic patients, as it can access areas that arch wires make inaccessible to polishing cups. The PERIO-FLOW handpiece features a specialized nozzle that is disposable, flexible, comfortable, and designed to be inserted directly into subgingival pockets (up to 5 mm deep. This makes it the modern solution to the modern problem of removing biofilm from implant abutments and preventing peri-implant mucositis, or worse, peri-implantitis.

As with any other field, changing times call for changing thoughts and processes, which is why we should start questioning the longstanding standard dental appointment outlined above. What if instead of polishing after all the hand scaling is complete, we polished first? Would that seem strange or backwards to you? It shouldn't, especially when we consider that biofilm is removed in the process.

When used beforehand scaling, air-polishing is a boon to productivity and efficiency, saving 8-12 minutes per patient. Because an advanced air polisher can completely remove biofilm, clinicians can follow up with hand or power scaling on hard deposits and remaining stain only, no longer wasting time scaling biofilm in addition to calculus. The 8-12 minutes saved during a prophylaxis appointment allow the hygienist to focus on other tasks, such as explain and sell billable services, update patient charts, or educate the patients on home care.

Longtime hygienist and air polishing expert Nancy Miller, RDH, BA, explains, “As a veteran of 40+ years in dental hygiene, I am a huge proponent of working smarter, not harder. Anything I can do to save time and effort during my procedures is not only welcome, but ensures the longevity of my career. The ability to ‘pressure wash’ my patient’s mouth prior to instrumenting the hard deposits off is a time saving benefit, as I don’t have to instrument soft deposits. Instead, I just ‘blow’ them away! Glycine powder used in an AIR-FLOW device is just the ticket to deliver great biofilm removal while saving me time and energy.”

The value brought by air polishing systems goes beyond the time savings. Patients regularly report on how comfortable their appointments are whenever AIR-FLOW is used with glycine Perio Powder. Additionally, many state that their teeth feel noticeably cleaner and smoother than when scaling is followed by prophy polish paste. Patients with implants and orthodontic braces or who are especially sensitive or anxious during their visits are valuable patients, and they are likely to gain the most noticeable benefits from the procedure. And what do happy patients do? They return on schedule, and they refer their friends and colleagues to your practice. Moreover, they are likely to refer other valuable implant and orthodontic patients as well.

Hu-Friedy has a variety of air polishing options, including multiple stand-alone units as well as AIR-FLOW Handys that can be attached to your existing high-speed handpiece tubing. You are sure to find an option that works well for your space and your patient population. Additionally, the units are easy to set up and have a minimal learning curve, meaning that you can go from purchase to use in no time at all.

AIR-FLOW and Perio Powder represent a change in dentistry, just like the growth in dental implants and orthodontics did before them. Isn't it time that your practice changes, too?

Featured Key Opinion Leader

Nancy J. Miller, RDH, BA, is a hygienist in a quality general practice in Green Bay Wisconsin after working 15 years in a specialty periodontal practice. She has her own consulting company, Ultraconcepts, and specializes in instruction in power instrumentation. She is a Clinical Advisor for Jameson Management for 18 years specializing in coordinating the clinical and business sides of a dental practice. She was selected one of the Top 25 Women in Dentistry for 2016 and is a Key Opinion Leader for Hu-Friedy and several other dental manufacturers.