amalgam separator, dentistry, rdh, Uncategorized

NEW Handheld or Traditional Amalgam Separator – What’s Right for your Practice?

This year, we have a major deadline!  The EPA has set a deadline on July 14, 2020 requiring the majority of dental offices to install an amalgam separator or similar device that prevents mercury contained in dental amalgam from entering the air, water, and land. (1a)

For the past few years dental offices have been gradually installing traditional style Amalgam Separators to prepare for the EPA ruling.  For reference, traditional style Amalgam separators are devices designed to capture amalgam particles from dental office wastewater through sedimentation, filtration, centrifugation, or a combination of these mechanisms and work with the central evacuation. (1b). They are most likely installed next to the central vacuum to tie all lines together and offer ease of access for routine maintenance required.

Traditional amalgam separators have been an excellent choice to meet the compliance requirements over the years.  However, as many offices will attest, routine maintenance, space requirements, installation challenges, wear and tear, leaking, cleaning and recycle-ability all can make these various systems time consuming, costly and aggravating.

We are not here to disparage or downplay the role these systems have played in protecting the environment!  All have had an excellent impact on assuring mercury stays out of municipal sewer systems.  With the challenges posed above, we would like to introduce you to a new alternative system that may be right for your dental office compliance, Capt-all!

Capt-all is a handheld amalgam separator HVE Tip.  It allows offices to become compliant removing amalgam by meeting the EPA 441.30(a)(2) requirement that includes a provision that allows the performance standard of the rule to be met with the use of an amalgam-removing technology other than an amalgam separator (i.e., equivalent device). (1c)

The benefits of Capt-all make it a viable option for many offices who may fit into these categories:

*Amalgam removal cases are reducing – Capt-all is used ONLY when necessary.  If you’re a office only doing a few removals here and there, the introductory 25 pack allows you to remove when you need to!

*Space is limited for access and installation of a traditional separator – Space is a premium and many offices have limited space in the utility room.  This makes routine maintenance and access difficult to empty and clean.  Capt-all is a chairside device and takes NO space up in the utility room.  Unused Tips are small enough to place in a drawer.

*The office is tired of cleaning prophy and everything else inside the Amalgam Separator – because traditional separators collect heavier waste, they tend to fill up with all sorts of junk.  It’s a yucky job that no one likes to do.  Capt-all alleviates this because its used only when necessary, not when prophy or other materials are used.  Also, Capt-all has NO cleaning and simply removed and contained after use!

*High Cost of the equipment, installation and maintenance – Most traditional systems will start around $1000 to include installation.  Recycling costs can vary as well as routine maintenance.  Capt-all is $7 per HVE Tip!  So if your office removes 5 a week or 5 a day the cost is $35!  The recycling fee is included, NO installation is necessary, and maintenance is a thing of the past!

*Its not just the amalgam separator that requires cleaning, so do traps and filters – when removing amalgam particles are created.  They do not all filter into the separator.  The do line the filters, traps and interior pipes where it flows.  Capt-all alleviates the worry and keeps all particles chairside!

*Our office has no time for installation and or recycling commitments – offices are busy and time is precious.  The standard Capt-all kit includes everything to be compliant, requires NO installation and makes recycling easy!  After usage of a Capt-all Tip, simply place the used tip into the accompanying recycle container that has a prepaid shipping label.  Once fully, simply reorder Capt-all Tips and drop the recycling container in the mail back to us!

Hopefully this answers some questions about the new handheld Capt-all Amalgam Separator HVE Tips when compared to traditional amalgam separators.

Capt-all is scheduled for market introduction at the Chicago Midwinter Dental Meeting this February in 2020 and is stocked by the following distribution partners:

Henry Schein Dental                       Patterson Dental Supply

Benco Dental Supply                      Dental Health Products Inc

For further information, please visit our website at www.dovedentalproducts.com.

(1a) https://www.epa.gov/eg/dental-effluent-guidelines

(1b) https://www.ada.org/en/member-center/oral-health-topics/amalgam-separators

(1c) https://www.epa.gov/sites/production/files/2017-12/documents/dental-office-category_frequent-questions_nov-2017.pdf

dental assisting, dental hygiene, dental safety, dentistry, distribution, infection control, rdh, Uncategorized

2020 Dental Distribution Partners

We are excited for this year, 2020 to announce our partnerships for dental distribution of the DOVE Dental Products full line.  They include:

Henry Schein Dental

Patterson Dental

Benco Dental

DHPI (Dental Health Products)

Each has our new products (Capt-all and SE Plus) stocked as well as our legacy disposable valves.  If you have any questions, please contact your local representatives from each company.

Have a great year!

cross contamination, dental assisting, dental hygiene, dentistry, infection control, rdh, Uncategorized

Inconsistency Causes Risk

Recently, Dove Dental learned of another dental breach at a U. S. Dental School.  It was discovered that for nearly 2 years dental handpieces were merely wiped between patients instead of following the mandatory sterilization protocol set forth by the CDC, the dental school and the manufacturer’s instructions for use (IFU).  Given our access to education and technology how can this continue to occur?

Starting in the late 1990’s I spent over 10 years working with accredited teaching programs at dental schools and universities as a school and government regional manager with KaVo Dental.  In those years, there were many infection control inconsistencies ranging from incorrect methodology to simple carelessness.  For example, teaching basic routine dental handpiece maintenance varied between programs and in some cases was not taught at all.  Unfortunately much of this became engrained and passed onto the next generation of dental professionals, as last week’s breach makes clear, this issue is ongoing.

Some of the major problems in the 90’s with improper cleaning were a result of not having enough instruments on hand to ensure proper cleaning; students were typically instructed to purchase just one handpiece (dental offices traditionally contain 3 highspeed handpieces per room).  Additionally, instructions (IFU) were not strictly taught or followed with some instructors relying on central sterilization instead of teaching the student to properly clean the instrument by hand.

From my experience, variations in cleaning, sterilization and performance included:

Variations on handpiece maintenance
*Using incorrect lubricant or wrong nozzle to spray
*Autoclave/reprocess with a sheath/bag
*Autoclave/reprocess with no sheath/bag
*Lubricating with a bur
*Lubricating without a bur
*Lubricating after sterilization
*Purging with a bur
*Purging without a bur
*Not Purging
*Usage of a purge/lubrication machine vs manually
*Disassembly during cleaning (lowspeed components)
*Not disassembling lowspeeds or motors during cleaning
*Reprocessing that never dries
*Too much or too little air pressure PSI
*Dental water line flushing or lack there of
*Shortage of instruments resulting in hurried processes between patients
*Using a hot handpiece immediately out of the autoclave and cooled under water

Naturally, after graduation any bad habits learned persisted and many continue today. When educators conducted due diligence at a dental office we often saw that processes were all over the map, even within a single office: some purged, some lubed, some did not purge and some lubed with odd lubricant/oils not intended for dentists.  Naturally, performance reflected these practices.  For example, a result of not purging was water line biofilm continuously clogged most water ports and electric motors on the market.  Dental offices tended to become defensive about their procedures and quick to blame the manufacturer of handpieces for poor performance rather than focusing on proper cleaning and maintenance.  And while educators noted the inconsistencies around cleaning protocols and resultant risks, much went unnoticed by the industry.

An important note:  handpiece repair service was and continues to be a highly profitable business with direct ties to the inconsistent and incorrect maintenance methods learned early on.

Subsequent to my experience at KaVo Dental, I worked at SciCan and continued to witness inconsistencies in the schools, distributors and hundreds of offices that I examined.  At SciCan we specialized in the Statim Sterilizer, a fairly simplistic machine. But again, practices varied resulting in some of the following:

Variations of maintenance on Statim usage
*level machines that drained properly
*machines that dried correctly
*pouches that were dried correctly
*unleveled machines that did not drain
*leaking seals around cassettes resulting in failed cycles
*instruments (handpieces) not disassembled
*pouches that never dried
*some instruments were bagged, others were not in the same cycle
*never using a spore test
*stopping cycles ½ way through hot, because they did not have enough instruments for the next patient
*never cleaning the cassette
*never changing the bacteria filter or not knowing it exists
*using incorrect water in the machine

As I continued to examine the inconsistencies, I understood that the key to proper handpiece performance at the best value is heavily influenced by the processes that maintain the instruments between patients. Patient safety is at its highest level when the dental staff is properly trained consistently on instrument management through schools, teaching programs, Universities and mentors. When instrument management training is poor and inconsistent, the results carry on for years and patient safety risk is tremendous.

Since 2014 I’ve served as the VP of Sales at DOVE Dental Products where I focus on teaching Evacuation Valve maintenance 101. Through hundreds of office visits, trade shows and phone interviews our company listens to how offices maintain HVE and Saliva Ejector Valves.  We discover the same inconsistencies that existed in the 1990s.  The use and maintenance of valves varies widely, resulting in unclean instruments, poor performance and leakage and backflow; major risks to patients, a critical issue that only grows in importance with each passing year.

They include:

Variations of maintenance on Evacuation Valves
* removing the evacuation valve for cleaning frequency, sometimes, rarely, never
*cleaning the interior of valve frequency, sometimes, rarely, never
* reprocessing the valve components, sometimes, rarely, never
*only wiping exterior surfaces only between patients
*wiping, flushing between patients – some do it daily, weekly, monthly or often never
*cleaning the solids collector daily, weekly, monthly, or never
*never changing o-rings (3 in a HVE) and (2 in a Saliva Ejector) – these prevent seepage or leaking
*not knowing the valve is removable (very common)
*using a barrier between patients
*not using a barrier
*inspecting vacuum line condition routinely, sometimes, never
*ignoring leaks and bubbles from the sides of the instrument (very common)
*instructing patients to close around suction straws (very common)
*when patients do close around straws, nothing is mentioned to prevent Backflow
*warning patients to not close around straws

 

When we examine dental programs today we see many of the same problems with evacuation valves that we’ve seen in the past.  Many students have no idea that the valves are designed to swivel and should routinely be removed and cleaned even though every instruction guide clearly states: remove, scrub, reprocess routinely. Many rely on central sterilization or a person who maintains the chairs to insure clean and sanitary instruments.  As always, patient safety is critical and it is of concern that weekly we are contacted by a dental school or program to explain “backflow,” and to question its importance as related to protecting the patient.

It’s been 20 years since we first raised concerns about water line bacteria, inconsistent maintenance of instruments and the need for consistency in infection control processes.  Last week a U.S dental school had a major breach because dental handpieces were merely wiped and not properly cleaned for two years.  In 1993 researchers provided solid proof that saliva ejector backflow occurs in 1 in 5 patients who close their lips around straws.  However, just yesterday I had a conference call to explain saliva ejector backflow to a team of RDH’s in charge of infection control at 8 locations with nearly 50 chairs, and who did not know it exists.

Dove Dental continues to promote safe and effective dental practices for the benefit of the dental industry and for the patients.  We are confident that our products provide the best solution for both dentists and patients; a simple, cost effective and expedited cleaning and maintenance regime at the dental office which insures a safe and sanitary dental experience for the patient.

For more information on Dove Dental Disposable Evacuation Valves, visit dovedentalproducts.com

 

Uncategorized

NSU Dental Patients Possibly Exposed to Certain Viruses Due to Sterilization Issues

November 28, 2018
by Amanda Batchelor, ABC 10 News


Nova Southeastern University’s College of Dental Medicine recently informed patients that they might have been exposed to certain viruses due to an “inconsistency in the prescribed sterilization procedures.”

According to an NSU letter dated last Friday, the issue was discovered at the Post-Graduate Orthodontic Clinic at 3200 S. University Drive in Davie. None of the university’s 11 other dental clinics appear to have been affected.

To view the article in its entirety, click here:

https://www.oralhealthgroup.com/news/nsu-dental-patients-possibly-exposed-to-certain-viruses-due-to-sterilization-issues-1003938437/

Uncategorized

Backflow Matters — Think Disposable

November 22, 2018
by Sheri B. Doniger DDS


Do you ever request your patients to close on the saliva ejector to evacuate fluids from their mouths? If so, when was the last time you effectively cleaned out the valve? When a patient closes on the saliva ejector or the tip becomes occluded, backflow may occur due to a temporary drop in vacuum pressure. Saliva ejector backflow has been proven to potentially occur in an estimated 21-25%, as studied by the University of Montreal in 1998. 1 These studies indicated water contamination containing bacterial levels ranging from 1 CFU to 300 CFU* per occurrence. [*CFU (cfu or cFu) is defined as colony forming units in microbiology used to estimate the number of viable bacteria or fungal cells in a sample.] More plainly stated, one in five patients may receive the backwash in their mouths from the last patient. Think of how many times you ask your patient to “close”? That is a lot of bacteria!

To view the article in its entirety, click below:

https://www.oralhealthgroup.com/features/backflow-matters-think-disposable/