Wednesday, December 28, 2011

What Changed The Way I Practiced In 2011


Q: What changed the way you practiced in 2011?
A: As usual nothing remained constant in my practice in 2011. I really enjoy writing this column as I get to do a retrospective of the past year and see the changes technology makes in my practice.  There were some new technologies that have supplemented and replaced my previous way of doing things. The big thing about 2011 is that I can now say there is nothing that I do on a regular basis that I was taught in dental school.  This is not to say I don’t fall back to the tenants of my dental school education at times but those teachings are not the first way I do things in 2012.
So what was the last procedure to change in my office? It was extractions. I acquired the Golden Physics Forceps.  Physics Forceps are useful for achieving atraumatic extractions of all teeth. The unique design delivers a powerful mechanical advantage by employing an efficient first-class lever. Think of it the same way you take the top off a beer bottle with an opener. 

When the periodontal ligament is traumatized with the Physics Forceps or elevators, hyaluronidase (hyaluronate glycanohydrolase) is released. These forceps in many cases make extractions easier for me and less traumatic for the patients. In this age of regularly placing dental implants the need to preserve bone is paramount.  These forceps help preserve the buccal plate and have made extractions less stressful for me. Get a discount when purchasing the Physics Forceps by using promo code Marty100.

I am a big fan of the use of magnification and illumination in the practice of dentistry for use in every procedure. I have been wearing surgical loupes for years and have gone on a progression from tethered halogen lamps to battery powered LED’s along with increasing my magnification.   

The tethered halogens would give me whiplash when I would forget to remove the light from my head as I exited the operatory and were expensive to repair the broken fiber. I was very happy to switch to the smaller and lighter LED’s. Initially the battery packs were large but they have since come down in size and weight. The only problem with these portable LED’s lights and batteries for me was the cord was like a magnet for any doorknob or object jutting out in my office. I would occasionally watch the battery back fly down the hallway as it snagged on something. This year I acquired the Orascoptic Freedoms surgical loupes. They are surgical loupes with a cordless LED light attached. I chose the 4.8 magnifications. They are available in magnifications from 2.5 X  to 4.8.

The battery packs are attached to the back of the eyeglass frame. I love the fact I can now wander around the office with them on or dangling from my neck and I no longer have any errant battery packs being launched around the office.
The face of oral cancer is changing and I decided to step up my ability to find pathology in my patients so I acquired both a Velscope and an Identifi.




These devices assist me through the use of fluorescent technologies to help identify any areas of potential dysplasia in the mouth. So why did I need both? Because one is an extra oral device and the other is an intraoral device. Many HPV related oral pharyngeal cancers are located far back at the base of the tongue.  This can make visualization difficult. Each device has its benefits and weakness and I chose both to offer my patients all the possible tools to assist in identifying pathology. I can say that both of these devices have assisted me in detecting potential pathologic areas that required further follow up and that I may have previously missed with a standard white light examination. In retrospect it is not that the areas were not visible under white light exam but both the Velscope and Identifi helped to highlight these potential pathologic areas and assisted me in their visualization.

The use of cone beam 3-D imagining technology is assisting me in the treatment planning of implants and retreatment of failing endodontics. I have not yet purchased a cone beam machine but I hope to do so in the future.  I am lucky that there is a mobile cone beam scanning service available in my area that will either come to my office or the patient’s home or office to take the scan. This makes it easy to use the latest imaging technology without the capital outlay at this time.
I had never done orthodontics in my office but I started doing short term orthodontic treatment using the 6 Month Smile program in 2011.  The excellent 2-Day course gave me the confidence to try orthodontics. This easy to use system has allowed me to enhance the smiles of many of my patients in a way I had never been able to do before.  Treating cases has been easy and assistance from the 6 Month Smile webs site has been excellent. The orthodontist that I refer to is also happy because I have a better understanding of orthodontics and have referred additional cases to him that are outside the 6 Month Smile protocols and beyond my capabilities. Get a discount on the 6 Month Smile Course by using promo code Marty100.
The last thing that changed the way I practice in 2011 has been Kerr’s Sonicfill. Sonicfill is a specially formulated bulk fill composite and handpiece combination. Through the use of sonic forces the composite changes from a very high viscous state to a lower one.
The composite comes out of the handpiece and is fluffy. It reminds me of a soft ice cream machine dispensing my favorite flavor. As the sonic energy dissipates the composite starts to harden making for very easy carving of the composite. You can place up to 5mm increments into your preparations and light cure. This bulk filling greatly reduces the time and effort to place posterior composites.  Watch the Sonicfill video for how easy it is to place the composite restoration.
So these are the new technologies and procedures that I have incorporated into my practice in 2011.  What new technologies will be incorporated into my practice in 2012? I have some ideas of what is coming down the road in my practice and I am sure I will be in for a few surprises.  I have a whole year to see what new technologies enhance my practice of dentistry and make the 2012 list of things that changed the way I practice.




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