By Anne Guignon, RDH, MPH, CSP
Quite honestly, clinical practice would get boring really fast if one had to provide care the same old way, day in and day out, on every patient. Fortunately, many companies focus on innovation to drive their business. One of the best ways to learn about new products is to attend a conference that has an exhibit hall.
Every year, I attend both the Yankee Dental Congress in Boston in January and the Chicago Midwinter Dental Meeting in February. In 2017, the weather was very mild in both cities. A light down jacket kept me warm, and the lack of snow and ice made the visits much more pleasant. Both meetings had robust exhibit halls, full of new and exciting products. Five caught my attention. Three are designed to improve our workplace safety and comfort, and the other two focus on the patient experience.
Options in seating
Over the past six years, alternative seating has become the talk of the town. Clinicians always seek opinions about the best option for alternative seating or saddle stools. The answer is simple: Look for a saddle stool or another seating option that works best for your body. Period. Early saddle designs were limited to two configurations - Western and modified English. As interest grew, companies such as Crown Seating started taking a long look at hybrid designs that would accommodate different torsos and pelvic widths. The company believes in the Goldilocks principle; there is an optimal seating option for everyone.1-2
The Silverton saddle, launched this January, is a hybrid design containing elements from each of the original models. The seat pan is a bit smaller than the modified English and the sides slope more, creating a narrower sit/stand positioning. The rise in the middle of the seat is much less pronounced than a Western style. So if the two earlier models did not feel right to you, the Silverton might be the right solution.
Options in gloves
The next two products that caught my attention are for our hands. Microflex, a division of Ansell, is a huge company in the glove world. For years, the company has had a keen interest in offering products that not only work well from an infection control standpoint, but that also create the least amount of ergonomic stress on the hand.
Three of their premium glove brands now carry an ergonomic certification from US Ergonomics. Interestingly, the ergonomic testing was specifically designed to test procedure challenges found in the dental setting.3 Test subjects performed tasks both barehanded and wearing gloves under both wet and dry conditions. Artificial saliva was used to simulate a wet environment, and the actual test subjects were dental hygienists in New Jersey. In addition, dental hygienists in other parts of the country completed a questionnaire about how the gloves performed in their own clinical setting.
Two nitrile brands, Xceed and Ultraform, and one polychloroprene brand, Neogard, carry these certifications. The research demonstrated that Xceed gloves did not increase muscle effort in the performance of postural tasks over working without gloves, and there was no performance difference in postural and gripping tasks when wearing Ultraform gloves or doing the tasks barehanded.
This year’s breakthrough is the addition of half sizes in the Ultraform line that includes the sizes: XS/S, S/M, M/L, and L/XL. The addition of these four half sizes allows more clinicians to find the perfect fit for their hand dimensions.4-5 The icing on the cake is a sizeable reduction in cost for both the Xceed and Ultraform since the boxes of both nitrile brands contain 250 or 300 gloves, respectively. Cutting costs and improving hand ergonomics - what a combination!
Options in hand hygiene
Hand hygiene is important. We all wash our hands or use hand sanitizers much more often than most people. While both of these activities focus on reducing cross contamination, many suffer from dry, irritated skin, especially during the cold winter months. Frequent hand washing, insufficient hand drying, and using a damp cloth or nonabsorbent towels all contribute to breaking down skin, the body’s natural barrier.6
Alcohol-based hand sanitizers have become increasingly popular. But in order for alcohol to have a profound effect on surface microbes, the skin must remain wet from the product for two minutes. This length of time exacerbates dry skin, which can lead to microscopic breaks in skin integrity. To combat dry skin issues, it is important to know that petroleum-based hand creams and lotions can affect the integrity of certain types of gloves.
FiteBac germicidal hand gel is a proprietary, fragrance-free silicone formula that contains the antimicrobial benzalkonium chloride, known to be effective against pathogens such as E. coli, S. aureus, MRSA, C. albicans, and influenza A.7-8 It only takes a pea-size amount of the gel to coat both hands.
The silicone makes the application very smooth, and it also creates an invisible skin barrier that prevents absorption of water or other chemicals. The product does not contain water, petroleum, alcohol, or paraffin. FiteBac gel should be reapplied every four hours to maintain germicidal action. There are 300 applications in the small tube, which fits neatly inside most purses, computer bags, or backpacks.
Options in pain control
Do you have any patients who are needle phobic, or who would be willing to pay an extra fee to have a needle-free anesthesia experience on the maxillary arch? Drum roll, please. Kovanaze is a new way to provide a regional block anesthesia on the upper arch from bicuspid to bicuspid, resulting in full pulpal anesthesia.9
Kovanaze is a combination of tetracaine HCL and oxymetazoline HCL that is administered as a nasal spray.10 My recent experience with this drug was amazing and went way past the strict guidelines set forth by the FDA regarding drug claims.
While I realize that every person is different, this was my firsthand encounter with the drug. The small application device is inserted into the nose. While sitting upright, one spray is administered horizontally, and, five minutes later, the second spray is administered at a slightly more oblique angle. Within minutes, teeth numbers 9 through 13 were profoundly numb and, due to nerve crossover, 7 and 8 were also anesthetized. In my case, the palatal tissue was also numb.
While the drug claims can’t include soft tissue anesthesia, buccal and interproximal tissue felt different. According to the FDA drug claims, the anesthesia will last around 45 minutes. In my case, the effects of Kovanaze lasted for well over two hours, and there was no lip numbness. Afterwards, the anesthetic wore off quickly over a 10-minute period of time. While this is a niche product, it is truly minimally invasive and is considered a topical anesthetic in most states.
Options in dry mouth treatment
Every day, more patients grapple with dry mouth issues. Hyposalivation and xerostomia are not synonymous terms. Hyposalivation is defined as insufficient salivary flow, which, in extreme cases, can mean no saliva at all. Xerostomia is a patient’s perception that the mouth is dry. There are situations where the flow is sufficient, but the composition is poor, resulting in a feeling of dryness.
Despite the differences in definition, patients with dry mouth syndrome of any sort have significant problems with oral comfort, and oral dryness becomes a quality of life issue. While dry mouth is very common in those age 50 plus, the problem spans all ages (10% of all 30-year-olds). The factors that contribute to dry mouth are complex and complicated and include side effects of medications, symptoms of many diseases and disorders, lifestyle issues, and environmental challenges.11 Look for a comprehensive continuing education article in the next few months that will go into great detail on this subject.
Allday Dry Mouth Spray is the final product that caught my attention. Most existing mouth sprays offer temporary relief, but lack substantivity, so the relief is short-lived. It is well known that xylitol can stimulate salivary flow, but the trick again is keeping the xylitol levels elevated for a longer period of time.12 Allday Dry Mouth Spray is a supersaturated spray that contains 44% xylitol. In addition, it has mucoadhesive properties, so it sticks and stays much longer than other sprays.
The spray is formulated with a light mint flavor, is the consistency of heavy cream, and has a smooth mouth feel. The spray bottle fits nicely into the purse and meets all government regulations for liquid carry-ons on planes.
So, if you haven’t been to an exhibit hall recently, I invite you to make plans to see what is new at two meetings this summer: ADHA’s annual session in Jacksonville, Florida, during June, and PennWell’s RDH Under One Roof Conference in Chicago in July. Both exhibit halls will be packed and full of exciting new products that are sure to make life as a hygienist more interesting and more rewarding. I look forward to seeing you at one or both meetings! RDH
ANNE NUGENT GUIGNON, RDH, MPH, CSP, provides popular programs, including topics on biofilms, power driven scaling, ergonomics, hypersensitivity, and remineralization. Recipient of the 2004 Mentor of the Year Award and the 2009 ADHA Irene Newman Award, Anne has practiced clinical dental hygiene in Houston since 1971, and can be contacted at [email protected].
References
1. Guignon AN. Take a stand on seating: Strategies defuse occupational hazards associated with sedentary positions. RDH. 2016;36(9).
2. Guignon AN. 50 years of seated dentistry: The legacy and the outcome of just sitting down too much. RDH. 2016;36(9).
3. Mylon P, Lewis R, Carré MJ, Martin N. A critical review of glove and hand research with regard to medical glove design. Ergonomics. 2014;57(1):116-29.
4. Drabek T, Boucek CD, Buffington CW. Wearing the wrong size latex surgical gloves impairs manual dexterity. Occup Environ Hyg. 2010 Mar;7(3):152-5.
5. Guignon AN. Current glove trends in clinical dental hygiene practice. Data collected August 2010.
6. Callahan A, Baron E, et al. Winter season, frequent hand washing, and irritant patch test reactions to detergents are associated with hand dermatitis in health care workers. Dermatitis. 2013 Jul-Aug;24(4):170-5.
7. Molinari JA, Nelson P. Investigation of FiteBac germicidal hand gel properties. The Dental Advisor. 2012; 52.
8. Molinari JA, Nelson P. Investigation of prolonged activity of FiteBac germicidal hand gel. The Dental Advisor. 2012; 46.
9. Ciancio SG, Marberger AD, et al. Comparison of 3 intranasal mists for anesthetizing maxillary teeth in adults: A randomized, double-masked, multicenter phase 3 clinical trial. J Am Dent Assoc. 2016 May;147(5):339-347.
10. Hersh EV, Pinto A, et al. Double-masked, randomized, placebo-controlled study to evaluate the efficacy and tolerability of intranasal K305 (3% tetracaine plus 0.05% oxymetazoline) in anesthetizing maxillary teeth. J Am Dent Assoc. 2016 Apr;147(4):278-87.
11. Sreebny LM, Vissink A. Dry mouth, The malevolent symptom: A Clinical Guide. Ames, IA: Wiley, Blackwell: May 2010.
12. Chaffee BW, Cheng J, Featherstone JD. Non-operative anti-caries agents and dental caries increment among adults at high caries risk: a retrospective cohort study. BMC Oral Health. 2015 Sep 24;15(1):111. 4.
