Retractable cords are convenient. When cords dangle, the chances of tangling an item are very good. Things from irons to hairdryers now come with nifty cord keepers, which wind the cord neatly with a simple push of a button. How wonderful to have items such as keys or pens, which are easily misplaced, secured with a retractable keeper. Many pet owners walk their dogs on retractable leashes, which keep the animals in check and ensure control. In dentistry, patient tissues and lips need to be expanded and retracted so clinicians can see clearly and hold the lips securely during procedures.
The basic protocol in some dental offices may be simply to place cotton absorbants, twist the saliva ejector to fit, and pull oral tissues away with a mouth mirror or gloved finger for retraction. This is usually done while still providing care. However, expanding and holding tissues securely is no small task in the oral cavity. Today’s hands-free dental devices make retracting tissues so easy it’s almost like having a third hand.
During a lengthy procedure, a patient’s only or worst discomfort may be from holding his or her mouth open. Ivoclar Vivadent has developed a lip retractor, called the OptraGate expander, that is well suited for procedures requiring lips to be open and out of harm’s way. This total coverage works well for procedures such as in-office whitening. The OptraGate expander is flexible, not flimsy, and comfortably holds the entire upper and lower lip because it holds its form.
The OptraGate has an inner and outer ring with non-latex plastic between the rings for complete lip shielding. The expander rings have a memory, so when slightly squeezed during insertion, the rings adapt and return to an anatomical position that can be evenly controlled around the lip opening. Available in sizes from child to adult large, OptraGate should ideally be used during full isolation. Be careful, because patients are different and mouth openings are not standardized. The OptraGate is for single patient use, because the material cannot withstand sterilization procedures.
Other options for retractors are autoclavable. Made of a more rigid design, these retractors possess comforting features even though the materials are less pliable. ComfortView Lip and Cheek Retractors, made possible through Premier Dental, has lip and cheek coverage for both long and short appointments. ComfortView has upper and lower cushioned fingers designed to hold lips away from the teeth and offer comforting support. With this device, the mouth has four open areas on the lip when in position for treatment. The ComfortView is very stable and has replaceable cushions. Both can be easily placed into position and easily removed (because of the product’s gentle flexibility). Cheek stability is ensured and reinforced with small inner flaps.
During tedious orthodontic procedures, retractors keep the lips from interfering. Designed with this in mind, the Lip Ring Retractor from Ortho Technology is a good choice. Made of a transparent medical grade material, the product is not a hindrance when taking intraoral images or clinical photos. The retractor rolls over and protects the lips only and the corners are exposed. Fluoride varnish applications may be easily brushed on when using a retractor. Another product that protects the lips, available through Parkell Dental, is the Expandex Lip Retractor, which boosts intraoral visibility and is anatomically suited. It is available in both child and adult sizes.
J. Morita USA offers Free Access II. Hygienists often experience hand fatigue from wrestling with patients’ tight lips and cheeks. The Free Access II helps relieve this dilemma, and can withstand sterilization regimens. It contains no metal, so X-rays can be taken while using this tool. Another bonus is a rest spot on the device where the saliva ejector can sit.
The tongue in check
During hygiene procedures, a field free of a roaming tongue is welcome. Spectrum Dental, Inc. offers the clinicain a colorful selection of retractors that fit this specification. FastTrak Tongue & Cheek Retractors keep the tongue from roaming and are available in green (small), blue (medium), and red (large) color size-specific selections. A bar holding the device and attaching one side to the other rests gently near the tongue, and the corner of the lips are shielded, leaving the lips exposed. Holding the tongue securely away from the teeth helps during whitening procedures. Bleaching agents may irritate the papilla when the tongue finds the gel thickly placed on the teeth.
Retractors and expanders are useful during dental hygiene tasks. These devices work especially well for keeping the lips and tissues stable when working in hard-to-reach intraoral areas or along the margin cervicals. Easily inserted, anatomically comfortable retractors provide a third hand for hygienists.
The author did not receive compensation for the products mentioned. For more information about the products mentioned, visit www.ivoclar.com, www.getoptra.com, www.premusa.com, www.orthotechnology.com, www.jmoritausa.com, or www.specdentl.com.
Karen Kaiser, RDH, graduated from St. Louis’ Forest Park dental hygiene program in 1994 and currently practices at the Center for Contemporary Dentistry in Columbia, Ill. She has written several articles for RDH and other publications, sits on dental hygiene panels, and is an evaluator for Clinical Research Associates. She can be contacted at [email protected].