Toothio Staffing Platform Designed to Match Practitioner and Practice


This new staffing service called Toothio aims to create permanent hiring solutions for dental practices by matching them up with vetted dental professionals. Co-founded by Ian Prendergast, Toothio was created to address the staffing issues that the dental industry faces.

“The idea is that Toothio becomes an extension of your team,” Prendergast said in a press release from the company. “We want your patients to see the same smiling faces over and over.”

Dental practices can create an office profile to help Toothio find the best fit for whatever that practice needs. The practice then posts a shift and its pay rate, and then Toothio will do the rest, matching the dental practice with the right dental professional to suit their needs. Toothio handles payment and taxes. Toothio professionals can be utilized on a full-time basis, making it more cost effective than hiring full-time.

“When you factor in the cost of W2 overhead we are by far the most cost-effective option that does not include the cost of job ads, interviews, training, or turnover.” Prendergast said in the press release.

At the end of the shift, the dental practice can rate the professional based on performance and can then add them to be considered for future shifts. This platform is available now online at 

Articles

Toothio will help dental practices find the right dental professional to suit their needs while also handling payment and taxes. 

Toothio Staffing Platform Designed to Match Practitioner and Practice

Penn Dental Medicine Study Examines Microrobotics in Endo


Researchers from Penn Dental Medicine and its Center for Innovation and Precision Dentistry (CiPD) have released a study that examines the use of microrobots in endodontic treatment. During the root canal, these microrobots can reach the root canal’s surface to treat biofilm or receive samples for diagnostics.

Microrobotics are comprised of iron oxide nanoparticles that contain catalytic and magnetic activity. The magnetic field controls an aggregated microswarm that disrupts and retrieves biofilm on the surface of the root canal. The study also examined helix-shaped microrobots that were magnetically guided inside the root canal to dole out bioactives released on site.

“This technology offers the potential to advance clinical care on a variety of levels,” Co-corresponsding author Dr Michel Koo said in a press release from Penn Dental. “One important aspect is the ability to have diagnostic as well as therapeutic applications. In the microswarm platform, we can not only remove the biofilm, but also retrieve it, enabling us to identify what microorganisms caused the infection. In addition, the ability to conform to the narrow and difficult-to-reach spaces within the root canal allows for a more effective disinfection in comparison to the files and instrumentation techniques presently used.”

This study was done using 3D printed tooth replicas and mixed species biofilm containing endodontic bacteria. Microrobots were tracked in real time using an intraoral scanner, an X-ray, and cone beam computed tomography. This allowed for a visible maneuverability, according to Chair of Penn Dental Medicine’s Department of Endodontics, Dr Bekir Karabucak.

“Importantly, we demonstrated in an ex vivo model that the robots could be controlled by the magnetic field without interrupted by the soft and hard tissue surrounding the tissue,” Dr Karabucak said in the press release. “In addition, they showed tremendous maneuverability from the top to the bottom of the canal.”

These microrobotics could have a variety of uses in home care and other modalities, according to Dr Koo.

“From disinfecting medical devices like catheters to ensuring clean water lines, this technology holds the potential to transform areas far beyond dental medicine.” Dr Koo said.

Microrobotics studied at Penn Dental have the ability to disrupt biofilm on root canal surfaces as well as move inside the root canal to disperse bioactives. 

Penn Dental Medicine Study Examines Microrobotics in Endo

Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Dental Lab Products. He is also the author of 18 technology books, including the award-winning Green IT: Reduce Your Information System's Environmental Impact While Adding to the Bottom Line. As such, he’s particularly interested in the technological side of dentistry.

There are currently more than 200,000 dental hygienists in the United States of America – and that number is only expected to grow. The US Bureau of Labor Statistics (BLS) expects another 23,000 jobs within the next 8 years—a number, they say, that is going to grow faster than average. With that in mind, it might be a good time to look at which communities are best—and maybe not be so hot—to find a job.

There are a lot of factors that go into establishing which are the best and worst communities for dental hygienists to live and work. Certainly, money matters. But while dental hygienists certainly have a strong level of compassion for others, they still have bills to pay. When evaluating cities’ merits, we have to look at a host of factors.

We started by looking at the BLS data which gave us hygienists’ salaries based on city or region. But the cost of living varies depending where in the country one lives and works. For instance, things like food, housing, and discretionary spending are more expensive in San Francisco, California than they are in southern West Virginia. As such, we added the AdvisorSmith Cost of Living Index as a factor in the calculations.

However, there is more to life than making money (nationwide, dental hygienists earned an average of $77,810 in 2021). That’s why we started adding such factors as the overall economy, public safety, and so forth.

Cost of Living Index (this is a ratio comparing the cost of living in a certain area to the national average. Some areas are more expensive to live in than others, so the lower the COLI, the less expensive it is to live in an area.)

Stress (including work-related, family-related, money-related and health and safety-related stress)

Included, where available, is information about the total number in that profession for the community. Nationwide, there were a total of 206,100 dental hygienists in 2021.

In addition to BLS data, we refined our rankings from personal finance website Wallethub.com, US News & World Reports’ Healthiest Communities study and data from the Centers for Disease Control and Prevention for life expectancy by state.

We compiled all the rankings and then honed the list from there. Whoever got the lowest score earned the highest position on the list; whoever got the highest score, well, we talk about them also.

Top 10 (and Bottom 5) Cities for Dental Hygienists in 2022

With any top 10 list, there is a natural inclination to ask, “If those are the best places to live and work, where are the worst?” We crunched the numbers at the end of the list to present the following:

Bottoms 5

Here is the annual list of the top 10 and bottom 5 cities for dental hygienists to live and work in 2022.



The Top 10 (and Bottom 5) Cities for Dental Hygienists in 2022

Planet DDS has acquired QSIDental from NextGen Healthcare, Inc, a move that reinforces the company’s commitment to cloud-based solutions as a way for dental practices to navigate and uncover new opportunities through unprecedented times in the industry.

QSIDental offers cloud-based dental practice management software and has been a trusted clinical software partner to dental organizations for 40 years. Planet DDS, a leading provider of cloud-enabled dental software solutions serving over 10,000 practices in North America with over 60,000 users, will actively support the needs of existing QSIDental customers, empowering their growth and success through industry-leading cloud solutions.

“With rising costs and a difficult hiring environment, these are challenging times for dental practices. Planet DDS is committed to helping our customers to be more efficient and reduce costs while delivering better patient care,” says Eric Giesecke, CEO of Planet DDS. “This acquisition enhances our ability to deliver top-rated cloud-based software to more dental practices across North America, and we are excited to welcome QSIDental team members and customers into the Planet DDS family.”

Planet DDS and QSIDental share similar philosophies on the use of technology to deliver more efficient workflows for dental practices, maximize quality of care, and enhance the patient experience. Planet DDS delivers a complete platform of solutions for dental practices including Denticon Practice Management, Apteryx XVWeb Digital Imaging, and Legwork Patient Relationship Management.

A scalable solution backed by 4 decades of trusted service and innovation, QSIDental Web® is designed to keep data safe and secure, help expand dental businesses with peace of mind, and enable access to data anytime, anywhere.

Cloud-enabled dental software solutions company grows its reach by acquiring QSIDental from NextGen Healthcare.

Planet DDS Expands Cloud-Based Solutions with Acquisition of QSIDental

Designed for children by scientists, engineers, and pediatric psychologists, 

Robin is the first of its kind robot used in pediatric dental practices.

 Robin utilizes peer-to-peer interactions and engages children in various active distraction techniques and physical activities. Robin teaches children coping mechanisms to help reduce their stress and anxiety related to dental procedures. Robin also uses child-friendly terms and visuals to explain dental procedures and prepares children for the actual treatment. All of Robin’s doings have proven to increase the children’s collaboration with the staff, thus ultimately saving them valuable time.

Robin's charming character creates a welcoming atmosphere in every dental practice resulting in a successful patient visit and increasing the likelihood of the patient returning. With the addition of Robin the Robot, dental clinics experience 

improved customer satisfaction, improved social media presence

increased number of new customers, and higher retention rates

. Our clients see the ROI within the first few months. Robin brings new opportunities to provide exceptional 

Videos

We are excited to share coverage of Robin’s journey in pediatric dentistry by Fox 11 Los Angeles. Watch to learn more on how Robin helps pediatric patients and dentists by creating joyful and less stressful environment in the clinics.

Robin the Robot: An innovation transforming dental practices

Upon receiving her Bachelor’s degree in Business Administration and Accounting from Baylor University, Jennifer obtained her license as a Certified Public Accountant. After working in public accounting as an auditor of financial service companies, Jennifer transitioned her career to dentistry. She has been in the dental field since 2007 as a practice manager and accountant. 

The aspects of private dental practice that she enjoyed the most were developing the business and staff, and increasing the practice’s efficiency, and productivity. Jennifer combines her in-depth knowledge of dentistry with her extensive accounting background to provide clients with expert valuation services. Jennifer and her family live in Colorado Springs, Colorado. She enjoys being involved in her children’s activities, traveling, and attending as many sporting events as possible.

Many dentists who are considering selling their practice think that they can handle the valuation process themselves. They may have managed a large transaction successfully—the sale of a house, for instance—and assume that the process is similar. But selling a practice is far more complicated than selling a house.

To maximize profit, you must be familiar with the valuation methods used, understand how your objectives (immediate retirement or not) affect the transaction, and recognize the imperative need for specialized accountants and brokers. Overlooking any of these factors or being unaware of available strategies can cost you money. Here’s what every dentist should know about valuing a practice.


 Are you selling to an individual or a group that intends to practice dentistry and will require financing or to a DSO that is looking to invest and has access to private equity funding? The answer has implications for the type of valuation metrics that would be most advantageous for you.



 A practice may be valued using earnings before interest, taxes, depreciation, and amortization (EBITDA) or seller’s discretionary earnings (SDE). The best method in any given situation depends on the type of buyer involved and on the seller’s short- and long-term goals. Investors looking to make an acquisition are interested in the operating profitability of the business, which is what EBITDA describes and what DSOs use to evaluate a practice.

On the other hand, an individual or group looking to practice wants to know what the owner’s take-home pay is, including salary, net income, tax treatment advantages, and personal expenses charged to the practice. That’s what SDE describes. An SDE valuation makes more sense when buyers are owner-operators and need financing.


 Given the complexity of assessing the market value of a dental practice, it is in the owner’s best interest to consult experts who understand all of the factors involved. A team that specializes in dental practice transitions can apprise you of your options and help you choose the right ones based on your goals.

Many dentists use the services of a certified public accountant (CPA) to determine the value of their practice, but CPAs don’t necessarily have expertise in all available options. In many cases, CPAs provide SDE calculations that are incorrectly classified as EBITDA. That can put you at a disadvantage if you’re considering an offer from a DSO.

It’s a good idea to work with brokers experienced in various types of dental practice transitions. They can tell you which buyers (individuals, groups, DSOs) are likely to be interested in your practice, what valuation method is best in your case, and how your post-transition options (continuing to practice or hanging up your coat) affect the sale.


The bottom line? Selling your practice is probably the largest financial transaction you’ll ever make. In addition to getting the most out of the business you’ve built, with a professional on your side you’ll get advice on the strategy that will best help you achieve your objectives. If you go it alone or work with someone who doesn’t have the breadth of knowledge you need, you’re less likely to realize the maximum profit.

Start by understanding the factors at play and make sure you obtain professional advice. Even if selling isn’t on your radar, get an appraisal from a broker who specializes in dental practices. They can tell you what aspects of the practice, if any, can be improved to increase its value. Once you know how much your practice is worth and the long- and short-term factors that would affect its sale, you’ll be able to make an informed decision about your exit strategy and the timing of your sale.


What You Need to Know About Valuing Your Practice

Described as the only kids’ mouthwash scientifically proven to eliminate and prevent bad breath for 24 hours with just 2 rinses per day, SmartMouth Kids is the latest in SmartMouth’s line of innovative oral-care products.

SmartMouth Kids is available in a 10-ounce dual-chamber bottle on 

and Amazon at a suggested retail price of $6.99.Dentist-recommended, the rinse is designed to encourage sound oral-hygiene practices and help kids maintain a healthier mouth. SmartMouth Kids’ zinc-activated formula promotes oral health and boosts immunity, and its grape flavor was designed with kids in mind to help encourage regular oral-hygiene habits.

“No one likes bad breath, and that includes kids. But let’s face it – kids don’t always have the best oral-hygiene habits. That’s why we created SmartMouth Kids,” said SmartMouth CEO Jim Scheetz. “SmartMouth Kids eliminates and prevents bad breath just like our original activated mouthwash, but with a flavor that kids love and are more likely to use every day. And doing so will help kids maintain a healthier mouth.”

Similar to other products in the company’s activated mouthwash line, SmartMouth Kids employs 2 powerful liquids to fight bad breath. Its Sulfur Eliminating Solution destroys the root cause of bad breath: sulfur gases in the mouth. When added to its zinc ion Activating Solution, the combined solution instantly activates to release billions of zinc ions that bond to the germs in the mouth, stopping the return of bad breath for 24 hours with just 2 rinses a day.

A leading innovator in the long-term prevention of bad breath, SmartMouth also has developed a mild Zinc Ion Toothpaste kids love, a Clinical Activated Oral Rinse combining zinc ion technology with anti-plaque and anti-gingivitis benefits to prevent bleeding gums for optimal oral health, a Mouth Sore Rinse which helps alleviate oral pain and irritation, and a Dry Mouth Mouthwash designed to relieve dry mouth while preventing bad breath. SmartMouth also offers Dry Mouth Dual-Action Mints with zinc and xylitol to provide additional dry mouth relief throughout the day.

SmartMouth Kids formulated to eliminate and prevent bad breath for 24 hours with just 2 rinses a day and features a kid-friendly grape flavor to encourage good hygiene among children.

SmartMouth’s New Activated Mouthwash Formulated for Kids

uLab Systems™ Announces uAssist™ Treatment Planning Service for Ortho


has announced that they will be adding a new concierge treatment planning assistance service to its uSmile

 treatment planning software. This will allow orthodontists and dentists to communicate and assist in aligner treatment plans, according to a press release from the company. The uAssist service allows orthodontists to review case designs, make adjustments, return it for changes, or to order the final clear aligner. These adjustments are made within 2 review sessions per case, and are said to be returned in less than 3 days.

This streamlined system is designed to make orthodontic practice quicker and more efficient without compromising on quality, according to founder and chief technology officer at uLab Charlie Wen.

“We understand orthodontists need to have a balance of efficiency and control in order to provide the best care to their patients,” Wen said in the press release. “While some orthodontists will choose to plan their own treatments, we are providing a planning assistance option that has not been available in the market before; the best of both options in one aligner platform. If orthodontists encounter higher volumes, staffing challenges or an unusually complex case, our team is just a button away.”

All treatment plans done through uAssist must be reviewed and approved by the treating orthodontists.

This concierge treatment planning service from uLab Systems will let orthodontists and dentists efficiently and effectively send design and create clear aligners in 3 business days. 

uLab Systems™ Announces uAssist™ Treatment Planning Service for Ortho 

Somethings are just so simple, so basic that an explanation doesn’t seem necessary, but sometimes the details are essential. Case in point: surface disinfection. How hard can it be? You wipe on the chemical and then wipe it dry. The fact of the matter is that it’s not so simple. Surface disinfection is an important cog in the infection control machine and one that, regrettably, is often taken for granted.

It starts with the disinfectant chemicals, which are regulated by the Environmental Protection Agency (EPA).

“Disinfectant chemicals are unique,” Jackie Dorst, RDH, BS, observes. Dorst is an infection prevention consultant and speaker. “Disinfectants are regulated by the Environmental Protection Agency, and they come under the category of pesticides. These chemicals have a toxicity to be able to kill the microorganisms. And, of course, we want a chemical to use in healthcare that kills any pathogenic microorganisms in the categories of bacteria, fungus, or viruses. So, EPA regulates and approves disinfectants in different categories of efficacy.”

Those disinfectant categories come with varying levels of toxicity.

“Low-level disinfectants are more those janitorial-type chemicals that you would use in any public place during the pandemic,” Dorst says. “We all saw, even at the grocery store and at retail stores, that the carts that you pick up were wiped down with the disinfectant before you used it. Those were mostly low-level disinfectants, not the higher EPA List E disinfectants that are approved for healthcare and will kill those pathogenic microorganisms or disease-causing microorganisms. Healthcare disinfectants would be in an intermediate level category.

“There are also some disinfectants referred to as a high-level disinfectants, commonly called – in dental practices – ‘cold sterilization’,” she continues. “A high-level disinfectant will kill all vegetative microorganisms, but it doesn’t normally kill spores, and it’s very toxic. You can imagine, if it’s going to kill everything and it’s a liquid that we soak items in, then it’s got to be extremely toxic and very hazardous for the person using it.”

The appropriate chemicals for healthcare settings are included in a specific list.

“EPA has a list and it’s called the List E, which is for healthcare disinfectants,” Dorst says. “Any dental practice that wants to verify the disinfectant that they’re using is approved for healthcare and is it going to kill those pathogenic microorganisms, they need to search on the label or on the safety data sheet and locate the EPA registration number. They’ll use that registration number to search this EPA List E.”

It may seem that common sense dictates how to simply open a container of disinfectant wipes or spray on a disinfectant and wipe it dry. However, each disinfectant has its own usage rules, and those are laid out by the manufacturer.

“I think that people often don’t read the manufacturer’s instructions or the label on the actual product that they’re using,” Karen Gregory, RN, Director of Compliance and Education for Total Medical Compliance, observes. “And they may not make sure that the contaminated surface stays wet for the appointed contact time. Only when that contact time is met can you have the assurance that there has been adequate disinfection of that surface.”

“Contact time” is the magic phrase governing a disinfectant’s use.

“That’s the phrase that they’re looking for,” Dorst adds. “How long is it? It can be anywhere from 10 minutes to 1 minute. You don’t want just the shortest kill time that it says to kill a few microorganisms such as polio virus. There may be 5 different microorganisms that are listed on the front of the label, and it says, ‘Kills these in 30 seconds’. But then when you turn the label around and read the detailed instructions for effective disinfection in a healthcare environment, the manufacturer’s IFU may say, ‘But to kill all pathogens, leave wet for 5 minutes.’ That’s back to basics. What are the best practices for using a disinfectant?”

Regrettably, even the most seasoned professionals fall into bad habits.

“I had a clinician contact me within the past year, and she didn’t realize that the wiping portion of the spray – wipe – spray process was wiping with a paper towel,” Gregory says. “Her comment was, ‘I just didn’t read the directions’. I think, as adults, a lot of times we don’t read the directions. We also get so focused on turnover of that operatory because that next patient is waiting, that the appropriate time is not spent on the cleaning and disinfection process. This also may link back to, ‘I know how to do this. I’ve been in dentistry long enough’.”

Rudimentary as it may sound, team members must also keep an eye on the clock when disinfecting.

“When it comes to contact time, I feel like people don’t really understand how long 1 minute is or 3 minutes is,” Gregory says. “Contact time is equal to kill time. That surface has to be in contact with that disinfectant for the appropriate contact time to kill any contaminates that may be on that surface.”

Also, it’s important that staff take appropriate measures to protect themselves while using disinfectants.

“People may not realize how often they are coming in contact with these surface disinfection chemicals,” Gregory observes. “They may not protect themselves adequately. Over the course of 1 year workers could be exposed to this chemical thousands of times. I still have managers say to me, ‘I had a worker that was doing surface cleaning and disinfection, and they weren’t wearing any gloves’. So, knowing that this is a chemical and that they should be protecting themselves when they’re using the chemical, I think is something that needs to be stressed.”

How a product is applied is another important consideration with surface disinfection.

“A surface must be clean before you can disinfect it,” Dorst reminds. “Then the next step is to apply the disinfectant, and everybody’s heard this phrase, ‘Leave it wet for the contact time to kill all the microorganisms’. And that’s the important piece of information that is going to be on those detailed manufacturer’s instructions for use (IFU) on the back of that label.”

How the chemical is delivered matters, as well. That is, is the chemical used to spray onto the surface or applied using a premoistened wipe? Each has its own method of application.

“Most offices, for convenience, have gone to using disinfectant wipes,” Dorst says. “Not all wipes are the same. Some of them are a smaller size. Some are a larger size. Some of the disinfectant wipe containers contain more of the chemical. And those wipes are what I refer to as ‘juicier’. You really want a juicy wipe. When an assistant or a hygienist pulls that wipe out, it goes through a little sweeping process that wipes off the excess. You don’t want it to be dripping chemical all over every surface, but when you pull that wipe out, it should be wet enough that if you squeezed it in your hand, you could get a few drops of chemical out. If it’s not juicy and when you pull that wipe out and you squeeze it in your hand and nothing comes out, then that wipe is too dry. It doesn’t have enough chemical in it to leave the surface wet for the contact time to kill all the pathogens.”

Team members must also be mindful of how they are applying the surface disinfectant, being careful to be thorough.

“What is your technique for wiping down those surfaces?” Dorst asks. “Because a quick swipe over could miss some critical surfaces. It only takes a few viral particles of the norovirus to transmit a disease or a few viral particles of measles. Or as we have learned, if someone’s coughing with a COVID infection, and those aerosol droplets are on the surface –and we don’t get them clean – then touch that surface with our gloves on as we’re treating the patient there is a risk of infecting the patient (cross contamination).”

Surface contaminants are hard – impossible, really – to see. The right product and a good technique is, of course, necessary to eliminate those contaminants.

To underscore just how hard it is to see contamination, the Organization for Safety, Asepsis and Prevention (OSAP) produced a video called “If Saliva Were Red”. The video graphically depicts how patients’ saliva is left all over the operatory – including on team members.

“I would encourage people to see that video,” Dorst says. “It allowed us, with a dye, to see where the red splashes were in an operatory and why we need to wear PPE and what surfaces needed to be cleaned and disinfected.”

“The “If Saliva Were Red” video shows all the contamination that occurs in dentistry through the delivery of care,” Gregory adds. “If you could see where it was, you would be really surprised. There may be a contaminated surface that, because you can’t see the contamination, you might not clean it as well as you should. The takeaway is that that surface cleaning and disinfection is critically important, because there may be areas that are contaminated and you can’t see the blood on it. Just think about everywhere your hands may have touched or where you may have put a contaminated instrument, and make sure that those surfaces are taken care of appropriately.”

Dorst recommends using a product called Highlight, which is an additive that colorizes bleach spray so team members can visualize where bleach has been applied.

“Something like Highlight that can be added to the disinfectants is another visual that will prove to be a training benefit for many dental practices,” she says. “As we have new team members join the office – and as a refresher for us experienced infection preventionists – we need to be thorough with our cleaning and disinfection, so we don’t have any of those missed surfaces that could inadvertently transmit a disease.”

Surface disinfection may seem like an easy, rote task. However, taking the process for granted is the first step down the path toward a terrible mistake.

Best practices for surface disinfection in dental practices.

Surface Disinfection 101

Kelly Tanner, PhD, RDH, is a dental and leadership industry educator, and helps organizations reach goals through understanding employees and behavioral drivers. She works with all sizes and types of organizations, including dental organizations to strategically align people with outcomes and improve the psychological ownership of organizational goals. At a micro level, she helps individuals become high-performance leaders by developing emotional intelligence which directly affects their impact as leaders and as members of an organization and teams. 

Talk Techy to Me: Incorporating Technologies into Your Dental Hygiene. Photo courtesy of natali_mis/stock.adobe.com. 


One of my favorite aspects of being a dental hygienist is learning about new technology that helps to make my day easier, helps me take care of my patients, and gives patients the desire to return to the practice. I think of technology as a team member that helps me achieve my goals for the patient and the care I deliver. Technology supports my procedure by helping me assess, diagnose, treat, educate, and implement my care plan. I want to share information about the technology that has personally changed how I care for my patients and has improved patient satisfaction and health outcomes.

As a dental hygiene educator, one of the courses I taught for 9 years was radiology. How many of you remember taking X-rays on a Dexter manakin? I don't remember loving radiology class as much as I love teaching radiology now. I remember how difficult it was, not just as a student but also as a clinician, to find all the possible pathology and bone levels that the next person could or couldn’t see. This led me to Pearl's Second Opinion® chairside, artificial intelligence (AI) technology, which has changed how I practice. Second Opinion works as simple as taking the patient’s X-ray, pulling it up on screen, and allowing the software to indicate potential areas of pathology. Second Opinion is intelligent enough to recognize natural dentition and restorations, so there is no more guessing if you caught anything incorrectly. This technology doesn't take the place of a practitioner's diagnosis, but it spots abnormalities to say, “Hey Kelly! Look over here at this!” 

There are a few AI software with U.S. Food and Drug Administration (FDA) approval to detect caries, but Second Opinion is the only AI approved to also catch other common issues like subgingival calculus or overhanging restorations before we see a patient, especially for hygiene. Additionally, Second Opinion is also cleared to use with patients 12+ years of age and for bitewing & periapical X-rays. Beyond diagnosis and treatment planning, I have also found that using this software to educate patients is a way to build trust and establish the health status of hard and soft tissues. It also tells the patient that you are cutting edge by investing in the best technology for them.

Speaking of X-rays, how many of you have a Cone Beam Computed Tomography (CBCT) scanner in your practice? The CBCT scanner is also called a "cone beam scanner" by many practitioners. Typically, the doctor uses CBCT scanning to evaluate bone levels, anatomical landmarks, and potential pathology. CBCT scanners are not currently part of a typical hygiene workflow; however, I think this will change within the next 2 years. Although the CBCT does not take the place of bitewings, the device can image pathology and bone levels in a way that no other device can. 

On a CBCT, the contour and height of the bone can help you tell the story to the patient about how periodontal disease and malocclusion are affecting their oral and overall health. Visualization of periapical abscesses is effortless because of the contrast in the imagery, which also helps to improve the accuracy of diagnosis to correctly recommend treatment before the patient experiences pain or more expensive procedures.

Have you ever heard the story of a person going into the emergency room with appendicitis, and the imaging they take shows a tumor that the patient would have otherwise not found? 

Another benefit of taking a CBCT scan is that in the image, there is hard and soft tissue imaged from the skull and spinal column (depending on the field of exposure in the CBCT) that can show dental professionals valuable information. As with any type of radiograph, sometimes the pathology is more prominent, but what about what you aren't trained to see, such as cancer and vascular canals that may be blocked in the image? How would you even know what to look for? The good news is you don't have to be the expert. 

DentalRay is a subscription-based service that sends your CBCT to a medical radiologist, interprets the radiograph, and sends you back a pathology report of all imaged structures within 48 hours. You are already taking the image on the patient, so why not take advantage of the opportunity to clear your patients of any other abnormalities. Again, this service is positioning you as the provider connecting their oral and overall health and potentially saving their life. Additionally, DentalRay assumes the liability of the interpretation, and the interpretation is also eligible for medical reimbursement. Now it becomes, "Wow, you saved my life."

One of the most significant differences I have experienced in patient communication has been utilizing my iTero Element 5D Plus 3D scanner. Regardless of the brand of 3D scanner you have in your practice, you need to use a digital scanner to educate. The scan connects the patients to their mouths in a unique way, and your patients will think you are a rockstar. When I create a digital health scan with my iTero, I can show the patient gingival inflammation, interproximal caries, cracking, wearing, occlusal wear, and many other issues. I can track these changes over time. I can press "play" on the screen and show the patient the changes in their tooth structure from 6 months ago, a year ago, or whenever I want to choose the point in time based on the images gathered in the system. Not only can they see where they are currently, but they can also see where they have been and the consequences if their teeth are not treated. 

The iTero has single-handedly helped me compress time in my hygiene appointments while allowing me to leverage the information I have scanned to develop trust and answer questions they may have about their care.

Next up is clear aligners. We know about products such as Invisalign, Spark, OraFit, and OrthoFX, but we didn't learn anything in hygiene school about how clear aligners work, their materials, or how to tell patients to take care of them. I am a nerd about orthodontics. When I was 23, my dentist enrolled the team and me in 100 hours of continuing education across the United States to learn about functional orthodontics. I learned that malocclusion is a big deal. If the teeth aren't aligned, it puts them at risk for trauma, premature enamel, and tooth loss. Malocclusion is 1 of the 4 ways that we can lose our teeth: periodontal disease, caries, malocclusion, and trauma. Malocclusion is treatable and clear aligners make it so easy with advanced technology. 

Here is a fun fact. Did you know that orthodontic brackets have different prescriptions built into the brackets based on the type of bracket chosen? You may not have known that, but what is important to know is that 75% of the population has some form of malocclusion. The hygienist needs to be a part of the discussion, because of tooth loss and how malocclusion affects the progression of periodontal disease. Malocclusion is linked to the function of the teeth, airways, sleep apnea, oral systemic disease, and overall health. Again, it’s a big deal.

Clear aligners are now offered in many general practices, and now that you know how important it is to assess and discuss malocclusion, you can take the next step to discuss clear aligners. Clear aligners are made of a polymer and have differing technology. It's not just about the tooth being moved over in increments. It's also about how predictable the polymers are because of the technology built into them. 

The number one issue with clear aligners is patient compliance, so it is essential to reinforce and motivate patients to wear them as frequently as possible. One of the reasons why I find patients do not wear them is because they feel like the device has a bad taste or smell. Patients should not be brushing their clear aligners with a toothbrush because it causes scratching on the surface of many clear aligners on the market. Why does scratching matter? For the same reason why pitting of the aligner matters. Pitting is caused by denture cleaners and other home remedies and pitting and scratching cause biofilm adhesion to the aligner. I always get the question: "there is biofilm in my trays?" Yes. And the trays also contain other bacteria, yeast, and fungus. Dawn dishwashing soap with a toothbrush should be avoided. Some products, such as Steraligner, kill 99% of bacteria, yeast, and mold. Steraligner, which I also consider a technology, is designed to disinfect, and whiten the trays in 3 minutes while your patients brush their teeth. Much like your smartphone, once you use Steraligner, you cannot imagine life without it. Recommend it to your patients, try it yourself, and you will be hooked.

The next technology is a Piezo scaler. Yes, we love how the Cavitron busts off the calculus, and I understand the wide-eyed look and excitement when it happens. Many hygienists wonder if the Piezo is working because of its gentle nature. The Piezo removes the calculus more gently, almost disintegrating the calculus into a sand pile. What I love most about a Piezo is the patient comfort and the choice I get to have with tips. I love the Acteon’s Newtron for a lot of reasons, like the minimal water spray, the LED light built into the handpiece, an interchangeable reservoir (between water and medicament of your choice), and I have many tips choices. Piezo scalers can also be used around titanium implants because the lower vibration setting provides additional versatility. Acteon also has pure titanium Piezo tips (Implant Protect Titanium tips) that can be used around the implant to remove cement, biofilm, and calculus. As I write this, these are the only pure titanium tips on the market.

I must also include my favorite toothbrush—the Philips Sonicare Diamond Clean. I have been using Sonicare since 1994--I even have a picture of my first edition--and it provides the best predictable results for patients. Patients can change the amplitude, the brush heads include a microchip that tells them when to change their brush head, and of course, after every use, you feel like you came from the hygiene chair. Regardless of what you recommend to your patients for electronic toothbrushes, electric is better than a manual toothbrush, and the studies tell us this (regardless of manufacturer) over time that this is the case. Sonicare happens to reduce pocket depths 26x more than a manual toothbrush. Seventy percent of a patient's oral health success occurs at home. We need to help them establish a routine that works into what they are already doing at home and for them to know that the time they spend on any behavior modification is valuable. Your patients probably don’t use a flip phone anymore, so bring your patients into the era where technology makes their life easier and makes what they are already doing considerably more effective.

I would like to mention a new fluoride varnish I discovered, FluroCal. Not all fluoride varnish is created equal, and you may not have thought about your varnish for a while. In a fluoride varnish, we want what will work and what is pleasing to the patients, right? Do you know BISCO? BISCO is an adhesives company, and guess what varnish is? You guessed it! BISCO is known for its dental products and is a favorite among many dentists, including Gordon Christenson. FluroCal has many attributes: xylitol, 24-hour substantivity and release, immediate sensitivity relief, high fluoride uptake, and tri-calcium phosphate. All of the things required to check the boxes that you like in a varnish. Here is what I love. It's not sticky—it's not separated when you open it---it's not like a can of paint; you mix it with the end---its smooth and white. Patients love the subtle taste, and there are more flavors to be revealed soon. I call that technology.

Be encouraged that everything I have mentioned has helped my workflow and efficiency. I know it can seem overwhelming when we think of new products and technology and how and when to use them. Think about your why and how any of these technologies can serve your why and your patients. I encourage you to remain open to new opportunities that will benefit you and your patient by trying something different.

There is a wide variety of technology that can be implemented in everyday, dental hygiene practice, and here are just a few to get started. 