Caren M. Barnes

Applications of the air-powder polisher in clinical orthodontics

Air polishers are relatively new devices that have provided dentistry with an alternative method for cleansing the tooth surface. Many publications attest to the efficacy of the instrument in plaque and stain removal while advising the practitioner of potential health risks to the patient. In spite of the information available, little research has been published concerning air polishing procedures in the treatment of the tooth surface before placement of the orthodontic bracket. In light of the research supporting the efficacy of plaque and stain removal, the use of the air polisher has been shown to have no detrimental influence on the bonding of the resin bracket cement to the tooth surface. It would appear that the system may be ideal for use in conjunction with orthodontic treatment. The air-powder polisher has been found to be the most effective method of plaque removal for orthodontic patients without causing breakage of elastics or wires or loss of zinc phosphate or composite material. Another application for the air-powder polisher in the orthodontic practice is surface preparation of the tooth before bracket placement. The instrument should be held approximately 4 to 5 mm from the tooth surface, at a 60 degree angle for anterior smooth surfaces, at an 80 degree angle for posterior smooth surfaces, and at a 90 degree angle for occlusal surfaces. A constant circular motion should be used, with an exposure time of 30 to 60 seconds.

Dental Hygiene Intervention to Prevent Nosocomial Pneumonias

UNLABELLED Nosocomial and ventilator associated pneumonias that plague critically ill, elderly and long-term care residents could be reduced with effective oral hygiene practices facilitated collaboratively between nurses and dental hygienists. BACKGROUND Nosocomial pneumonias, specifically aspiration pneumonias and ventilator-associated pneumonias in the elderly and infirm have become a major health care issue, The provision of oral care in hospital and hospital-like facilities presents challenges that can prevent patients from receiving optimal oral care One sequela can be aspiration pneumonia which ranks first in mortality and second in morbidity among all nosocomial infections. Since aspiration pneumonia is linked to the colonization of oral bacteria in dental plaque and biofilm, it is time to look for creative solutions to integrating the expertise of dental hygienists into health care teams in these institutional settings. METHODS A comprehensive review of the literature was conducted regarding the etiology and prevalence of health care related pneumonias. Evidence describing the challenges and barriers that the nurses, nursing staff, and dental hygienists face in the provision of oral care in hospitals and long-term care facilities is provided. Intercollaborative solutions to providing optimal oral care in hospitals and long-term care facilities are suggested. CONCLUSION Dental hygienists have the expertise and practice experience to provide oral care in hospitals, long-term care and residential facilities. They can contribute to solving oral care challenges through intercollaboration with other health care team members. Yet, there are long-standing systemic barriers that must be addressed in order to provide this optimal care. Dental hygienists becoming better assimilated within the total health care team in hospital and residential facilities can positively impact the suffering, morbidity and mortality associated with aspiration pneumonias.

A comparison of the efficacy of 2 powered toothbrushes in affecting plaque accumulation, gingivitis, and gingival bleeding

BACKGROUND The purpose of this 30-day blinded, parallel-design study was to compare the effect of 2 powered toothbrushes, the Rowenta MH700 and the Braun Plak Control Ultra, on reducing plaque accumulation, gingivitis, and gingival bleeding in a cohort of 60 healthy adults. METHODS After baseline evaluation of plaque, gingivitis, and gingival bleeding, subjects were randomly assigned to one of the experimental groups, provided written and verbal toothbrushing instructions, and had their teeth polished. At 2 weeks (follow-up 1) and 4 weeks (follow-up 2) all clinical parameters were again evaluated. RESULTS The Braun group demonstrated a nearly significant reduction in gingival index (Gl) and a significant reduction in GI at follow-up 2. The Rowenta group demonstrated significant reductions in GI, plaque index (PI), and bleeding index (GBI) at both follow-up 1 and 2 examinations. At follow-up 1, the Braun group demonstrated a nearly significant reduction in GI, a significant reduction in PI, and a non-significant reduction in GBI. At follow-up 2, the Braun group demonstrated a significant reduction in GBI, but not a significant reduction in PI. The reduction in GI for the Rowenta group was significantly greater (P values of 0.0001 and 0.0001, respectively) than that demonstrated in the Braun group. However, the Rowenta group did not demonstrate a significantly greater reduction in PI (P values of 0.7135 and 0.3184 for follow-up 1 and follow-up 2, respectively) or GBI than the Braun group at either examination (P values of 0.0663 and 0.3397 for followup 1 and 2, respectively). CONCLUSIONS The results of this study support the findings of numerous other studies that powered toothbrushes have great potential to remove plaque and improve gingival health and that the improvement can be demonstrated in a relatively short period of time. J Periodontol 1999;70:840-847.