Importance of Properly Maintaining Handpieces and Quick Connect Couplers

A common issue that can occur with dental equipment is a loss of pressure or torque from air-driven high-speed handpieces.

High-speed handpieces use miniature turbines that look like small water wheels in the head and spin around from the compressed air. The air goes up one side of the handpiece, spins the turbine, then returns down and out the other side of the handpiece as exhaust. There are various reasons related to the maintenance of the handpiece that can cause low torque or loss of air pressure.

Aging gasket. Each handpiece or quick connect coupler will have a silicone gasket on the bottom of the connector. This gasket can age, become brittle, and need to be replaced periodically, such as five-year intervals to ensure a proper connection to the tubing to prevent air or water leaks.

Aging Gasket

The handpiece connection is not secure. The silicone gasket used on handpieces is a flange type gasket that requires the handpiece to be snugly tightened to the handpiece tubing. Most common handpieces use a quick connect coupler, so it is important to remove the handpiece and then verify the coupler is tight. Hint: To ensure a secure connection, tighten the coupler on securely and then loosen again. Clean the threads and then retighten.  The second time will secure more than the first time, and the reason is related to the fine threads used on dental handpieces that can gall when tightening.

The handpiece itself needs periodic service. The seals inside the handpiece head begin to wear and leak. Therefore requires more air pressure to operate or will run at less than efficient torque. Depending on the brand of the handpiece, you may need to replace or repair it based on the manufacturer’s instruction.

Exhaust air not able to flow freely. If the exhaust air is restricted, the result will be a loss in torque even though the handpiece air gauge is reading normal. If that air is not able to exhaust at all, symptoms will include very low torque and the potential for the bur to stop completely. Verify the oil mist recovery jar on the dental unit is unobstructed and that the air can freely exhaust out it. Secondarily, if you are using a quick connect coupler to attach the contra angle handpiece, the drive air or exhaust ports may be clogged with debris causing the handpiece to stall from a lack of airflow or exhaust.

Copyright 2020 All Rights Reserved.  ASI Medical, Inc. DBA ASI Dental Specialties

Update on Molecular Iodine Compatibility

We mentioned in early May that we would evaluate the equipment compatibility of molecular iodine if it were placed in the water bottle system for handpiece irrigation. We used the IORinse Concentrate that is made by IOTechInternational. We tested using both a 50% concentrate with water and 100% concentrate. By comparison, the manufacturer recommends a concentration of 10%. We did not find any issues or degradation with any of the internal components, gaskets, or O-rings. As a secondary test, we allowed the solution to remain in the tubing and handpieces for two weeks without use in between. We were pleased that there was no clogging in the lines or miniature ports on the handpieces, and there was immediate and responsive activation of the handpiece coolant and air/water syringe flow. Third, we did a test to evaluate potential staining of tubing, work surfaces and upholstery with repeated exposure to 100% concentrate. We found the solution easily cleaned off of hard surfaces and our White Silk tubing without staining. However, the chemical did leave a noticeable yellowing on the dental upholstery that could not be removed. The plastic water bottles used became visibly stained from the molecular iodine.    

As a result of these three tests, we can recommend that molecular iodine is safe to use with ASI’s line of dental equipment without adverse effects to working components or clogging of lines, but long term use may cause some staining to occur on dental upholstery and certain plastic surfaces.

Copyright 2020 All Rights Reserved.  ASI Medical, Inc. DBA ASI Dental Specialties

Assessing the Impact of “Should” vs. “Shall” on Your Practice

The difference between “Should” and “Shall” in Regulatory Speak can make a big difference in how you go about interpreting the many new guidelines coming out regarding infection control.

The rush of new recommendations coming out has been not only confusing with a lack of clarity but also sometimes contradictory. To add to the confusion, an often misunderstood but very important criteria when reading regulatory guidelines is to understand the implication of the wording being used. Words like “Shall” or “Must” will mean you are required to do what the regulation is stating if the agency has enforceable authority over your practice. However, words like “Should,” “Consider,” or “Recommendations” mean they are only suggesting you follow these guidelines, but there is no requirement or mandate that you must do so. For example, one protocol recommendation is to have patients wait in their vehicles and have staff accompany them inside. This is not a mandate in any of the regulations we have seen. Most patients and staff find this particular protocol disruptive and find other ways to achieve the same objective. An important note is that the ADA, CDC, and OSHA have recently put forth science-based recommendations that are guidance documents and not requirements. Therefore, dental offices should also be evaluating their state/local regulations because those are requirements that must be followed.

We have heard from a few customers that have expressed there doesn’t appear to be a clear authority or a step-by-step guide on exactly what must be done to be compliant. The short answer is that you are the De Facto Authority for your practice in a time of operation that lacks clarity in oversight or mandated protocols. The term De Facto has various meanings in how it is applied, but generally, when there is a lack of clear governmental directive or oversight, then the adopted standard practice becomes the De Facto way of doing it.

Being up to date on the various guidelines put forth by agencies and associations combined with your own experience and knowledge will allow you to ultimately choose required protocols and recommendations that are right for you and your practice. What protocols you implement to protect you, your staff, and your patients will become part of a universal way of practicing that eventually becomes adopted by the majority of dentists. Showing some discernment to implementing extraordinary measures could be prudent as they may be deemed unnecessary in the future as things return to normal. Using tried and proven protocols that have kept patients safe in the past can and should be an ideal starting point.

Copyright 2020 All Rights Reserved.  ASI Medical, Inc. DBA ASI Dental Specialties

ASI Waterline Disinfection

Disinfecting Your ASI Waterlines

The following is a primer on waterline disinfection and current recommendations for protocol.

Why You Need to do Waterline Disinfection

Even though modern dental units have non-retracting water valves inside, bacteria will always find its way into the waterline necessary to begin building a biofilm matrix. Many assume if the city water has diluted chlorine then it would eliminate biofilm, but it does not. It is due to the very nature and design of dental tubing versus household plumbing, which is why waterline disinfection is required in your dental units. The larger diameter of household plumbing provides a high flow rate to surface area for water flowing through the lines and essentially flushes the lines clear. On the other hand, dental waterline tubing is very small in diameter within handpiece lines. Given the very low volume of water used during a dental procedure is a slight fog spray of water for drilling, the flow rate of water to surface area of the tubing is incredibly low. This results in a matrix of bacteria that builds up on the inside wall of the tubing. Even flushing the lines with higher flow without the handpiece attached will not be sufficient to dislodge the biofilm matrix and keep it from growing. So, all dental units require some type of waterline disinfection to control the biofilm from growing within the tubing. Otherwise, the bacteria biofilm will grow to the point that it can release high bacteria counts to patients during treatment.

What Methods Are Commonly Available? 

The criteria would include: effectively mitigates biofilm growth, safe for patient use, does not damage equipment gaskets and cost effective to use. There are numerous methodologies that have been developed over the years ranging from liquids, tablets that dissolve, pick up tube cartridges, and central water treatment systems. All of these will have their purported benefits, but may also have drawbacks.

What Not to Use

After researching for years and obtaining valuable feedback on methods our customers were using, we gathered a wealth of information. We found that dissolvable tablets and pills are not recommended as their residue can gradually buildup and potentially block connections and narrow passageways. They may also adversely affect expensive handpieces over time. Some brands of the drop in tablets are caustic and will damage O-rings and gaskets within the delivery system. Certain powder mixtures, shock treatments and bleach contain harsh chemicals and damage gaskets and corrode valves. We also found some pick up straws tend to clog easily.

Why We Recommend DentaPure Cartridges for ASI Dental Delivery Systems

Ease of Use It installs in minutes and once the cartridge is installed, there is no daily staff attention or monitoring required for the life of the cartridge. This way there is no concern if a daily protocol was forgotten and staff time is used more beneficially in the practice.

No Shocking Needed – Shocking is an antiquated protocol that basically admits the disinfection method wasn’t working, so it is necessary to periodically chemically shock the biofilm to kill it. DentaPure goes to work every time water is run through the cartridge, so there is not a need to have to periodically bring down the bacteria count.

No Special Requirements for Water – Unlike some brands, you can use either tap or distilled water.

Does not Damage Equipment -With DentaPure cartridges there are no harsh chemicals that will damage the O-rings, gaskets or valves within the ASI dental system.

Safe for Patient Use – The elemental iodine is safe for patients to ingest and does not cause allergic reactions.

Effective at Controlling Biofilm – Studies have illustrated its effectiveness and feedback from our own customers has demonstrated its effectiveness.

Anti-Viral – Iodine is highly anti-viral and may be beneficial in mitigating viruses in aerosols.

Cost Effective – Not only will you save time, but money too! With 365 days of use, the cost of one DentaPure cartridge averages out to $0.54 per day. This is less expensive than most other waterline treatments.

How Does the DentaPure Waterline Disinfection Cartridge Work?

The DentaPure Cartridge contains non-allergenic iodinated resin beads. As water passes through, the resin releases 2 – 6 ppm of atomic isotopes of elemental iodine during a typical dental treatment. The isotopes control the bacteria, keeping dental unit water safe for 365 days. The DentaPure is a slim cartridge that simply hangs down inside the water bottle. 

Save time and money with DentaPure cartridges by reducing waterline treatment to a simple, annual routine. Remember to do some follow up testing of your water lines to ensure you are getting the desired results.

ASI is offering 20% off each DentaPure purchased – Promo code for online purchase* = dentapure20

*Prices, terms and specifications are subject to change without notice.

Copyright 2020 All Rights Reserved.  ASI Medical, Inc. DBA ASI Dental Specialties

Do I Need to Hire a Dental Architect?

You’re not alone if you have contemplated hiring a dental architect. In fact, it is becoming more common in today’s competitive market for dentists when looking to design their dental office space and treatment rooms. The choices would seem to be between using the design services of a dental supply house or a commercial architect that specializes in dental office design, but the answer is dependent on the extent of build out, cost, and style factors. To address this, let’s look at three typical scenarios:

Remodel or Refresh of an Existing Dental Space -This type of scenario may involve a slight refresh or a major remodel of the entire space where the flooring, wall coverings, cabinets, etc. will be removed and even some walls tore down to build new ones. Even though it may be a major overhaul, it really doesn’t fit the needs of an architect or their time to get involved. This type of scenario is better handled by a dental supply house or a good dental contractor and interior designer. The contractor should be able to handle any of the permitting process required and consult with the interior designer to create the new look you wish to achieve.  An advantage of a dental contractor/interior designer team is that they will give you the freedom to select dental equipment for the best application and from any source.

Build-Out of Office Building or Retail Space – A complete build-out of an open space can become a complex project. Determining the best design and workflow to fit in the space requires someone with expertise to accomplish the office objectives as well as handle the utility runs and building code compliance. In order to handle these types of projects, it is always better if you can utilize someone with dental office space experience because they already understand the equipment needs and how the workflow and patient flow works best.

 So, in this scenario should you use the services of dental supply house or a dental architect?

The dental supply house can generally be less expensive and they have years of experience providing design, so the results should turn out without issue. However, the supply houses tend to be unimaginative and use cookie cutter designs that are based around a certain brand of equipment they promote. It is easy to end up with a bland design that doesn’t work best with new technology or how you wish to work. This scenario tends to tie the dentist’s hands in that they have to use the equipment provided by the supply house, which reduces the ability to negotiate. Additionally, their design may be heavily weighted towards calling out expensive cabinets that don’t fit with modern looks or current minimalist dental office design themes. You end up paying for a lot of extras that you wouldn’t normally purchase on your own.

A dental architect, on the other hand, will tend to cost more up front but save in the long run.  They can masterfully design your space to create the modern feel your patients and staff will appreciate, while embracing a workflow around mobile and modular dental technology rather than fixed cabinets. Since architects are independent of dental equipment companies, they are free to recommend styles that best fit your needs or work with the equipment brand of your choice. You will pay more for a dental architect, but save by not having to buy excess expensive fixed dental cabinets while achieving a truly exceptional design to separate your office from the typical office.

Complete Ground Up Building Construction– This scenario requires someone with structural design knowledge of the building itself while also having the ability to design the interior office space. This will require a commercial architect or a dental architect with structural design capability. Therefore, the design services of a dental supply house wouldn’t make sense since you will already be working with an architect. The cost of architectural design will be high, but you will have the ultimate freedom to create the space you desire and open up the selection of dental equipment and technology you wish to use.

So the extent and scope of your project ranging from a straightforward  remodel to a complete build-out will most likely be the determinant of whether to use a dental supply house, dental contractor/designer or a professional dental architect firm.   See ASI’s National Directory of Dental Architects for a listing of professional architects that specializes in dental office designs.

Copyright 2019 All Rights Reserved.  ASI Medical, Inc. DBA ASI Dental Specialties  |  Terms & Conditions of Use

 

Tips for Selecting the Best Self Contained Portable Dental Delivery System

When reviewing portable dental delivery systems, it may seem daunting to try and choose between all the various brands of self contained dental units available. Prices can vary widely with some seemingly too good to be true to even higher priced units not always being clear on what and how well they work. The purpose of this article is to simplify the purchase decision and explain some of the mechanical features and what to look for when comparing and reviewing different models of portable dental units for your office or portable dentistry.

Look for these specific features when evaluating a portable dental delivery system:

Vibration – We will start our discussion with one of the most overlooked but important characteristics of evaluating a mobile dental delivery unit. An ideal system will have a powerful compressor and vacuum system, meaning the motors could generate significant vibration. Vibration leaving a chassis can cause sound but also can make the work surface unusable if instruments and trays vibrate excessively and cause more sound. A well-designed unit will ensure that the vibration is minimal and allows for dental procedures to be performed without the interruption of tools vibrating off and that storage of trays and instruments can be utilized on top of the system.

High Grade Compressor and Vacuum Pumps – Higher quality pumps are made with greater precision and the dynamic balancing of the motors and piston will make them run smoother. This smoother operation is the key to beginning with proper construction to eliminate vibration at its source.

Engineered Isolation Mounts – The best way to mount pumps requires not only stable and secure connection to keep the pumps from moving around but also need to eliminate transfer of vibration from the pumps to the chassis. Rubber mounts do a fine job of securing the pump but don’t do very well at absorbing vibration. Improved dynamic mounting is higher quality and eliminates a high percentage of vibration.

Solid and Robust Construction Materials – Units that have poor construction or use flimsy materials will not handle vibration well and will cause problems. A well-built portable dental unit will be not only constructed of high-grade components, but will have thicker walls and materials. To keep these units lighter yet stronger they should use aluminum or an equivalent type of construction. Be cautious of units that are too small or lightweight to properly absorb vibration.

Suction Performance – One of the most difficult design areas for a mobile dental unit to create, is the powerful suction desired for dental procedures. It needs to provide high flow with moderate strength to pick up debris, capture water coolant effectively and pull viscous solutions through smaller tubings like the saliva ejector or surgical tips. To effectively work for restorative procedures the system should be able to not only power the high-volume suction, but also be able to extract liquid through the saliva ejector simultaneously. When doing comparisons make sure to evaluate the suction strength of both the high volume and saliva ejector handpieces when used together. Doing so will let you know that you have a well-designed portable dental suction system.

Suction Canister and Purging Ability – The suction canister should be sized to allow for a standard day of procedures with normal rinsing during treatment. Generally, a good baseline is that the canister should hold around two to three liters of liquid. The canister should prevent overflowing by shutting off the vacuum when full and should have an indicator light to let staff know the system needs to be emptied.

Another area when consider portable dental equipment for in office use is a hands-free solution to emptying the contents of the suction canister through a pump and discharge hose system. This eliminates the need to have to manually dump and clean the canister. A purge system can be used to discharge directly into a sink basin or a convenient quick disconnect connected to the plumbing drain system. Once empty, the system can be easily rinsed by evacuating clean water and then cleaned overnight by suctioning in enzymatic cleaner that breaks down the proteins in blood and saliva.

Sound Performance – A very common and important question when selecting a portable unit for an office is how loud is it? The reason is that many in the dental field have heard how loud inexpensive and poorly designed dental units with air compressors can be. A well-engineered portable dental system should be very quiet and operate under 48 decibels measured right next to the system. However, sound can be elusive and decibels doesn’t always truly represent sound and secondarily there is no standardized testing certification that can be used to truly compare brands to the sound levels they list. So, the best way to find out if the system you are looking at would be to hear it in person. If that is not practical then either listen to a video of the system operating or from a recommendation from someone you trust that has actually heard the systems. Sound quality varies greatly between suppliers of these systems so it is important to dive into this one area in more detail.

Compressed Air and Handpiece Performance – When evaluating a portable dental unit with compressor, make sure that the internal air compressor provided can produce enough air flow at the right pressure to operate air driven dental turbine handpieces properly. Even electrical dental high speeds use air for cooling and need proper air flow.

Don’t be tricked into using horsepower to try and compare models. Unfortunately, horsepower ratings have a wide range of latitude and marketing companies have used the HP rating to trick many consumers into believing one model is more powerful than another. This is often seen in electric hand tools sold in the big box stores. The best way is to find out if the system you are evaluating can adequately run common brands of dental turbine handpieces for an extended period without pressure dropping.

Aesthetics and Working Easily with the System – Since the system you will be using is in an office it is very important that it looks like a professional piece of dental equipment that delivers high quality care. Even though it is a mobile dental unit, it shouldn’t look like it. Look for systems that have enclosures made of not only quality materials but are finished in a way that look modern with rounded corners and edges. Work surfaces should provide adequate working area and provide an easy to clean and attractive surface. As a mobile cart, it should roll easily with high grade casters. Other considerations include ensuring that the dental unit has non-clinging and non-stiff dental tubings, and that handpieces holders should be modern, rounded and easy to clean.

Electrical Requirements and Testing Lab Approval – A well-designed self-contained dental unit should be able to operate from a standard electrical outlet without overloading the circuit even with both pumps running at the same time.

Ensure that the model you select has a UL certification by an approved testing lab. This will give you peace of mind knowing that all the electrical components, wiring, switches are high quality and have been assembled correctly.

Dental Water Supply and Water Line Disinfection – Current requirements are mandating that the water lines in dental delivery units be disinfected to remove the biofilm that can grow inside the small diameter tubings. Tablets and other chemicals can clog or damage mobile dental delivery unit components and require consistent management to ensure that the removal of biofilm is obtained. An ideal self contained dental unit should have a water line disinfection cartridge that can be part of the bottle system so that no daily maintenance is required. Since these cartridges can be expensive, select a system with tandem water supply that gives ample water supply for a full day’s procedures but only requires one cartridge to filter both bottles.

Amalgam Separation – If you will be using the portable dental unit for restorative procedures such as removing old amalgam fillings, the suction system will need the ability to use an amalgam separator. This can require the use of an amalgam separator that the unit can be purged through to collect the heavy metals. To meet state and EPA regulations, the amalgam separator must have been tested and approved by a certifying agency. Verify that the portable model you use provide a certified separator option.

Nitrous Oxide scavenging – In office use of a self-contained dental unit often will require the ability to use the portable dental suction to connect to the nitrous patient mask to scavenge off the excess gas. Check to ensure that the portable dental system has the optional capability to be used for nitrous exhaust scavenging.

Please visit ASIDental.Com/Portable-Work  for additional information on ASI Dental’s line of advanced mobile dental delivery system technology.

Copyright 2019 All Rights Reserved.  ASI Medical, Inc. DBA ASI Dental Specialties  |  Terms & Conditions of Use

 

How to Plan Your Dental Treatment Room Setups and Office Build-Out

Cost control is an important criteria for new dentists setting up their first practice.   To keep budgets from spiraling out of control, dentists can now select new types of modular dental equipment that are more cost efficient than traditional fixed dental cabinets.  Plus this type of equipment easily allows them to scale their equipment budget to the growth phase of their dental practice.  This can allow dentists to defer purchasing all the equipment when they first open.

The first step is to plan well and to only purchase the dental delivery systems, chairs, equipment and supplies you can put into production right away. This may mean avoiding supply stocking programs and the temptation to fully equip the entire office unless you really believe all the dental treatment room setups will be used from the start.

Planning out your office and expenditures is more than just getting the right look. Use discernment when reviewing pre-formatted budget templates, and consider the importance of each area to generating initial practice revenue. Before you purchase equipment, ask yourself if extra equipment is really necessary for you to open your practice. This will help you get down to a much more realistic overall budget that isn’t filled with excess equipment, supplies or post construction décor.

Select types of modular dental equipment that easily adapt and be added in as practice growth requires it.

Think like a large manufacturer that is planning to grow. These companies need to be able to easily ramp up their production lines in the future, but don’t want to over spend until their sales numbers justify the expansion. So while they would consider finding a large enough facility that allowed for planned growth, pre-wiring it and completing some of the interior finish, they would not buy additional production line equipment until it was required.

The trick is to ensure construction is completed and readily allows for modular dental equipment to be moved in, set up and easily connected. There are now handy in-wall and floor dental junction boxes that facilitate running electrical wiring, IT cabling and plumbing. These built-in boxes come neatly enclosed and don’t detract from an empty treatment room’s appearance, yet they make it very easy to connect equipment as needed.

To maximize your dental office space cost, it is important to get the most from your space. Building leases are based on a price per square foot, which is the horizontal dimension. Keep in mind you pay nothing more for the vertical space. Large dental cabinets require a big horizontal footprint without adding to treatment capability. Modern dental delivery carts are more compact and can integrate instruments, computer systems and monitors into one console, reducing the footprint and taking advantage of the vertical space. You can design smaller treatment rooms yet achieve an open and spacious feeling for you and your patients.

Modern modular dental delivery systems and mobile dental carts are much easier to set into place and connect without a lot of installation difficulty. This type of dental equipment easily adapts to expansion and even different operators’ requirements, including ambidextrous or multi-specialty needs.

No matter what equipment you invest in as you start your practice, don’t feel like you have to buy it all at once. Take a phased approach instead.

 

Modular Dental Office

Dr. Massad discusses his Modular Dental Office with ASI’s Cabinet-Free operatory design.

Dual Ultrasonics – Dr. Thomas McClammy

The purpose of this article is to emphasize that ultrasonics that are readily available and ergonomically delivered can be a valuable adjunct to endodontic procedures for the well trained and astute endodontic clinician specialists and generalists alike.

ASI for Your Dental Equipment Needs

Six Significant Reasons to Select ASI for Your Dental Equipment Needs.

There are many choices of dental equipment manufacturers. However, ASI Medical, Inc. provides many unique capabilities and features that separate our dental equipment line from the others. Listed below are six significant reasons to evaluate when selecting dental delivery units and systems for your office.

 

1. Improve Treatment Times – ASI’s Unique Advanced Dental Systems® are a unique type of dental delivery system that can improve efficiency and reduce treatment time. Having the right dental instrument readily available can eliminate wasted time reaching for instruments by the dental team throughout the entire day. Just as process improvements help manufactures reduce production time, having properly placed instrumentation can improve dental treatment times.
2. Custom Configurable with Everything in One Dental System – ASI’s Advanced Dental Systems utilize a unique modular instrument panel that operates from only one foot control, allowing each dental system to be custom configured. Select your desired instrumentation, determine which control panel each of the instruments will be integrated and on which location on the holder bar in the order the dental practice wants. This allows the dental delivery system to specifically meet the practice recruitment needs through the ability to perform procedures from endodontics to periodontics with only one dental unit.
3. Ambidextrous and Ergonomic – ASI’s dental operatory equipment can be fully ambidextrous allowing for ease of positioning within a well-designed operatory space. Dental cart designs allow for infinite positioning without movement constraints or reach limits of arm based dental units. Having easily accessible instruments positioned correctly for the staff improves not only their efficiency but enjoyment of their daily work.
4. Robust Designs for Lasting Quality – For over twenty years, ASI been making high quality dental equipment constructed of thick walled aluminum, stainless steel control valves and titanium instruments. Our dental equipment stands the rigors of daily institutional use. Durability is partly why ASI mobile dental systems were selected as the deployable dental system for all branches of the military. It is also why our specialized Advanced Dental and Endodontic Systems are used in over 60% of dental teaching schools.
5. Made in America and Selling Direct to our Customers – ASI manufactures a complete line of dental delivery systems in the U.S. Advanced manufacturing techniques are utilized in our machining centers and chassis fabrication. We sell our products to dentists and institutional buyers to save on distribution mark ups. This allows us to tailor configured dental unit models in the price points needed by our customers.
6. Comprehensive Tech Support – ASI provides support to your staff and for the products in a comprehensive fashion. This includes videos on use and maintenance that can be readily accessed by new dental staff at any time for their orientation and training. Over the past twenty years, we have developed a network of independent dental service technicians to facilitate on site installation and repairs of our dental equipment. Additionally, our tech support staff is a phone call away if your own service or dental team has questions for use or troubleshooting of your dental equipment.