Tag Archives: equipment dental

  • Practice Tips #74: Infection Control (Part 1)

    Practice Tips this month is getting a little dressed up for Halloween (you will want to read until the end for an American Dental treat). We are going to tell you a few "tricks" to keep your vacuum facts straight.

    In the history of dental practices, infection control has had two major characters when it comes to chairside disposal: central vacuum canisters and debris baskets.

    The assistant’s instrumentation (particularly the high volume evacuator valve) is your first line of defense in infection control as it reduces contaminated aerosols which can spread blood borne pathogens which can contribute to cross-contamination.

    The high volume evacuator (HVE) and Saliva Ejector (SE) are often collectively referred to as the “assistant’s instrumentation” and will both connect to a collection canister or “chairside trap” as many refer to it.

    The collection canister serves two primary functions:
    One: Splits the main vacuum line from the central vacuum so you can have multiple vacuum valves in the operatory. Most canisters have 4 ports on the bottom, 2 for the HVE, one for the SE, and one to connect to the main line from the central vacuum. The different vacuum valves will reduce the expulsion of contaminated aerosols into the operatory, evacuate fluids from the oral cavity to improve visibility and allow bonding of various materials, and can even be used in conjunction with nitrous oxide to scavenge exhaled gases . In fact, the 2nd HVE port is often dedicated to a valve to use with your scavenger circuit.

    30-60_PORTS

    It is fairly common for the 2nd HVE port to be plugged with a port plug on new equipment. The port plug available from American Dental Accessories is different from most plugs in that it is tapered so it will fit inside the HVE port and outside the SE port. One plug can thus be used for either port. This plug is also made of a long lasting synthetic rubber rather than the thin plastic caps used by many equipment manufacturers.

    Two: Filter solids picked up by the HVE valve(s). As you can see in the photo below, the HVE ports poke up through the collection canister, so solid debris picked up will be caught in the basket. The SE normally only picks up liquids, so the SE port does not penetrate the basket.

    30-59_W_BASKET-18-90

     

    American Dental Accessories, Inc. carries 3 styles of collection canisters, referred to as types “A”, “B” and “C”:

    The Type “B” canister has a ½” outside diameter port to connect to the central vacuum line (the same size as the HVE ports). This is also the smallest canister with a basket (filter screen) that is only 1-7/8” in diameter. Because of the small size, the HVE ports are off center. This off-center design is unique to the type “B” canister. If using color-coded baskets, the baskets for a Type “B” canister are green.

    NOTE: HVE holes are off center due to the smaller size of the basket NOTE: HVE holes are off center due to the smaller size of the basket (1-7/8" diameter). Item #18-91.

    The type “A” and type “C” canisters both have a 5/8” port to connect to the line from the central vacuum (“drain port”) so they can offer superior suction. The overall size of the canister is bigger and they accept a basket that is 2-1/8” in diameter. The larger size allows placing the HVE ports along the diameter of the canister (and basket). There are other older designs that have this feature as well, however, so having ports along the diameter is not a clear indicator of which canister (or basket) one might have. If using color-coded baskets, the basket for the type “A” and “C” canisters is blue.

    NOTE: NOTE: HVE ports are centered due to the larger size of the basket (2-1/8" diameter). Item #18-90.

    The “A” and “C” canisters are distinguished from each other by the location of the drain port. The “A” canister has the 5/8” drain port on the bottom of the canister, the “C” canister has the port coming out of the side of the canister. The side drain allows the “C” canister to be used at the end of telescoping arms (#08-98 for example) or in other configurations that may not allow for a drain on the bottom. With a telescoping arm mount, the side port allows the drain line to feed through the arm aiding in asepsis and giving the unit clean aesthetics.

    NOTE: NOTE: There is a lack of a visible drain line in #08-98.

    When you look at vacuum canisters and debris baskets in such a way, they aren't quite the scary and characters for Halloween that we are used to. Just remember to watch out for the location of the HVE ports of the canister and the correlating baskets.

    We hope you liked our version of Halloween Practice Tips this month. We have a treat for you! By mentioning this blog post, you can buy one vacuum canister and receive a pkg. of 10 correlating baskets (#18-90 or #18-91) for free (call 800.331.7993 to order)! Check back next month for another installment.

  • Practice Tips #73: Dental Unit Air Pressure (Part 2)

    Welcome back!  In previous Practice Tips #3 (previously known as Tech Tips) we discussed the basics of dental units and the required operating pressure (80 psi air, 40 psi water).  After a few technical calls from dentists lately, we thought it would be a good topic to revisit.

    air pressue

    As discussed before, insufficient air pressure can lead to a myriad of problems. In most systems, air is also used to prevent handpiece function.  Air flows through the handpiece holder (see below for a holder or go to our holders & bars for more variety) pushing down on a diaphragm to keep the handpiece from running when it's in the holder. For this system to work, the main air pressure needs to be higher than your drive air, so that it can keep the drive air from forcing its way through the system. This is another reason your main pressure needs to be quite high (typically 80 psi).

    10-03-G Automatic Handpiece Holder (#10-03) with Lockout Toggle

    If you have a cuspidor, air pressure can be used to activate the water to rinse the bowl and fill the cup. For systems with a timer (the bowl rinse or cup filler will run for a time and then automatically shut off), an air reservoir is typically used to provide the timing. When activated (usually via a pilot valve- #10-10), air flows into the reservoir which gradually drains as it flows into a block to turn the water on. Once the reservoir is emptied of air, the pressure is released on the water valve and the water then shuts off. The timer adjustment simply controls how long it takes for the air to empty from the reservoir.

    Since water is denser than air, air pressure needs to be at least twice your water pressure for the air activated functions to work more efficiently. Otherwise, the greater density of water can allow it to “force” its way through the lines.

    Your foot control, also, operates under standard regulated line pressure. The foot control is the first point at which your drive air pressure is stepped down. By having a solid 80 psi inlet pressure, you have plenty of range to control the outlet pressure. If the pressure came in at only 40 psi (for example), you’d have much more difficulty getting a full 40 psi to your handpiece when you need that much power.

    Your foot control may also have air operated accessories, such as a water on/off toggle. You need ample air pressure at this toggle for the same reason as you need high air pressure inside the unit. Of course, you can’t have 80 psi in the operatories unless you have enough pressure coming out of your compressor, which should be set to cycle at 90-100 psi (to support the inevitable loss of pressure as it travels).  The regulators (#05-54) in the operatories can only step the air pressure down, so you need to be sure the pressure coming into the room is in excess of 80 psi. Adequate air pressure is the first step in keeping your units running well.

    We can't tell you how many calls we get that could be quickly diagnosed in-house had the doctor simply checked the gauges first, so don't forget to check yours when experiencing issues with any dental unit component.  Please give us a call at 800-331-7993 with any questions.

    Thanks for reading and see you next month!

  • Practice Tips #72: Motors, Attachments, and Handpieces; Oh My! Part 2: Attachments

    Part 2: Attachments for Slow-speed Handpieces

    There are 2 basic types of attachments used with slow-speed motors: nosecones and contra angles.

    A nosecone is a straight attachment that will accept a slow-speed bur or a shaft-driven angle (contra angle or prophy angle). Nosecones are unique and come with different gear ratios. The default is a 1:1 ratio – the nosecone will operate at the same speed as the motor. 4:1 is a common gear reduction, the nosecone will spin at ¼ the speed of the motor. Some nosecones (primarily those designed for use with electric motors) will also have speed increasing gears, so they will operate at a 1:5 gear ratio (for example), or 5 times the output speed of the motor.

    Nosecones are standardized so they all will accept the same diameter bur or shaft driven attachment. Nosecones also incorporate a pin of some sort to prevent rotation of any shaft driven attachment placed on the nosecone. All shaft driven attachments have a groove that slides over this pin.

    latching-grooveAs nosecones can accept a slow-speed bur, all you may need to perform a particular procedure may be a motor and nosecone (and bur, of course).

    The other type of attachment, a contra angle, will work with gear driven attachments only (most commonly some sort of head). They will not accept a bur, so further attachments are required. As the name implies, a contra angle provides an angle for the next attachment which can improve intra-oral access.

    Both Midwest and E-type contra angles accept the same type of gear driven heads. The heads incorporate a drive shaft with a gear at the end that seats into the contra angle meshing with the internal drive shaft causing the head to spin. The drive gear has pointed teeth making it easier to seat the two halves together. The head also has square “teeth” under a threaded collar that mesh with the square “teeth” on the outside of the contra angle. These teeth hold the head onto the contra angle and prevent the entire head from spinning (so only the drive shaft spins). It is these teeth that one must count to determine compatibility between a head and contra angle. Heads and contra angles come with either 12 or 14 locking teeth.

    attachment teethStar systems do not normally use a contra angle attachment. Instead, they use a straight attachment which accepts a Star-specific head. Star heads have an elbow incorporated at the end to provide the angle normally provided by a contra angle attachment as used by other systems.

    elbow attachmentAmerican Dental Accessories, Inc. also has an after-market contra angle that will work with a Star-type motor. This angle will allow you to use standard heads with your Star system (which can save money over the more costly Star-specific heads).

    Contra Angle (#25-509)

    Regardless of system, a contra angle (or angle attachment) will require a 3rd attachment for use with a rotary instrument and will not be a complete set-up for a given procedure (as a motor and nosecone alone can be).

    Finally, there are heads. As mentioned above, heads will have both drive teeth and attachment teeth (or drive teeth and a threaded elbow). The number of attachment teeth will determine compatibility with a particular contra angle. The head will accept the rotary instrument with which one will perform a given procedure. The most common head is a latch head which will accept a latch (or RA, for “Right Angle”) bur. RA burs have a groove at the end into which the latch of the head will secure holding the bur in. Some heads also accept standard friction grip burs, exactly as used in a high-speed handpiece.

    Other heads are designed only to accept prophy cups. Prophy cups can come with either a threaded “screw on” shaft or that simply “snap on” a knob designed for this purpose. Some are also attached to a standard latch-type shaft so they’ll work in a standard latch head.

    Snap-on, Screw-on, & Latch-type Prophy Brush & Cups

    The flexibility afforded by the various head configurations allows for a tremendous range of applications for a slow-speed set-up. This flexibility can allow for great value with a slow-speed system.