Practice Tips #16: Dental Tubing Made Easy

Choosing a tubing size:

Nothing is more frustrating than receiving your replacement tubing and finding out you ordered the wrong size. Here is a quick guide to measuring tubing.

Vacuum tubing is normally measured by the inside diameter or “i.d.” as it attaches to fittings by sliding over them.

Vacuum tubing usually comes in these sizes:
7/32" i.d. for saliva ejectors valves (or SE's)
1/4" i.d. for surgical aspirators tips
5/8" i.d. for vacuum hookup tubing
1/2" i.d. for high volume evacuator valves (or HVE's)

Supply tubing is usually measured by the outside diameter or o.d. as it is secured with sleeve clamps which go over the tubing (although the tubing will also go over barbs etc. first)

Quick Hint:
Tubing has an influence on the aesthetics of your operatory. Discolored or dirty tubing can make an otherwise spotless office look less than clean. Sometimes it is better to just pull the old stuff out and replace it. Your delivery unit will look great with the fresh tubing connected to the vacuum valves and handpieces. Tubing comes in several colors to match today’s dental units.

Are you having trouble getting that tubing to slide onto that  tubing barb, vacuum collection canister port, or other fitting? Try some liquid soap on the tubing or fitting to lubricate it, or try dipping the tubing into hot water (about the same temperature as a cup of hot coffee).

Choosing HVE Tubing: What style is right for you?

• • Corrugated HVE Tubing is extremely flexible and very light weight. Nevertheless, because of the ridges in the tubing it gets dirty very quickly.
  • Asepsis HVE Tubing is very strong and can even handle having a chair roll over it. This tubing’s smooth surface makes it the easiest to clean. However, it is heavier and less flexible than corrugated.
  • Asepsi-flex HVE Tubing is an older design of asepsis tubing that is strong and somewhat flexible. The asepsis design is easy to clean and has a plastic spiral molded in to provide strength. Unfortunately, this design does limit flexibility and the plastic spiral can be crushed if rolled over with a chair etc.

  Quick Hint:
  Have you ever noticed on “multiple-line” tubing such as 4-hole foot control tubing that it has lines that may need to be cut different lengths to install correctly on the barbs in the foot control, handpiece connector, block, etc.? Always make sure to buy a little extra. It is much easier to cut off what you do not need- than to not have enough.

  Choosing Fiber Optic Tubing:

  This can be confusing but with answers to a couple of quick questions, you will be able to pick out the correct tubing.

  “Where is the light bulb?”

  • • If the bulb is located in the handpiece connector, you would need "Bulb Style Illumination” tubing. You can get this tubing with a connector and bulb or just the tubing.
    • If the bulb is in a separate box, you will need a fiber optic tubing bundle. There are a couple of different styles so the next question will help you figure out which style of fiber optic bundle to get.

  “When does my light turn on?”

  • If the light comes on when you press your foot control, you would want to choose tubing without a ground wire.
  • If the light comes on when you pick up your handpiece, you need the “touch” activated style of tubing, which has a ground wire.Keep in mind the distance the light box is from the handpiece, as you may need to choose tubing with a longer fiber optic bundle.Some 6-pin Illumination systems use a “lamp module”.There are many 6-pin systems that look very similar; you would need to know which type you have if you are going to replace the tubing or the lamp module. See below:
  • The picture shown below is referred to by some as ”new-style"- this is an “ISO-C” coupler which is the new international “standard” for 6-pin couplers. Unfortunately, many non-standard couplers do exist and are still made. Most "new" style couplers have a red handpiece gasket.
  • The picture shown below is an "old-style" 6-pin coupler designed before any standard was set. Some systems are still being made with non-standard couplers. Most "old" style couplers have a black handpiece gasket.As you can see, the ISO-C ("new") style coupler has a slightly thicker diameter on the exhaust hole than the non-standard (“old”) style. On the “old” style, both the drive air and exhaust ports are the same size. Be sure to note your configuration when replacing the tubing or lamp module for your system. NOTE: while one design is newer than others, many non-standard systems are still being manufactured, so always check your configuration before replacing, do not rely on the age of your system exclusively. Unfortunately, other possible configurations can exist, but the two examples shown are the most common.Quick Hint:
    Sleeve Clamp troubles? It can be difficult to slide sleeve clamps on and off tubing, and it can be easy to break a barb in the process. Luckily, there are options. To put those clamps on use a Sleeve Tool (pictured below).It works like a charm for both 1/8" or 1/4" o.d. tubing. Extraction forceps work great for removing those tubing clamps- our techs suggest #74N.

     

    A Bit about Waterlines and “Biofilm”:

    This section borrows heavily from the book, "Dr., Did You Check the Breaker Too?" by American Dental Publishing.In “small-bore” dental unit waterlines, biofilm can become a problem. Biofilm is caused when bacteria form on surfaces that are in contact with water for extended periods. Dental unit waterlines are a great breeding ground for these bacteria and they can grow very quickly.

    The ADA has set a standard of no more than 200 CFU (colony-forming units) per milliliter of mesophilic hetrophobic bacteria coming from your waterlines.

    Here are some quick suggestions to help deal with biofilm in your waterlines:

    At the beginning of your day, run your lines for several minutes to expel excess biofilm, it is recommended to do this between patients as well for about 20-30 seconds to prevent cross contamination:

  • Most dental units have a purge or flush system installed on them. If your unit does not, use your foot control to accommodate the water line flushing mentioned above.
  • If you have a self-contained water bottle system we also recommend air-purging the system at the end of every day. Many water systems have an air purge toggle. If there is no air purge on your bottle system, use an empty bottle to air purge your lines.
  • Make sure to direct any hoses into a sink or other appropriate receptacle to catch the purged liquid, point tubing away from you.
  • Use distilled water in a self-contained water bottle system. This will help you keep better control of the quality of the water.
  • Use a waterline maintenance product regularly (be sure to follow the manufacturer’s instructions.)

  There are many types of waterline cleaners from which to choose. American Dental carries two different types: Sterilex Ultra Waterline Cleaner, which is a “once-a-week” system, and BluTab Waterline Cleaner, which you add to your water bottle each time you refill it.