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While the cornstarch often used as a powder to aid in donning gloves is not allergenic, it can carry latex proteins and allergenic chemicals from the glove material. The National Institute for Occupational Safety and Health (NIOSH) provides this caution related to powdered latex gloves (1): "when powdered gloves are worn, more latex protein reaches the skin. Also, when gloves are changed, latex protein/powder particles get into the air, where they can be inhaled and contact body membranes (2). In contrast, work areas where only powder-free gloves are used show low levels or undetectable amounts of the allergy-causing proteins (3,4)."
References:
(1) DHHS. NIOSH Alert. Preventing Allergic Reactions to Natural Rubber Latex in the Workplace. June 1997. Publication No. 97-135
(2) Heilman DK, Jones RT, Swanson MC, Yunginger JW. A prospective, controlled study showing that rubber gloves are the major contributor to latex aeroallergen levels in the operating room. J Allergy Clin Immunol 1996;98(2):325-330.
(3) Tarlo SM, Sussman G, Contala A, Swanson MC. Control of airborne latex by use of powder-free latex gloves. J Allergy Clin Immunol 1994;93: 985-989.
(4) Swanson MC, Bubak ME, Hunt LW, Yunginger JW, Warner MA, Reed CE. Quantification of occupational latex aeroallergens in a medical center. JAllergy Clin Immunol 1994;94(3): 445-551.
Question: Are bead sterilizers an effective means of sterilization?
Answer :A bead sterilizer is a device using glass beads 1.21.5 mm diameter and temperatures 217ēC232ēC for brief exposures (e.g., 45 seconds) to inactivate microorganisms. This term is actually a misnomer because it has not been cleared by the Food and Drug Administration (FDA) as a sterilizer. Bead sterilizers have been used in dentistry to sterilize small metallic instruments (e.g., endodontic files), however they are not acceptable for sterilization of items between patients. Studies have shown inconsistent heating and significant temperature variation in these devices. Also, there is no system to monitor exposure of the instrument to sterilization conditions or to demonstrate that sterilization exposure parameters have been achieved in the device. Furthermore, there is no way to maintain sterility of items following removal from the bead sterilizer.
The FDA is the governmental agency that regulates medical and dental devices. The FDA has determined that a risk of infection exists with these devices because of their potential failure to sterilize dental instruments and has required their commercial distribution cease unless the manufacturer files a premarket approval application. If a bead sterilizer is used, dental health-care personnel assume the risk of employing a dental device FDA has deemed neither safe nor effective.
Common acceptable methods for heat sterilization include steam, dry heat, and unsaturated chemical vapor. The only sterilization devices that should be used in dental offices are those that have been approved by the FDA.
References
CDC. Guidelines for infection control in dental health-care settings 2003. MMWR 2003; 52(No. RR-17):166.
U.S. Department of Health and Human Services Food and Drug Administration. 21 CFR Part 872 Dental Devices; Endodontic Dry Heat Sterilizer; final rule. Federal Register 1997;62(13):29002903. - (Lt Col Harte)
Deciding to buy a major piece of equipment is one of the biggest decisions a practice owner can make. Throw a rock and you're likely to hit a colleague with more than a few expensive relics collecting dust in the office closet.
Though prices have fallen over the years, lasers remain a big-ticket item. But dentists who own one or more of these devices say that a little prep work and an inquisitive mind can help you make an informed decision.
We talked to two laser dentists to get an ideas of how they made their first purchases.
Motivate yourself. The first question you have should not be posed to a vendor, but to yourself. "I was not on the hunt to purchase a laser just because I wanted a laser," says Dawn Bloore, D.D.S. What she wanted was a device that would help her achieve better results in perio treatment than conventional means. Once she knew what she wanted, she could begin searching for the laser that would best suit her needs.
Ask around. "Whenever I purchase any technology, I want to know if it works," says Dennis Mihalka, D.D.S. His quest for a laser began on the Internet, searching for dentists and hygienists who were using lasers. "I contacted them just to get their experiences."
The devil's in the details. "The things that weighed heavily in my mind was [included] the price," says Dr. Bloore. "Was there a warranty? How solid was the company in terms of their support for their client base?"
School daze. Like any technology, there's a learning curve. "Everybody in our team chose to be certified through the Academy of Laser Dentistry [ALD], so all of us are certified. Then [the practice] contracted with a registered dental hygienist, a certified trainer via the ALD, who came into our office [to provide] training," Dr. Mihalka says. "It was phenomenal. We brought in a patient who was open to being used as a demonstration patient, so she was able to train us using that patient. It gave us the comfort zone we might not get sitting in a lecture hall or doing a hands-on in someone else's office."