Dentistry Gone Digital

Dentistry Gone Digital

dentist using ecosite elements for restoration

The Race to the Finish Line with Ecosite Elements

September 4, 2024

By: Sable A Muntean, DMD, MHSAThis article originally appeared on DMG-Connect.com. Dr. Muntean granted permission for it to be shared with igniteDDS readers. It is a super busy day at the office and you have a patient walk in with two chipped front teeth that need to be addressed because he has a big business…

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dental patient having an occlusal examination

Occlusal Examination: Why and How

August 30, 2024

By: Bill Gregg DDSThis topic originally appeared on Pankey.org. Dr. Gregg gave permission for igniteDDS to share with our readers. The occlusal examination during hygiene assessment is important to maintain a healthy patient dentition and to ensure that the temporomandibular joint is functioning properly. This will help prevent any upcoming symptoms like muscle pain, which…

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stop dental assistants from cross contamination by communicating and teaching

Correcting a Dental Assistant Who Chronically Cross-Contaminates in a Dental Office

August 26, 2024

Cross-contamination in a dental office poses serious risks to both patients and staff. By: Ronda Holman When a dental assistant frequently engages in behaviors that lead to cross-contamination, it’s crucial to address the issue promptly and constructively. Here’s how to effectively manage and correct this situation: Assess the Knowledge Gap Start by identifying whether the…

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How Do You Know If You Achieved Centric Relation? By: Dr. Leonard A. Hess, DDS Clinical Director, The Dawson Academy This article originally appeared on TheDawsonAcademy.com, Dr. Hess allowed igniteDDS to share with our readers. When we talk about utilizing bimanual manipulation as a way to get centric relation, one of the biggest misunderstandings we see is the tendency for dentists to think CR is achieved by forcing the jaw back to seat the condyles. When we are in a situation where we have a tight patient, or patients that are resisting, the worst thing we can do is force it. Bimanual manipulation provides verification of: The correctness of the physiologic position The alignment of the condyle-disk assembly The integrity of the articular surfaces Steps to Achieving Centric Relation Recline the patient so your arms are parallel to the floor and their chin is pointing up. Stabilize the patient’s head by cradling it between your rib cage and forearm. It is essential that the head be stabilized with a firm grip so it will not move when the mandible is being manipulated. Lift the patient’s chin to slightly stretch the neck, keeping your forearms parallel to the floor. Gently position the four fingers of each hand on the lower border of the mandible. The little finger should be slightly behind the angle of the mandible. The pads of your fingers should align with the bone and stay together as if you were going to lift the head. Bring the thumbs together to form a C with each hand. The thumbs should fit in the notch above the symphysis. Remember, NO PRESSURE should be applied. With a gentle touch, and with almost zero pressure from your hands, have the patient slowly hinge open and closed in rotation (an arc of 1-2mm is acceptable), never letting the teeth touch. Do not jiggle or load the joint at this point. The whole idea here is to let the condyles go to where they physiologically want to be – properly seated in each fossa. When the hinge movement is consistent, the mandible will retrude automatically and you should feel the jaw go back. At that point, hold the jaw firmly on that hinge point. With proper hand placement, there is a torque effect from the thumbs and fingers that loads the joints in an upward and forward direction. This allows upward pressure to be maintained through the condyles while still allowing them to rotate freely. Load the joint by applying firm (but gentle) pressure UP with the fingers on the back half of the mandible and DOWN with the thumbs in the notch above the symphysis (keeping the teeth separated). Note: Sudden heavy loading can injure retrodiskal tissue and cause considerable pain. Ask the patient, Do you feel any tension or tenderness in either joint? If yes, stop and determine the cause. If no, continue. Increase to moderate pressure, then firm pressure. With each increment of loading, ask the patient, “Do you feel ANY tension or tenderness in either joint?”. If tension or tenderness is experienced at any load interval, stop and determine the cause. The dense vascular connected tissue that makes up the disk will be able to handle enormous pressure through it without any sort of tenderness if you have a properly aligned condyle-disk assembly, and that condyle is completely seated. And if the condyle is seated completely, such that the medial aspect of the condyle is engaged with the medial aspect of the glenoid fossa with a properly inter-closed disk, then there can’t be any stretching of the muscle. What It Looks Like When the Condyle is Not Completely Seated in Centric When you load test, there will be a tension on that lateral pterygoid, and they will feel some tightness or fullness or a pull. Because of this feeling, they’ll have awareness in that joint. If there’s pathology in the joint or an intracapsular problem, they’re likely to have some sort of discomfort or tenderness. But also, remember that as we assess the joint, we’re relying on the totality of the exam; the questions that we ask, the palpation of the muscles, the load testing, the range of motion, doppler analysis, all these things that we do, to develop a visual picture of what’s going on there. But the short answer to, how do you know if you’ve achieved centric relation, is by load testing; by load testing in three pressure increments and making sure there is no tension or tenderness in either joint. If a Patient Has Had a Lower Block, You Can Still Put Them in Centric Relation Anesthesia locking the trigeminal nerve really doesn’t have any effect whatsoever on whether you can achieve centric or not. Those are sensory nerves and we’re not really messing with the motor. The fact is, we’re going to take bilateral manipulation to achieve centric relation, whether they’re numb or not. And the technique is going to be exactly the same. You can actually achieve centric relation even if the patient is asleep. We’ve done a number of bite records while the patients were under Pentathol. It’s exactly the same as when they’re awake. Just remember, when you’re putting a patient in centric relation, it’s the natural physiological hinge of the joint you’re looking for. If you’ve previously taken Core 2: Examination & Records with us, I encourage you to review all the principles in the book (Chapter 9: Determining Centric Relation) and in the manual, as well as what we taught in class. If you haven’t taken the Examination & Records course, we spend a day and a half doing load testing, so that students get very comfortable with the hand position and how to get repeatable precise results.

How Do You Know If You Achieved Centric Relation?

August 23, 2024

By: Dr. Leonard A. Hess, DDSClinical Director, The Dawson AcademyThis article originally appeared on TheDawsonAcademy.com, Dr. Hess allowed igniteDDS to share with our readers. When we talk about utilizing bimanual manipulation as a way to get centric relation, one of the biggest misunderstandings we see is the tendency for dentists to think CR is achieved…

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dentist doing shade matching on a patient

Prioritizing Value for Ideal Shade Matching with Composites 

August 16, 2024

By: Lee Ann Brady DMDThis topic originally appeared on Pankey.org: Dr. Brady allowed permission for igniteDDS to share with our readers. Determine Value Before Chroma and Hue Shade matching is one of the biggest challenges for dentists when it comes to composite restoration. It requires a great knowledge of color science and playing with enamel…

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hpv and oral cancer patient

HPV and Oral Cancer: Early Detection and Prevention

August 9, 2024

By: Lee Ann Brady DMDThis topic originally appeared on Pankey.org. Dr. Brady granted permission for igniteDDS to share with our readers. Human papillomavirus (HPV) is a virus that can cause cancer later in life. Infection with this virus is very common, and almost everyone with get this virus at some point in life.  Most of…

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talking with a CFP about the role of psychology in financial planning

The Crucial Role of Psychology in Financial Planning

August 7, 2024

By: Todd Doobrow, CFP Financial planning isn’t just about numbers and spreadsheets; it’s equally about understanding how human behaviors influence our financial decisions. Psychology plays a pivotal role in shaping how individuals perceive, prioritize, and manage their finances, ultimately impacting their financial well-being and long-term goals. We this play out in six different ways; how…

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Photo by Pixabay: https://www.pexels.com/photo/two-gray-condenser-microphones-270288/

Tongue Ties, Restricted Fascia, and Mouth Breathing

August 2, 2024

By: Dr. Soroush Zaghi, MDThis topic originally appeared on TheDawsonAcademy.com. Dr. Zaghi granted permission for igniteDDS to share with our readers. The consequences of tongue ties, restricted fascia, and mouth breathing, are explained by a leading expert, physician, and researcher in nasal obstruction, snoring, and sleep-disordered breathing. Conversation with Dr. Zaghi on Tongue Ties, Restricted…

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dental assistant has a tray to restock the treatment room

Help…My Dental Assistant Won’t Restock the Treatment Rooms

July 29, 2024

By: Ronda Holman My name is Ronda Holman and I have been sitting across from a dentist for a living for the last 25 years. I thought it might be time to make some written confessions about what I have been guilty of over the years and how my dentist effectively molded me into their…

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maximizing dental team members engagement

Maximizing Team Member Engagement

July 26, 2024

By: Mark Kleive DDSThis article originally appeared on Pankey.org. Dr. Kleive granted permission for igniteDDS to share it with our readers. Keeping your team members motivated and actively participating throughout the year is no small feat. Without a solid communication-based framework,  things can easily fall apart, undermining the cohesion and productivity of your practice. During…

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