Trip Plans

alaska pic

R-Tech Dental of MN will be closed for a week during the month of July. I’m taking my wife to Alaska to make up for all of the years without a real vacation and to give her the honeymoon in Alaska that she never got. We will be gone from July 16th (Sunday) until July 25th (Tuesday).

If during this time an emergency should occur… Eeeek!

I have the following options for you:

  • R-Tech Dental of MN (Richard Briney)
    Elko, MN
    (952) 461-2322 (Home)
  • R-Tech Dental Equipment Services (Matt, Rick, John)
    Chippewa Falls, WI
    (715) 723-0737
  • Sullivan-Schein Dental
    Eagan, MN
    (800) 645-6594

If it is not an emergency, please leave a message for me or call me back on Wednesday and we will get you scheduled up for a service call.

Thanks for understanding!

Mike

Gentling Dental Care Welcomes New Dentist

Join us in Welcoming Dr. Melissa McCulloch to our staff!

She is a 2002 graduate of Marquette University School of Dentistry in Milwaukee, WI. After dental school, she completed one-year General Practice Residency at the Veteran’s Affairs Medical Center in Minneapolis. Dr. Melissa practiced in St. Cloud for 2-1/2 years before relocating to Rochester. She is a member of various national, state and local dental organizations.

Gentling Dental Care
2210 North Broadway
Rochester, MN 55901
507-288-7379

Dental office space for sale

Dr. Tony Lund has a dental office space available in Rochester, MN. The space is located directly above the offices of Dr. Truax and Dr. Praska (orthodontists). It is across the street from Lourdes high school at 15 NW 7th Ave. The space includes 5 operatories complete with chairs, lights, delivery units, and X-ray units. There is a waiting room, private back office, records room, consult room, bathrooms, storage, and a sterilization/break room.

Dr. Lund can be reached at (507) 319-3508 if you are interested in a tour of the space.

Blogger Implementation

We are making some changes to our newsletter that we hope will be exciting and make this area even more functional for our customers. You will notice now at the end of each of our newsletter articles is a comment and email buttton.

The email button will allow you to forward the newsletter article to a colleague or anyone else that you think might have interest.

The comment button will allow you to comment on any of our articles that you read. If you have a question about something that I write, or if you want to add a comment please do so! Maybe you have a suggestion of a better way to do something, or maybe you have some other conclusions. As with any blog, these comments will be visible to others.

In the next few weeks, we will be more finely integrating the blog into the framework of the website to make it feel more comfortable. We will also be making all of the historical links active as well.

Thanks, and I look forward to hearing from all of you.

-Mike

Children’s Dental Health Services

Dental Hygienist Kris Billman of Byron, MN opened the doors of Children’s Dental Health Services on Feb 1, 2006. She provides dental services for children from ages 1-5 without dental insurance. Her office is located within the United Way building and her office hours are 8AM – 5PM Monday through Friday. Billman is seeking any donations that can be provided. CDHS will run primarily through reimbursement from programs like Medicaid and MinnesotaCare. She plans to expand her services to cover children up to the age of 18 by March. Way to go Kris!

Children’s Dental Health Services
United Way Building
903 W. Center St.
Rochester, MN
(507) 273-7257 (for appointment)

Hot Utility Rooms

Heat can damage your compressor and vacuum systems. If you have a small utility room that has no ventilation it can get extremely hot in there. To avoid problems with the room getting too hot, you may want to consider adding some ventilation. This means either having a vent and a return installed in the room or having some kind of bathroom fan installed to vent the hot utility room to the outside. Now, nobody wants to vent their heat to the outside in the dead of winter or have a bathroom fan running 12 hours a day venting air conditioned air to the outside in the summer either. So here is the solution if you cannot get a vent and a return installed. Have an HVAC installer put in a bathroom fan that is controlled by a thermostat. That way, the bathroom fan only runs when the utility room gets too hot and does not when it is unnecessary.

Another option is to use a type of fan and thermostat that are used to keep greenhouses cool:

exhaustfanexhaustfanthermostat

Charles Hawk, D.D.S. Practice For Sale

Dr. Charles D. Hawk of St. Charles, MN is looking to sell his practice. Please contact his office at (507) 932-4530 for further information. His office is located here:

931 Whitewater Ave
P.O. Box 677
St. Charles, MN 55972

Check Valve Retraction

Today, Penny, from Dr. Tim Flor’s office in Waseca, told me that she attended a seminar where they suggested that all units be checked to make sure that the handpiece hoses have check valves installed to prevent retraction of liquids from the patients mouth.

Check valves do serve a purpose when they work. Check valves are designed to only permit the flow of air or water in one direction. There is normally a small arrow stamped on their exterior that indicates which way flow will be permitted. They are installed on each water bearing handpiece line within a delivery unit. Check valves are usually constructed of either a small piece of rubber tubing that is pinched flat on one end (A duckbill valve) or they are constructed using a small ball bearing, a spring, and an o-ring.

DCI_7140

Penny wanted to know if I felt that it was necessary to have them inspected and to have new check valves installed. My thoughts on check valves are as follows:

PROS:

  1. Check valves do prevent backflow from the patient when they are working properly. This helps prevent additional bacteria contamination of the unit.
  2. They are necessary in some applications such as flush toggles on delivery units, or cavitron dual select devices that allow for selection of different medicaments.

CONS:

  1. The check valves tend to get a contamination within them that causes them to leak thus defeating their originally intended purpose.
  2. Check valves tend to clog preventing all flow of water to the handpiece.
  3. As they are “anti-retraction” devices, they tend to not allow the water to drawback upon termination of a foot pedal depress. This means that a small amount of water dribbles from the end of the handpiece everytime you stop.
  4. They really need to be checked every 6 months to see if they are retracting and should be replaced if they are.

Here is a picture from a microscope showing a check valve that has failed due to buildup of bacteria on the surfaces of the duck bill valve:

 

checkvalvefail

If you would like, we can check your delivery system handpiece hoses for retraction and offer suggestions. Check valves do work, but they do go bad and must be replaced regularly if you intend to reap the benefits that they provide. A strict regiment of waterline disinfectant use (such as Mint-A-Kleen) will help extend the life of your check valves.

Relocation of Birch Lake Dental

Birch Lake Dental is relocating. Their new address is as follows:

Birch Lake Dental
4641 White Bear Parkway
White Bear Lake, MN 55110
(651) 429-0404

View Map

Our congratulations go out to Geetha J. Damodaran, D.D.S. and her staff.

Recent glut of non-digital pan and pan/ceph units

Due to the fact that many offices are going to a complete digital setup, there has become an increasing number of good quality non-digital pan and pan/ceph units that are available. Below is a list of some of the more recent machines that are available and the doctors that would like to sell them:

Siemens OP10 Pan machine — Dr. John Gawlik 952-884-8337
Gendex Orthoralix Pan/Ceph — Dr. Philip Perry 651-565-2888
Panoramic Laser 1000 Pan/Ceph — Dr. Jeffrey Loveless 507-451-5993
Panoramic PC-1000 Pan machine — Associates in Family Dental Care (Attn Connie) 507-455-1641

Please feel free to call these doctors/offices to inquire about their used X-Ray machines.

Just a friendly reminder about vacuum line cleaners

Bleach and various other cleaning chemicals (including some acidic vacuum line enzymatic cleaners) are NOT your vacuum system’s friend. It amazes me how much damage can be done by the wrong types of cleaners. To give you just a little taste of what I’m talking about, here is a picture of a brass fitting on a wet-ring vacuum pump. Keep in mind that this fitting is made of solid brass and has a nominal wall thickness of about 3/8″.
Vac_pump_Corrosion

As you can see from the picture, there is a gaping hole where solid metal used to be. The really tragic problem with this is that bad cleaners adversely affect the entire vacuum system, including any copper vacuum lines, pump fittings, pump impellers and housings, and even any amalgam separators that are inline. So once a problem like this is noticed, plenty of damage has had a chance to occur.

To avoid this problem in your office we recommend that absolutely NO bleach be allowed to be run down your vacuum lines, and we also recommend that you try to use vacuum line cleaners that have a fairly neutral pH. We have a chart of acceptable cleaners listed right here:

Acceptable Cleaners Sheet

OSHA label permanency

Yesterday, I was working at Dental Health Affiliates, the office of Dr. Charlie Smith, in Rochester, MN. I noticed something that I have not seen in any other offices. They have taken the time to have plastic signs engraved with all of the various OSHA compliance labeling. In many offices this labeling has been accomplished using simple adhesive stickers that eventually peel and/or look worn after short periods of time. The engraved plastic signs that Dental Health Affiliates have posted look very professional, and have a permanency to them that regular stickers will never have.

With Charlie’s permission I took a couple of quick snapshots of some of the labeling that has been done in his office to give you all a chance to see what I was talking about:
SMITH_BIOHAZARDsmith_biohazard2

smith_refrigeratorSMITH_X-RAY

Now compare the above pictures with what we commonly see in many dental offices:

smith_biohazard_bad

How far should clean water bottles be filled?

I understand that when your operatory has a clean water bottle system that it can be frustrating when that bottle runs out. Consequently, many assistants have had a tendency to fill their water bottles all the way to the top before screwing them onto the clean water systems. Clean water systems are fairly simple devices. They consist of a manifold that the bottle screws into, a water feed tube (Hangs down inside of bottle), and a small hole near the top of the bottle where regulated air (approximately 40PSI) enters the bottle. As strong as the tendency to fill the bottle to the top is, I want your staff to refrain from this practice. Here’s why:

#1 As a bottle is screwed onto a clean water system manifold, the feed tube displaces water as it enters the bottle causing water to spill over causing a mess, especially if the solution in the bottle is a waterline cleaning agent.

#2 If a bottle is completely full of water when screwed onto a clean water system manifold the water is at such a high level within the bottle that it comes into contact with the air inlet hole of the manifold. If the bottle gets pressurized and then de-pressurized, the water tends to get into the air line. This water can damage bottle on/off toggles, pressure regulators, as well as even cause water to come out when the air button is pressed on a syringe. This condition is referred to as air/water crossover and is something we want to avoid if at all possible.

Ah, so here comes the answer to the question that everyone is asking right now. “How full should I fill the clean water bottle?” — We suggest that you stay down about 1.5 inches from the neck of the bottle. Some of the newer clean water bottles actually have a raised fill line molded onto the bottle. We basically want to make sure that there is a gap of air near the top of the bottle even after it is screwed onto the manifold.

CWS_FILL_LINE

Dr. Garrett Starr’s new office

Today we finished moving Dr. Starr into his new office. Wow! What a nice upgrade for him, his staff, and his patients. We wish Dr. Starr and his staff well in their new location and want to thank him for the chance to be a part of this relocation.

stagar_map

Christmas and New Years wishes

At R-Tech Dental, we would like to wish you and yours a very Merry Christmas and a Happy New Year. We also want to let all of you know that R-Tech Dental of MN will be closed the last week of December this year (December 24th – January 1st). R-Tech Dental of MN will re-open on Monday, January 2nd. Mike is taking time off to spend with his kids.

Panoramic Lead Aprons

I have seen many assistants improperly using a lead vest while trying to take a panoramic X-ray. The rotation of a panoramic tube head usually starts on one side of the patient, rotates around the back of the patient’s head, and ends on the opposite side of the patient’s head. Does placing a lead vest over the patient’s chest do anything to protect them from radiation during exposure? No. The radiation on a panoramic rotation comes from the sides and from behind the patient not the front. If you must use a full size lead vest for panoramic X-rays you are better off placing it over the patient’s back being careful to not allow it to be placed too high on the patient’s neck. If the lead vest is placed too high, you will very likely loose the anterior teeth and/or the lower half of your radiograph.

We have a better solution — The panoramic cape. It is a lead vest that is specifically designed for use with a pan. It covers the shoulder area and wraps the patient from front to back covering just the critical areas that are in harms way during a panoramic exposure. Click on the image below to be taken to the product information page.

rinn_lead_aprons

Why are screen contact tests required annually?

Inspection of cassettes for good film screen contact is an often overlooked yet important quality control procedure. Poor film/screen contact can be the reason for areas of increased density, reduced density and blurring. The film that you install into your cassette is not exposed solely by radiation. It is exposed by the screens within the cassette that glow when hit by radiation. If these screens are dirty or are not in good contact with the film, they can yield poor radiographs that can possibly lead to a mis-diagnosis of a patient’s condition.

Some states, like Minnesota, require screen contact testing on an annual basis. We perform this testing using a screen contact test tool which is a flat device that is about 14″ x 17″ consisting of a wire mesh encased in plastic.
RMI_Screen_Test_Tool

We place the test tool on top of your cassette. Using an intra-oral, we make a uniform exposure that covers the entire cassette surface. After that, we process the film. If the film has a uniform density with a solid grid pattern and does not show areas of fogging, spotting, or blurring then it passes. Below is an example of a good screen contact test:
screentest_pass

And here are some examples of tests that have failed for various reasons.
screentest_fail1screentest_fail2screentest_fail3

Poor screen film contact can sometimes be corrected by cleaning the screens using an anti-static intensifying screen cleaner such as Kodak’s Anti-static Intensifying Screen Cleaner which comes in a pump spray bottle. You clean cassette screens by moistening a lint-free wipe with a small amount of screen cleaner, then rubbing the screens with the wipe. Always remember to allow the screens to dry completely before re-testing. Avoid any excessive rubbing, abrasive gauze, pouring of any solution directly onto the screens, or using an excessive amount of solution. If cleaning does not work, screen replacement would be the next step. If that does not work due to worn out cassette seals or flattened foam backings then the cassette itself will need to be replaced. Judging by how the screen test fails and how the cassette seals/foam backing look, we are normally able to recommend the course of action that will get your cassette to pass again.

We have an informational sheet from the MDH on the subject of screen contact testing available here:

http://www.rtechdental.com/documents/mnscreentest.pdf

Kodak also has a good informational page on screen contact testing, although it deals more with screen testing for mamography:

Can Peri-Pro chemistry be used in a full size AT-2000 film processor?

This question was posed by a doctor that had a bunch of Peri-Pro chemistry in the basement that he wanted to use up. He was hoping to avoid having to buy cases of full-size processor chemistry.

The first point I want to make here is this: Our recommendations have and always will be to use chemistry that is specific to the type of processor that you have. Manufacturers will adjust the quantities of component ingredients in their Chemistry formulation to match the performance and price parameters they have established for their product. Formulations also change based on the time and temperature that the chemical is designed to work under.

If you have a Gendex GXP processor, you should use GXP chemicals. If you have an Air Techniques Peri-Pro then use Peri-Pro chemistry. The use of generic or non-unit specific chemistry can cause damage or discoloration in the long term, not to mention providing you with image quality that is less than optimal.

Peri-Pro processors are designed to operate at room temperature (ideally 72-74 degrees F). Peri-Pro IIs and Peri-Pro IIIs still only heat the chemistry to 72 degrees F. Full size Air Techniques processors operate at 82 degrees F. This temperature difference would, I believe, lead to darker X-ray images if Peri-Pro chemistry were heated in the full size processor. Thus, I suggested to the doctor that he not use it as a temporary replacement.

If you would like to talk with Air Techniques directly about this, they can be reached at 1-800-AIR-TECH (800-247-8324). They are also available on the web at:

http://www.airtechniques.com/home.aspx

Disturbing X-Ray arm drifting

Today I was at Professional Drive Dental doing routine service work, when one of the hygienists mentioned to me that she was having trouble with her X-ray arm drifting.

Upon inspection of the X-ray, we found that the swing arm had cracked. After inspection of the unit, the doctors and I both agreed that the arm needed to be secured and the machine disabled until a replacement arm could be ordered and installed. Nobody ever wants the liability of a heavy tubehead crashing down on a patient’s face.

We also decided it would be prudent to investigate the remaining X-ray units in the office. Low and behold there was a second arm that was also cracked but not nearly as bad as the first. We went ahead and ordered and installed an arm for that unit as well.

Not knowing if this was a fluke or something of a problem that everyone could possibly have, the doctors suggested that I recommend that other offices have their X-ray arms checked. So, if you have us in your office on a normal service call, we will happily inspect your X-ray arms for any problems.

The biggest point that I have in all of this is that I want staff to be observant of the equipment and how it is supposed to function so that they can let me know when something just isn’t right. This was a good catch by the Professional Drive dental staff!

Below are pictures detailing where to check for problems:
gendex770arm1sm

 

We noticed that the horizontal arm was not horizontal.
gendex770arm2sm

 

You remove this plastic cover to look inside.
Gendex770arm3sm

 

The crack on this arm was quite evident.

How do I properly use a water tester and why do we have to test the water anyhow?

POL_TDS_METER

We have been supplying the above water testers to anyone that has a Statim sterilizer. The Statim works by injecting distilled water under pressure into a very small boiler. This boiler immediately turns the water into steam. Within this boiler is a small temperature sensor (thermocouple) that relays the boiler temperature to the control circuitry. If you happen to use non-distilled water the thermocouple within the boiler can get coated with calcium, lime, rust, etc. Once coated it is less acurate in its readings and can cause the boiler to burn out. To avoid this problem, we use the water tester to make absolutely sure that the water that is being poured into the reservoir is as clean as possible. Generally this is considered to be anything that contains three parts per million (ppm) total disolved solids (TDS) or less. The water tester that we provide reads 0-999 ppm TDS. Below are the steps for proper testing:

  1. Take gallon of water and shake it to make sure that any disolved solids that have settled on the bottom of the jug are now floating.
  2. Remove the black cover from the bottom of the water tester and insert the tester into the neck of the bottle submerging the base of it approximately 1 inch into the water. It may be necessary to squeeze the jug of water to get the water level to rise enough to reach the tester.
  3. Press and hold the “ON” button. Preferrably for at least 30 seconds to allow the water tester to adjust to water temperature. The unit uses a thermometer in combination with electrical conductivity to determine the ppm TDS.
  4. If the reading is 003, 002, 001, or 000 then the water is acceptable for use in the statim. If not use if for some other application within the office.
  5. Dry off the end of the water tester and re-cover for use next time.

So, whether you buy gallons of distilled water or make it yourself, always test every bottle prior to pouring