Tooth Whitening

Transcription

Tooth Whitening

Tooth Whitening
Then & Now
tHE
Focus on
Infection Control
Amy Melillo
Published by the Ontario Dental Assistants Association
Doing our Profession Proud
A Special Spotlight
on June Cook
tHE
Published by the Ontario Dental Assistants Association
09 05
fall
V o lume 1 2
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ODAA Executive
2005-2006
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The Journal is the official publication
of Ontario Dental Assistants Association.
The Journal’s objective is to
promote the advancement of
dental assisting and dental reception.
President
Constance Steinborn HBA, CDAII, CDR
President-Elect
Wendy Bambridge CDA II
Vice President
Stephanie Davenport CDA II
Executive Director
Judy Melville BA
Editorial board
Editor
Judy Melville BA
Associate Editor
Lana Thistle
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Deadline Date for Journal Submissions
December 1, 2005 (Winter 2006 Issue)
The opinions expressed in this Journal are those of the writers
and do not necessarily reflect those of the Ontario Dental
Assistants Association. Publication of a signed editorial or of an
article in The Journal does not imply endorsement of its contents
by the Ontario Dental Assistants Association, or its agents, or
any ODAA member. Information drawn from other published
sources is the responsibility of the writers.
Subscription information
$40.00 Subscription (Canada)
$11.00 Single Copy (Canada)
$55.00 Subscription (Out of Country)
$15.00 Single Copy (Out of Country)
Contact ODAA
Advertising Inquiries
Judy Melville
Tel: 519.679.2566 Ext 25
Fax: 519.679.8494
Email: jmelville@ody.ca
Commercial Publication Mailed Under Agreement
No. 1553356 Customer No. 0248575398
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Change of Address
Members please be sure to inform ODAA
Business Office of any change of name,
address or telephone number. Please send us
your email address as well.
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President’s Message
From Judy’s Desk
Letters to the Editor
Regulation Update
Meet Amy Melillo CDA II
Tooth Whitening Then & Now
Focus on Infection Control
Frequently Asked Questions
Announcements
Open Wide. A Campaign for
Change in Dental Care
869 Dundas Street, London ON N5W 2Z8
Tel: 519.679.2566 Fax: 519.679.8494
Web: www.odaa.org
Office Hours: Mon – Fri 8:30 am to 4:30 pm
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A Special Spotlight on June Cook
Members: Please see the back of your
membership card for our toll-free number.
Have your certification or member number
available when calling the Business Office.
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Home Study Programs
Ontario Dental Assistants Association
Affiliate News
Show your Pride with
New Promotional Items
ODAA President
Constance Steinborn, HBA, CDA II, CDR
President’s Message
Hello everyone! Once again our
summer has gone by too quickly.
I hope all of you enjoyed the
hot weather we had! Although
summer time is usually a little
quieter for ODAA, this year has
definitely been the exception.
We’ve been doing some amazing
things since our last Journal
publication and we’re very excited
to share them with you.
“Project Smile” is our code name for the
development and launch of the ODAA’s
brand new professional identity, and
this issue of The Journal is the “official
unveiling” of our bold new look! You’ll
be seeing our new identity on our website,
letterhead, membership certificates and
pins later this fall.
firm will ensure our professional success
and recognition for future self-regulation.
Therefore, a small increase in membership
fees will be essential in this process.
The Board will be reviewing financial
recommendations later this fall and
will finalize a decision prior to our
membership renewal period.
If you had the opportunity to attend our
AGM back in April, then you’ve already
had a sneak preview of some of our
promotional items with our new logo.
However, if you were unable to attend,
then you’re in for a treat! See inside
for an exciting look at our new jackets,
velour vests, gym bags, water bottles
and uniforms. All members will have an
opportunity to order these professional
promotional items in the near future.
Your voluntary membership and
commitment to ODAA has been especially
noticeable this year! As of July we had a
record increase in membership. We are now
7,700 members strong—the highest number
in years! I personally wish to welcome
all of our new members, and extend my
congratulations to those of you who have
renewed lapsed memberships with ODAA
this year. Thank you!
Recently, your Board of Directors approved
a fall media campaign as recommended
by our marketing firm back in April.
While this media campaign works to
raise awareness of the issues facing the
dental assistant profession in Ontario, our
government-relations firm will be focused
on getting the message to our provincial
members of parliament. Your Executive
Director, Executive Committee and Board
of Directors will be jointly committed to
our pursuit of self-regulation.
As mentioned at our AGM and in my
previous report to you, our financial
commitment to the government-relations
03
F A L L ONTARIO DENTAL ASSISTANTS ASSOCIATION JOURNAL
Most of you have already received your
affiliate newsletters. Data retrieved
from our most recent survey has been
compiled and your region’s wages have
been published. Please use this data in
your salary negotiations. Many members
have reported pay increases after their
employers received and reviewed ODAA’s
recent letter regarding Ontario wages for
dental assistants.
As the ODAA faces more challenges this
year, I will continue to draw on your
membership support and strength. Let us
all step forward into this exciting new era.
Together we share our pride...and shape
our future!
Executive Director
Judy Melville
From Judy’s Desk
Notice anything different?
At the end of 2004, we embarked
on an incredible journey of
change. We felt that it was time
for the ODN&AA to turn a corner,
to instill renewed pride and
professionalism into our work, and
to create a strong and sure future
for dental assistants across Ontario.
As of January 1, 2005, the ODN&AA
became the ODAA (Ontario Dental
Assistants Association). This was
the first signal of change within our
organization. From there, we decided
to repackage ourselves, with a bold
new logo and a powerful tagline, both
of which grace the front cover of our
new Journal. The logo represents you,
the dental assistant, embraced by the
support of your organization. It is
contemporary, energetic and positive.
The tagline, Sharing our pride.
Shaping our future, gave us goosebumps
when it was first presented to us at a
meeting of your Board of Directors.
Why? Because it captures the very
essence of our organization—where
we’ve been and where we are going.
We started in the late 1920s, at a time
when women in Canada were just
getting the vote. Our founder, Marion
Edwards, formed the association in
1927, and we incorporated in 1934.
In 1929, under the Person’s Act,
women got the vote in Canada.
Back then, Marion recognized the value of
fellowship, unity and professional growth.
Over the years, others have continued
this work and shaped our association into
what it is today. So, indeed, we are sharing
our pride. Pride in professionalism, in
patient care and in certification, thus
ensuring our professional growth. We
are now in our 71st year of being an
incorporated professional association.
Now it is time to shape our future. It is
time for the ODAA to be the leader of
dental assistants in Ontario. It is time for
us to take the steps to self-determination
for the profession of dental assisting. It is
time for dental assistants to determine
the duties or scope of practice of dental
assistants, rather than allowing others to
define them.
Becoming a self-regulated health
profession will enable us to form our
own disciplining body. In Ontario, a
disciplining body of a regulated health
profession is called a College. The College
of Dental Assistants will be governed by
dental assistants and by public members.
We will determine what we do and how
we do it, and ensure that only formally
educated and certified dental assistants
perform the work of dental assistants.
Advocacy, lobbying and ensuring that
the profession of dental assisting is
recognized and respected will shape
our future. And as members of the
ODAA, you will share it with us.
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Letters to the Editor
Dear ODN&AA,
It is with great regret that I need
to inform you of 2005 being
my last year as a member of the
ODN&AA, and being a certified
dental assistant.
It has been over ten years since
I graduated and became a member. I
started working as a dental assistant as
soon as I graduated in a part-time position
in Brantford, Ontario. Six months later,
my husband and I moved back to New
York, after which I started searching for
work in a dentist’s office. Much to my
disappointment, the closest dentist was 30
minutes from my home, through rolling
and winding snow-covered roads, which
was not appealing. Two months after we
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were living there, I was offered a position
with the County, which soon became
permanent. We have since moved from
New York, and I am again working with
the County in a Sheriff’s office. It is not
looking as though I will ever work in a
dental office again. So, after ten years of
continuing education and staying current,
I am going to let this year be my last one.
I have enjoyed the ODN&AA immensely,
and the challenging courses through the
years. ODN&AA has given much to my
life!! I cannot begin to thank you and
everyone in your office for the kindness
all of you have shown me through the
years. I have never known an organization
with so much kindness, courtesy and
politeness. We, in the States, need to take
lessons and learn from you. I have grown
as a person with the knowledge of the
school and the continued education.
The “Attitude” Home Study really made
an improvement in my life. So, I thank
you for every way in which I have grown
as a woman through the years because of
the ODN&AA!!
May God continue to bless you and
the ODN&AA!
Sincerely, Mary Jane Prospero
Have a question, opinion or comment?
Send your typed letters to us by
e-mail to jmelville@ody.ca, by snail mail
to c/o ODAA, 869 Dundas Street,
London, Ontario N5W 2Z8 or by fax to
519-679-8494. We reserve the right to edit
all submissions.
Regulation Update
Developing a personal
relationship with a client
Recently, an Ontario dental hygienist
This hygienist was found to be having a
and there is a perceived power imbalance
lost her Certificate of Registration
sexual relationship with a client. As such,
between a health professional and a client.
because she was found to have
she had committed an act of professional
As well, sexual abuse tarnishes public trust
committed an act of professional
misconduct. The penalty for this under the
in the entire profession.
misconduct (sexual abuse) when
Code is a reprimand and revocation of her
she developed a personal and sexual
relationship with a client.
Sexual abuse of a client is defined in Section 1.(3)
of the Health Professions Procedural Code as:
a) sexual intercourse or other forms of
physical sexual relations between a
registrant and a client,
b)touching, of a sexual nature, of a client
by a registrant, or
c) behavior or remarks of a sexual nature
by a registrant towards a client.
Certificate of Registration. In this case, she
lost her ability to work as a dental hygienist
for a period of five years.
Sexual abuse by professionals is a serious
violation of boundaries, deemed unacceptable
by all regulated health professions. Should
a health professional wish to engage in
an intimate relationship, the professional
relationship must first be terminated.
Though our profession is not yet regulated,
one must weigh the costs of becoming
involved with a client. It is certainly not
advisable given the desire of dental assistants
to be regarded as healthcare professionals.
We would encourage our members to act as
if they are regulated health professionals and
refrain from engaging in activities defined by
the Health Professions Procedural Code as
“sexual abuse” of a client.
The Code dictates zero tolerance because
clients are generally considered vulnerable,
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CDA Profile
Doing Her Profession Proud
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AmyMelillo
A highly committed dental assistant
with a CDA II designation, Amy
Melillo has a personal desire to
inform and teach her patients as
much as possible. “When they ask
me about dental procedures, or
they need to make a decision about
whitening, for example, I have to
have answers for them,” she says.
“The more knowledgeable I am, the
better it is for our patients.”
encourages me to take extra courses to
earn my 15 points each year and keep up
my membership.”
She also takes advantage of many
other exclusive benefits that come with
ODAA membership. “I get a lot of great
information from The Journal. When it
arrives, I always make a point of going
through it. I even do the quizzes.”
In addition, Amy appreciates the
discounted services she is eligible for as
a member. “I joined Goodlife Fitness at a
special rate, and also signed up for the life
insurance plan for ODAA members.”
For the Demarco, Panwar, Graber and
Fuzy Dental Office, who employ seven
dental assistants, certification has been
an absolute prerequisite since the office
opened 28 years ago. “We hire dental
assistants that have been well-trained
and educated by reputable schools, and
form them the way we want them to be.
We surround ourselves with the best
people, treat them well and they stay,”
says Campeau.
Employees attend monthly meetings
with industry speakers, and were sent
to Las Vegas for training in cosmetic
dentistry. “It’s a team approach and
Clockwise: John Demarco, Hans Graber, Michelle Fuzy,
Manu Panwar
Left to Right: Derek Viveiros, Kathy Samson, Diane Kozachuk, Denis Campeau, Andrea Renault, Sambeth Seang,
Megan Srigley, Amy Melillo, Amy Zimmerman
A graduate of the Dental Assisting
Program at Fanshawe College, Amy joined
the Ontario Dental Assistants Association
in 2000 after hearing about it in a class.
Her initial incentive was practical. “It
seemed like a good organization, and by
joining I got a head start on earning my
points for the year.” But now Amy sees
the ODAA as something more—a means
of helping her further her education and
stay on top of her profession. “The ODAA
Employer support makes
all the difference
At the Demarco, Panwar, Graber and Fuzy
Dental Office in London, Ontario, where
Amy works, dental assistants receive a level
of respect that is rare in the industry. Denis
Campeau, the clinic’s business manager,
believes that “dental assistants are hardworking, well-trained professionals that are
undervalued in the marketplace.”
you need your whole staff behind you.
We have assistants and dental hygienists.
We all have to know what the products
are and what can be done.”
It’s an investment that is not lost on Amy
and her co-workers. “They really want us
to succeed and be the best at our jobs.
It reflects positively on everyone.”
Amy feels very fortunate to be a part of
a professional team committed to doing
what’s right for the patient. “If we’re
properly trained and knowledgeable, our
patients have more faith in us.”
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Tooth Whitening
Then & Now
Dr. Len Boksman D.D.S., B.Sc. F.A.D.I., F.I.C.D.
Everyone wants to have a radiant smile with gleaming pearly whites—and today, practically everyone can! Sales
of over-the-counter whitening products have been estimated to approach $1 billion a year in North America alone.1
Tooth whitening has become a multi-million dollar industry, and there are literally hundreds of competing products
to whiten teeth, be they in-office procedures or take-home systems. The more you know about tooth whitening, the
better prepared you’ll be to help your patients make informed decisions about what system is right for them.
How it all began
The dental use of hydrogen peroxide, the basic
ingredient in all tooth-whitening products, has been
documented for over 80 years. Initially, hydrogen
peroxide was used for periodontal treatment and
wound healing, because it was proven to prevent
and retard the colonization and multiplication of
anaerobic bacteria.2,3
In 1966, Schneider et al.4 documented the use of a
peroxide-containing gingival strip to apply peroxides
in periodontal tissue healing. It wasn’t long before
an accidental side effect was observed—peroxide
actually whitened the teeth.
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Later, a pediatric dentist, Dr. Jerry Wagner, used
Proxigel in custom-fitted, vacuum-formed trays
specifically for whitening teeth. These were FDAapproved oral antiseptics containing 10% carbamide
peroxide.1 The concept of tooth whitening was born.
How it works
Hydrogen peroxide releases the oxygen that breaks
down the conjugated bonds in protein chains (stains)
into a single bond, which increases the absorption
of colour wavelengths resulting in the reflection of
little colour (i.e., a whitening effect).5
Extrinsic staining, which affects only the enamel
surface, can be caused by tea, coffee, nicotine,
chewing tobacco, blueberries, wine and
natural aging. These stains are all relatively
easy to treat with tooth whitening. The
intrinsic stains that discolour the internal
aspect of the tooth such as fluorosis,
tretracycline, trauma and systemic conditions
are infinitely more difficult to treat.
Even though peroxides in whitening
materials have been shown to permeate
intact enamel in just a few seconds6,
changing the colour of the dentin
requires long exposure to realize
positive results.
Is it safe?
The safety of using hydrogen peroxide and
carbamide peroxide has been documented
in numerous studies. In a retrospective
look at two hundred and fifty-six major
medical and dental journals, Yarborough7
states that “the safety and efficacy of
hydrogen peroxide is well established.”
Studies on the effect of hydrogen peroxide
on the oral hard tissues and pulp have
shown that “hydrogen peroxide does not
adversely affect enamel morphology or
microhardness and hydrogen peroxide is
not expected to inhibit pulpal enzymes.”8
Even when used for extended periods
when treating tetracycline-stained teeth,
no adverse effects have been noted using
carbamide peroxide.9
Tooth whitening
and tooth sensitivity
In some cases, tooth sensitivity may occur
as a side effect of tooth whitening. Tooth
sensitivity as a result of whitening teeth is
dose- and time-related. The higher the dose
or concentration of the whitening agent
and the longer the teeth are exposed, the
greater the risk of tooth sensitivity.
If sensitivity occurs, the first and easiest
way to address the problem is to decrease
the time the patient treats the teeth or
decrease the dosage of the peroxide.
Many products contain water to decrease
the dehydration effects of whitening,
and others have fluoride and potassium
nitrate to decrease the incidence of tooth
sensitivity. Potassium nitrate penetrates
the dentinal tubules and depolarizes
the nerves, decreasing the painful
stimulus.10 Potassium nitrate gels, which
can be utilized in bleaching type trays
for hypersensitive root surfaces, include
UltraEZ (UltraDent), Den-Mat Desensitize
(Den-Mat) and Relief (Discus). Recently,
Amorphous Calcium Phosphate has been
added to products like Zoom2 (Discus
Dental) to address this issue.
In-office tooth whitening
In-office tooth whitening uses high
concentrations of hydrogen peroxide.
It is more expensive for the patient than
take-home whitening due to the chair time
required. In-office tooth whitening is best
for those patients who want faster, more
immediate results, or patients who need close
monitoring for clinical conditions, such as
extensive tissue recession or deep unrestored
abfraction lesions. It is also necessary for
endodontic or internal tooth whitening.
Many current systems employ lightactivated bleaching. Some of these include
Laser Smile (Biolase Technology)
37% hydrogen peroxide, ArcBrite (Biotrol)
30% hydrogen peroxide, BriteSmile
(BriteSmile) 15% hydrogen peroxide,
Rembrandt Smile (Den-Mat) 35% hydrogen
peroxide, Zoom (Discus Dental)
20% hydrogen peroxide, and LumaWhite
Plus (LumaLite) 35% hydrogen peroxide.
Because of media coverage about lightactivated bleaching, patient demand for
this process is increasing. However, CRA
clinical trials repeatedly show that light and
heat do not increase tooth lightening and
are not necessary for vital tooth bleaching.
Contact time and concentration of active
ingredients are the critical factors.11 The
use of lights may impress patients, but
they add cost, occupy operatory space,
can cause soft-tissue burning and can
increase operatory temperature.12 All
systems recommend a take-home tray as an
adjunct, so the question is whether
any observed benefit is due to the light or
the tray.13
Before utilizing a light-activated bleaching
system, ask the patient if he/she is on
any medication. Some medications can
cause minor to extreme photosensitivity.
These include acne medications,
anti-cancer drugs, antidepressants,
antihistamines, antimicrobials, antiparasitic
drugs, antipsychotic drugs, diuretics,
hypoglycemics and non-steroidal antiinflammatory drugs.
In-office whitening systems not using
light or heat include Illumine (Dentsply
Professional) 15% hydrogen peroxide,
Office White (Life-Like Cosmetic Solutions)
40% hydrogen peroxide, Perfecta White
(Premier Dental Products) 35% hydrogen
peroxide, Niveous (Shofu Dental) 25%
hydrogen peroxide and Opalescence Xtra
Boost (UltraDent) 38% hydrogen peroxide.
Due to the negative effects on gingival
tissue of these high concentrations of
hydrogen peroxide, many of these systems
utilize various forms of tissue protection to
minimize the potential for gingival damage.
The application times and number of
applications vary by product.
Take-home tooth whitening
In March of 1989, Dr. Harald Heymann
and Van Haywood introduced the concept
of tooth whitening using a nightguard
with a viscous gel containing a thickening
agent (Carbopol), which allowed for longer
bleach activation and increased retention in
the tray.14
In 1989, Dr. Dan Fischer, who created
Opalescence carbamide peroxide
(UltraDent), received a patent for creating
the thick and sticky whitening gel
formulation that is still the basis for most
nighttime gels marketed today.
This was the first ADA-approved system for
whitening.1 This product was developed
with a high water content to minimize
tooth sensitivity, a neutral pH, and a
thixotropic viscosity to stay in the tray.
It was designed for sustained release of
the hydrogen peroxide.
The degradation over time of carbamide
peroxide shows that after two hours, more
than 50 percent of the active ingredient is
available and 10 percent is available after
10 hours.15 Therefore, for nighttime wear,
the maximum whitening effect occurs in
the first two hours.
Whitening agents that are recommended
for nighttime use by their manufacturers
include: Opalescence (UltraDent) 10%,
10
15%, 20%, Nupro White Gold (Dentsply
Professional) 10% and 15% carbamide
peroxide, Nite White Turbo (Discus Dental)
6% hydrogen peroxide, Gentle White
(IMDS) 35% hydrogen peroxide, and Pola
Night (Southern Dental Industries) 10%,
16% and 22% carbamide peroxide.
For daytime use, both carbamide peroxide
and hydrogen peroxide are effective
at-home bleaching agents.16 Products
that are indicated for daytime use by their
manufacturers include: Opalescence
(UltraDent) 10%, 15%, 20% carbamide
peroxide, Rembrandt XTRA-Comfort (DenMat) 16%, 22%, 30% carbamide peroxide,
Natural Elegance (Henry Schein) 10%,
15%, 22% carbamide peroxide, JustSmile
(JustSmile Whitening Systems) 2—10%
hydrogen peroxide, Perfecta Bravo (Premier
Dental Products) 9% hydrogen peroxide,
and Pola Day (Southern Dental Industries)
3%, 7.5%, and 9.5% hydrogen peroxide.
An innovative new product by UltraDent
Products is Treswhite, the first pre-molded,
pre-filled, disposable tooth-whitening tray.
The tray contains 9% hydrogen peroxide
gel along with a gingival barrier protector
gel around the sides. The thixotropic nature
of the gel ensures that it stays in contact
with the teeth.
When it comes to tray tooth-whitening, the
use of reservoirs is still an issue of debate.
The reservoir technique creates a little
bubble of space on the inside surface of
the tray immediately adjacent to the buccal
surface of the tooth. This space will
trap a greater quantity of bleach than a
non-reservoir technique. The increased
bleach quantity will release more oxygen
ions over a longer period of time in the
vicinity of the tooth, creating a greater
early whitening effect.17
In a study by Matis, he states that
“there is no clinical difference in tooth
whitening after two hours of tray use
whether or not reservoirs are present,”
yet in his conclusions he states that
“bleaching with tray reservoirs produced
significantly greater tooth lightening than
bleaching without reservoirs.”18 The author
prefers using trays with reservoirs.
Companies like Proctor and Gamble and
Colgate offer non-tray whitening products
that have been well researched and
documented.19,20 These include Crest
Whitestrips, containing a 6.5% hydrogen
peroxide, many different versions of Colgate
Platinum whitening toothpaste, and Colgate
Simply-White Whitening Gel, a paint-on gel
containing 5.9% hydrogen peroxide.21
As a valued member of the dental team,
you are in a unique position to play an
active role in encouraging and educating
your patient about the choices available
for tooth whitening. If you have utilized a
tooth-whitening system yourself, don’t be
afraid to talk to your patient about your
experience, and proudly show them your
pearly whites!
Bibliography:
1. Goff S. “Getting the White Right,” Dental Products Report (Jan. 2005) 14—19
2. Wennstrom J., Lindhe J. “Effect of hydrogen peroxide on developing plaque and gingivitis in man,” J Clin
Periodontol 6(2): (Apr. 1979) 115—30
3. Volpe AR et al. “Gingival tissue oxygenation: The effect of a single application of four commercial
preparations,” J Periodontol 37.6 (Nov.-Dec. 1966): 478—82
4. Schneider HG et al. “Clinical experience with the peroxide-containing gingival strip from the Leipziger
Arzneimttelwerk,” Dtsch Stomatol (Germany East), 16.9 (Sep. 1966): 656–67
5. L. G. Wade Jr., Conjugated Systems Organic Chemistry, 3rd ed. (Upper Saddle River, NJ: Prentice Hall; 1994):
695, 1106
6. R. C. Craig and J. Powers, Restorative Dental Materials, 11th ed. (St. Louis, Missouri: Mosby Inc., 2002).
7. D. K. Yarborough, “The Safety and Efficacy of Tooth Bleaching: A Review of the Literature,” Compendium
12.3 (Mar. 1991): 191–96.
8. G. Pugh, et al. “High levels of hydrogen peroxide in overnight tooth-whitening formulas: effects on enamel
and pulp,” J Esthet Restor Dent 17.1 (2005): 40—45, discussion 46—47
9. V. B. Haywood and R. H. Leonard, et al., “Efficacy of Six Months of Nightguard Vital Bleaching of
Tetracycline-Stained Teeth,” J of Esthet Dent 9.1 (1997) 13—19
10. R. Orchardson and D. G. Gilliam, “The efficacy of potassium salts as agent for treating dentin
hypersensitivity,” J Orofac Pain 14 (2000): 9—19
11. CRA Newsletter 4.4 (April 2000)
12. CRA Newsletter 26.11 (November 2002)
13. G. Kugel, “Is there a benefit to light-activated tooth whitening? JCDA Point of Care 71.6
(June 2005): 420—21
14. V. B. Haywood, “Nightguard vital bleaching,” Quit Internat 189 20.3: 173—76
15. B. A. Matis, et al., “In vivo degradation of bleaching gel used in whitening teeth,” JADA,
130 (February 1999) 227—35
16. G. R. Mokhlis, et al. “A clinical evaluation of carbamide peroxide and hydrogen peroxide whitening agents
during daytime use,” J Am Dent Assoc (Sep. 2000) 1269—77
17. “Dentistry today Buyers’ Guide to Whitening Systems,” Dentistry Today Dec 2004: 120
18. B. A. Matis, et al., “A clinical evaluation of a bleaching agent used with and without reservoirs,” Operative
Dentistry 27 (2002) 5—11
19. R. W. Gerlach and Zhou X., “Clinical trial comparing two daytime hydrogen-peroxide vital-bleaching
systems,” Compend Contin Educ Dent 25.8 (Suppl. 2) (Aug. 2004): 33—40
20. P. A. Sagel and W. F. Landrigan, “A new approach to strip-based tooth whitening: 14% hydrogen peroxide
delivered via controlled low dose,” Compend Contin Educ Dent 25.8 (Suppl. 2) (Aug. 2004): 9—13
21. G. Gambarini et al., “Efficacy and safety assessment of a new liquid tooth whitening gel containing 5.95%
hydrogen peroxide,” Am J Dent 17.2 (Apr. 2004): 79—5
tHE
11
Le blanchiment Dentaire
Alors et Maintenant
Tous veulent un sourire éclatant avec des
dents d’un blanc perle – et aujourd’hui,
pratiquement tout le monde le peut!
On estime les ventes de produits de
blanchiment disponibles en comptoir à
près de 1 milliard de dollars par année,
en Amérique du Nord seulement.1 Le
blanchiment des dents est une industrie
qui rapporte des millions de dollars, et
on retrouve littéralement des centaines de
produits compétitifs pour blanchir les dents,
tant bien par procédures en clinique que
par des systèmes pour utilisation à domicile.
Plus vous en connaissez sur le blanchiment
des dents, mieux vous pourrez aider vos
patients à prendre une décision avertie sur
le système qui leur convient le mieux.
Comment tout cela a commencé
Depuis plus de 80 ans la documentation
existe sur l’utilisation dentaire du peroxyde
d’hydrogène, l’ingrédient de base dans
tous les produits de blanchiment dentaire.
Initialement, le peroxyde d’hydrogène
était utilisé pour le traitement parodontal
et la guérison des lésions, parce qu’il était
prouvé que le peroxyde d’hydrogène peut
prévenir et retarder la colonisation et la
multiplication des bactéries anaérobiques.2,3
En 1966, Schneider et al.4 documentaient
l’utilisation d’une bande gingivale
contenant du peroxyde pour application
de peroxyde dans le traitement des tissus
parodontaux. Très vite on observa, par
accident, un effet secondaire – le peroxyde
actuellement blanchissait les dents.
Plus tard, un pédodontiste, le Dr Jerry
Wagner, utilisa Proxigel dans des gouttières
confectionnées sur mesure spécialement
pour le blanchiment des dents. Celles-ci
étaient des antiseptiques oraux contenant
10% de peroxyde de carbamide approuvés
par la FDA.1 Le concept du blanchiment
dentaire venait de naître.
Comment cela fonctionne
Le peroxyde d’hydrogène libère l’oxygène
qui brise les liens conjugués dans les
chaînes de protéines (taches) en lien
singulier, ce qui amène une plus grande
absorption de la longueur d’ondes
de couleur résultant dans la réflexion
de peu de couleur (p. ex. un effet de
blanchiment).5
Les taches extrinsèques, qui n’affectent
seulement que la surface de l’émail,
peuvent être causées par le thé, le café, la
nicotine, le tabac à chiquer, les bleuets,
le vin et le vieillissement naturel. Ces
taches sont toutes relativement faciles à
traiter avec le blanchiment dentaire. Les
taches intrinsèques qui décolorent l’aspect
interne de la dent comme la fluorose,
la tétracycline, un traumatisme et des
conditions systémiques sont beaucoup plus
difficiles à traiter.
Même si le peroxyde dans les matériaux de
blanchiment a clairement démontré qu’il
peut pénétrer l’émail intact en quelques
secondes seulement,6 altérer la couleur
de la dentine requiert une exposition
prolongée pour affecter la couleur.
Est-ce sécuritaire?
L’utilisation sécuritaire du peroxyde
d’hydrogène et du peroxyde de carbamide
a été très souvent documentée dans de
nombreuses études. Après un regard
rétrospectif à deux cent cinquante-six
revues médicales et dentaires, Yarborough7
déclare que “la sécurité et l’efficacité du
peroxyde d’hydrogène sont bien établies.”
Les effets du peroxyde d’hydrogène sur les
tissus durs et la pulpe ont été évalués dans
plusieurs études. “Le peroxyde d’hydrogène
n’affecte pas d’une façon adverse la
morphologie ou la micro consistance
de l’émail et il n’est pas anticipé que le
peroxyde d’hydrogène gênera les enzymes
pulpaires.”8. Même durant des périodes
prolongées d’usage de peroxyde de
carbamide, lors de traitement de dents
tachées par la tétracycline, aucun effet nocif
n’a été noté.9
Le blanchiment dentaire et
la sensibilité dentaire
Dans certains cas, une sensibilité
épisodique résultant du blanchiment
dentaire peut se manifester comme effet
secondaire. Cette sensibilité est reliée à la
dose et au temps d’exposition. Plus la dose
ou la concentration d’agent de blanchiment
est grande et plus longtemps les dents
sont exposées, plus grand est le risque
de sensibilité dentaire. Si la sensibilité
se produit, la façon première et facile
d’adresser le problème est de diminuer
le temps de traitement ou de diminuer la
dose de peroxyde ou de peroxyde
de carbamide.
Plusieurs produits contiennent de l’eau, ce
qui diminue les effets de déshydratation
du blanchiment, et certains ont du fluor
et du nitrate de potassium pour diminuer
l’incidence de sensibilité dentaire. Le
nitrate de potassium pénètre les tubulures
dentaires et dépolarise les nerfs, diminuant
ainsi la douleur.10 Les gels de nitrate de
potassium qui peuvent être utilisés dans les
gouttières de blanchiment pour surfaces de
racine hypersensibles comprennent UtraEZ
(UltraDent), Den-Mat Desensitize (DenMat) et Relief (Discus). Tout récemment
pour adresser ce problème, du phosphate
de calcium amorphe a été ajouté aux
produits comme Zoom2 (Discus Dental).
12
Blanchiment dentaire
en clinique
Le blanchiment dentaire en clinique utilise
une forte concentration de peroxyde
d’hydrogène. Le coût est plus élevé que le
blanchiment à domicile dû à l’occupation
de la chaise. Ce type de blanchiment est
recommandé pour les clients qui désirent un
effet rapide, des résultats immédiats et pour
ceux qui requièrent une surveillance due à
des conditions cliniques comme par exemple
une récession extensive de tissus ou des
lésions abfractaires profondes non-restaurées.
Il est aussi requis en endodontie ou pour le
blanchiment intérieur dentaire.
Plusieurs systèmes actuels utilisent le
blanchiment activé par la lumière. Certains de
ceux-ci comprennent le Laser Smile (Biolase
Technology) 37% de peroxyde d’hydrogène,
ArcBrite (Biotrol) 30% de peroxyde
d’hydrogène, BriteSmile (BriteSmile) 15%
de peroxyde d’hydrogène, Rembrandt Smile
(Den-Mat) 35% de peroxyde d’hydrogène,
Zoom (Discus Dental) 20% de peroxyde
d’hydrogène et Luma White Plus (LumaLite)
35% de peroxyde d’hydrogène.
La demande croissante par les clients,
du procédé de blanchiment activé par
la lumière, est due à sa publicité par les
médias. Cependant, les essais cliniques
effectués par le CRA montrent constamment
que la lumière et la chaleur n’augmentent
pas l’éclaircissement dentaire et ne sont
pas nécessaires pour le blanchiment de
la dent vivante. Le temps de contact et la
concentration des ingrédients actifs sont
les facteurs importants.11 L’utilisation des
lumières peuvent impressionner les clients,
mais elles augmentent le coût et le temps
d’occupation de la salle de traitement, elles
peuvent causer des brûlures aux tissus mous
ainsi que l’augmentation de la température
dans la salle de traitement.13 Tous les systèmes
recommandent une gouttière comme
supplément à domicile, donc la question
reste; est-ce que le bénéfice découle de la
lumière ou de la gouttière?13
Avant de procéder à l’utilisation du
système de blanchiment activé par la
lumière, demandez au patient s’il prend
des médicaments. Certains médicaments
peuvent causer une photosensibilité allant
de mineure jusqu’à l’extrême. Ceux-ci
comprennent les médicaments contre
13
l’acné, contre le cancer, les antidépresseurs,
les antihistaminiques, les antimicrobiens,
les antiparasites, les antipsychotiques, les
diurétiques, les hypoglycémiques et les
anti-inflammatoires non-stéroïdes.
Les procédés pratiqués en clinique qui
n’utilisent par la lumière ou la chaleur
comprennent Illumine (Dentsply
Professional) 15% de peroxyde
d’hydrogène, Office White (Life-Like
Cosmetic Solutions) 40% de peroxyde
d’hydrogène, Perfecta White (Premier
Dental Products) 35% de peroxyde
d’hydrogène, Niveous (Shofu Dental) 25 %
de peroxyde d’hydrogène et Opalescence
Xtra Boost (UltraDent) 38% de peroxyde
d’hydrogène.
Dû aux effets négatifs que ces grandes
concentrations de peroxyde d’hydrogène
ont sur le tissu gingival, plusieurs systèmes
utilisent des protections variées pour
le tissu afin de minimiser le dommage
gingival potentiel. Le temps et le nombre
d’applications varient selon le produit.
Blanchiment dentaire à domicile
En mars 1989, les Drs Harald Heymann
et Van Haywood introduisaient le concept
d’emploi d’un protecteur buccal de
blanchiment contenant un gel visqueux
renfermant un agent d’épaississement
(Carbopol), qui allouait un temps
d’activation plus élevé et une meilleure
rétention de la gouttière.14
En 1989, le Dr Dan Fischer, qui créa
Opalescence peroxyde de carbamide
(UltraDent) recevait un brevet pour
la création d’une formule de gel de
blanchiment épais et adhérant qui est
encore le principe de base employé dans
la plupart des gels de nuit sur le marché
actuel. Ce fut le premier système de
blanchiment approuvé par ADA.1 Ce
produit fut développé avec une grande
concentration d’eau pour minimiser
la sensibilité dentaire, conserver un
pH neutre et appliquer une viscosité
thixotropique pour demeurer dans
la gouttière. Il fut conçu pour libérer
une quantité soutenue de peroxyde
d’hydrogène.
Après un certain temps, la dégradation
du peroxyde de carbamide se résume à
ceci, après deux heures, on ne retrouve
qu’un peu plus de 50 pour cent de
l’ingrédient actif et seulement 10 pour
cent s’y retrouve après 10 heures.15 Donc
pour le port de la gouttière durant la nuit,
on en déduit que le maximum effet de
blanchiment se produit au cours des deux
premières heures.
Les agents de blanchiment recommandés
pour la nuit par les manufacturiers sont:
Opalescence (UltraDent) 10%, 15%, 20%,
Nupro White Gold (Dentsply Professional)
10% et 15% de peroxyde de carbamide,
Nite White Turbo (Discus Dental) 6%
de peroxyde d’hydrogène, Gentle White
(IMDS) 35% de peroxyde d’hydrogène, et
Pola Night (Southern Dental Industries)
10%, 16% et 22 % de peroxyde de
carbamide.
Pour une utilisation durant le jour, le
peroxyde de carbamide et le peroxyde
d’hydrogène sont tous les deux efficaces
comme agents de blanchiment à
domicile.16 Les produits qui sont
indiqués pour l’usage durant le jour par
les manufacturiers sont: Opalescence
(UltraDent) 10%, 15%, 20% de peroxyde
de carbamide, Rembrandt XTRA-Comfort
(Den-Mat) 16%, 22%, 30% de peroxyde
de carbamide, Natural Elegance (Henry
Schein) 10%, 15%, 22% de peroxyde
de carbamide, Just Smile (JustSmile
Whitening Systems) 2-10% de peroxyde
d’hydrogène Perfecta Bravo (Premier
Dental Products) 9% de peroxyde
d’hydrogène et Pola Day (Southern
Dental Industries) 3%, 7.5% et 9.5 % de
peroxyde d’hydrogène.
Un produit innovateur d’UltraDent
Products, le Treswhite, est la première
gouttière pré-moulée, remplie et jetable.
La gouttière contient 9% de peroxyde
d’hydrogène en gel ainsi qu’une barrière
de gel protectrice sur les côtés. La nature
thixotropique de ce gel assure qu’il reste en
contact avec les dents.
L’utilisation de réservoirs, dans le
blanchiment dentaire utilisant une
gouttière, est encore débattue. La technique
du réservoir est qu’une petite bulle est créée
sur la surface intérieure de la gouttière,
immédiatement adjacente à la surface
buccale de la dent. Cet espace retiendra
une plus grande quantité de décolorant que
dans la technique sans réservoir.
La hausse de la quantité de décolorant dégagera plus d’ions
d’oxygène au cours d’une plus longue période de temps dans les
environs de la dent, créant ainsi un effet supérieur de blanchiment
plus rapidement.17
Dans l’étude conduite par Matis, il rapporte “qu’il n’y a pas de
différence clinique dans le blanchiment d’une dent après deux heures
d’utilisation d’une gouttière avec ou sans réservoir”, encore ajoutet-il dans ses conclusions que “le blanchiment avec une gouttière
à réservoirs produit un effet blanchissant plus grand que sans les
réservoirs”.18 L’auteur préfère utiliser les gouttières avec réservoirs.
Les compagnies comme Proctor & Gamble et Colgate offrent
des produits de blanchiment sans gouttière qui ont fait l’objet de
recherche et d’une bonne documentation.19,20 Ceux-ci comprennent
Crest Whitestrips contenant un peroxyde d’hydrogène de 6.5%,
plusieurs versions de dentifrices blanchissants Colgate Platinum sont
disponibles et un gel que l’on peut appliquer avec un pinceau, le
gel blanchissant Colgate Simply-White Whitening Gel contenant un
peroxyde d’hydrogène 5.9%.21
En tant que membre important de l’équipe dentaire, vous êtes dans
une position unique pour jouer un rôle actif en encourageant et
en éduquant votre patient dans les choix qui se présentent dans le
blanchiment dentaire. Si vous utilisez un système de blanchiment
dentaire, ne craignez pas de parler à votre patient de votre expérience
et soyez fière de mettre en évidence vos dents blanc-perle!
Bibliographie:
1. Goff S. “Getting the White Right,” Dental Products Report (Jan. 2005) 14—19
2. Wennstrom J., Lindhe J. “Effect of hydrogen peroxide on developing plaque and gingivitis in man,”
J Clin Periodontol 6(2): (Apr. 1979) 115—30
3. Volpe AR et al. “Gingival tissue oxygenation: The effect of a single application of four commercial
preparations,” J Periodontol 37.6 (Nov.-Dec. 1966): 478—82
4. Schneider HG et al. “Clinical experience with the peroxide-containing gingival strip from the
Leipziger Arzneimttelwerk,” Dtsch Stomatol (Germany East), 16.9 (Sep. 1966): 656–67
5. L. G. Wade Jr., Conjugated Systems Organic Chemistry, 3rd ed. (Upper Saddle River, NJ:
Prentice Hall; 1994): 695, 1106
6. R. C. Craig and J. Powers, Restorative Dental Materials, 11th ed. (St. Louis, Missouri: Mosby Inc.,
2002).
7. D. K. Yarborough, “The Safety and Efficacy of Tooth Bleaching: A Review of the Literature,”
Compendium 12.3 (Mar. 1991): 191–96.
8. G. Pugh, et al. “High levels of hydrogen peroxide in overnight tooth-whitening formulas: effects
on enamel and pulp,” J Esthet Restor Dent 17.1 (2005): 40—45, discussion 46—47
9. V. B. Haywood and R. H. Leonard, et al., “Efficacy of Six Months of Nightguard Vital Bleaching of
Tetracycline-Stained Teeth,” J of Esthet Dent 9.1 (1997) 13—19
10. R. Orchardson and D. G. Gilliam, “The efficacy of potassium salts as agent for treating dentin
hypersensitivity,” J Orofac Pain 14 (2000): 9—19
11. CRA Newsletter 4.4 (April 2000)
12. CRA Newsletter 26.11 (November 2002)
13. G. Kugel, “Is there a benefit to light-activated tooth whitening? JCDA Point of Care 71.6
(June 2005): 420—21
14. V. B. Haywood, “Nightguard vital bleaching,” Quit Internat 189 20.3: 173—76
15. B. A. Matis, et al., “In vivo degradation of bleaching gel used in whitening teeth,” JADA,
130 (February 1999) 227—35
16. G. R. Mokhlis, et al. “A clinical evaluation of carbamide peroxide and hydrogen peroxide whitening
agents during daytime use,” J Am Dent Assoc (Sep. 2000) 1269—77
17. “Dentistry today Buyers’ Guide to Whitening Systems,” Dentistry Today Dec 2004: 120
18. B. A. Matis, et al., “A clinical evaluation of a bleaching agent used with and without reservoirs,”
Operative Dentistry 27 (2002) 5—11
19. R. W. Gerlach and Zhou X., “Clinical trial comparing two daytime hydrogen-peroxide
vital-bleaching systems,” Compend Contin Educ Dent 25.8 (Suppl. 2) (Aug. 2004): 33—40
20. P. A. Sagel and W. F. Landrigan, “A new approach to strip-based tooth whitening: 14% hydrogen
peroxide delivered via controlled low dose,” Compend Contin Educ Dent 25.8 (Suppl. 2)
(Aug. 2004): 9—13
21. G. Gambarini et al., “Efficacy and safety assessment of a new liquid tooth whitening gel
tHE
containing 5.95% hydrogen peroxide,” Am J Dent 17.2 (Apr. 2004): 79—5
14
Dean Swift BSc, FADM
Focus On
Infection Control
Five key concepts to consider in improving asepsis in the Dental Laboratory.
1
2
1. Receiving
3
One area of the lab should be designated for
receiving impressions and prosthetics. This area
should have surfaces that are easy to clean and
disinfect. Impressions and trays should be sprayed
or immersed with a quality non-toxic disinfectant
that kills in one minute in the presence of blood
and saliva. To prevent disolution or distortion,
never exceed one-minute exposure, then rinse the
impression lightly and pour the model immediately.
Prosthetics and models are then sent to the
appropriate department.
The laboratory benefits from this procedure as staff
are protected from incoming disease. In addition,
some disinfectants have surfactants that act as an
inexpensive debubblizer for the plaster. Ensure that
the surfactants in the disinfectant are not part of
the toxic alkyl or nonyl phenol ethoxylate family
(NPE’s).
2. Plaster Sink AND Trap
The area for plaster mixture should have easily
cleanable and disinfectable surfaces with a sink for
rinsing. Remember that the minerals in plaster and
stone are nutrients for bacteria. At the end of each
week, rinse expired Ultrasonic disinfectant solution
down the trap. The trap will smell much more
pleasant. When the trap is cleaned, use disinfectant
spray—wait one minute—then wipe with disposable
towels. The laboratory benefits as staff are protected
and the plaster trap smells better.
15
4
5
3. Pumice AND Polishing
This area of the lab is often neglected. Water that
sits over the weekend in pumice trays is a perfect
environment for the multiplication of bacteria. Use
diluted non-toxic/minimal taste disinfectant instead
of water to lubricate pumice to prevent the growth
of moulds or fungi.
4. Pens AND Paper
Often the receiver of impressions and prosthetics will
wear gloves to protect themselves. A problem arises
when the same pair of gloves opens up several cases
of impressions that have blood or saliva on them.
Infection can be transferred to the prescription, or
the pen and from one case to another. It is therefore
recommended to disinfect all of the cases first.
Ensure that the gloves are rinsed and disinfected
between cases. Then, when all of the disinfecting
is complete, the paperwork can be done with the
assurance that infectious bacteria are not being
transferred between cases or around the lab with a
shared pen.
5. Circle of Infection
Most important in the understanding of infection
control principles is the sense that the circle of
infection is effectively broken. Whenever there is a
possibility for the transfer of infectious material, it
is necessary to disinfect. Living in a bubble is not
necessary, neither is a sterile lab.
Quite simply - just Break the Circle of Infection!
Reprinted with permission. Journal of Dental Technology, Feb 2000, pp66.
tHE
Frequently Asked Questions
What steps are Level II dental
assistants able to perform with the
ZOOM Bleaching System?
Dentists can only authorize Level II assistants
to administer bleaching agents generally
available to the public without prescription
(or equivalent). Health Canada limits for
tooth-whitening products available over the
counter are 3% hydrogen peroxide or
10% carbamide peroxide. This means that
the tooth-whitening agents used for in-office
bleaching systems, such as ZOOM, can only
be applied by a dentist or a dental hygienist.
The Royal College of Dental Surgeons of
Ontario (RCDSO) advises that only dentists
or dental hygienists apply the liquid dam
because of the risk of injury to the soft
tissue from the bleaching agent.
Anybody can hold the light once the
bleaching agent has been applied.
Dentists can authorize a Level II assistant
to take impressions for study models and
for the fabrication of bleaching trays for
at-home use. The dentist must assess the
suitability of the models for the fabrications
of the trays and must be present in the
office when the impressions are being taken
by the Level II assistant.
Are Level II dental assistants allowed
to take alginate impressions for
the purpose of making orthodontic
appliances, such as space maintainers
and lingual arch? Also, are Level II
assistants allowed to take alginate
quadrant impressions for the
fabrication of temporary crowns?
The taking of working impressions
for orthodontic appliances and for the
fabrication of temporary crowns are
controlled acts under the Regulated Health
Professions Act and dentists cannot delegate
these duties to dental assistants. Therefore
a Level II assistant can’t take these types of
impressions regardless of the impression
material that would be used.
Can dental assistants do denture
adjustments outside the mouth?
A dental assistant can do lab procedures
under the supervision of the dentist. Lab
work not supervised by a dentist must
be done by an RDT (Registered Dental
Technician). Laboratory work can be
taught in office. Some assistants may
have a lab background and not require
“in-house” training.
An assistant cannot deal directly with the
patient and provide an adjustment. If a
patient presents for a denture adjustment,
the dentist must examine the patient and
determine what adjustment is required.
If that involves a lab procedure, such as
removing some acrylic, an assistant can
perform this task as directed by the dentist
(extra-oral). The dentist must return to
examine the completed lab work and deliver
the denture to the patient to insure that a
satisfactory result was achieved.
tHE
17
Announcements
ARE YOU INTERESTED IN
THE GOVERNANCE OF YOUR
ASSOCIATION?
We are now ready to take
applications for Board
Directors.
For more information, contact
Judy Melville, Executive Director
@ 519-679-2566 ext. 25, or call the
toll-free number on the reverse side of
your membership card.
GoodLife Fitness Program
As an ODAA member you are eligible
to obtain a GoodLife Gym Membership
at more than 50% off the regular rates.
For more information, please contact
Lana Thistle at the ODAA business office.
Email: lthistle@ody.ca or download the
enrollment form from: www.odaa.org
TORONTO ACADEMY OF DENTISTRY
WINTER CLINIC
Friday November 4, 2005
Metro Toronto Convention Centre,
North Building www.tordent.com
NDAEB Level II
Examination Dates
Exam: December 10, 2005
Application Deadline: October 28, 2005
Exam: March 25, 2006
Application Deadline: February 1, 2006
Members will receive 5 continuing-education
credits for attendance. Sign-in for credits is
required at the ODAA Membership Booth on
the exhibit floor.
INFECTION CONTROL WORKSHOPS
9:00 am—12:00 pm
Exam: June 24, 2006
Application Deadline: May 12, 2006
Members will receive three credits
for attendance
www.ndaeb.ca or call 613-526-3424
Saturday, October 15, 2005 London
ODAA Level I Certification
ExamINATION Dates
Saturday, October 22, 2005
Niagara-on-the-Lake
Exam: June 3, 2006
Application Deadline: April 28, 2006
Saturday, November 12, 2005 Oakville
Exam: November 4, 2006
Application Deadline: September 29, 2006
Call 519-679-2566 to receive information or
www.odaa.org to download an application
form. (Use the toll-free number listed on the
reverse side of your membership card.)
Saturday, November 26, 2005 Kitchener
Contact Lynne Brandon for more information
and registration, 519-679-2566 ext 22 or
email: lbrandon@ody.ca (Use the toll-free
number listed on the reverse side of your
membership card.)
Congratulations to the ODAA
A new image and a new era
for dental assistants
in Ontario.
Saskatchewan Dental Assistant’s Association
18
Open Wide
Campaign for change in dental care
“I am tired of having my teeth decay and fall apart in pieces over time. I haven’t been
to the dentist in eight years to have my teeth cleaned. I do not see being able to go
anytime in the future. I worry that my children will also end up with teeth like mine.”
Parent, Lindsay, Ontario
Family Dental Health Scrapbook, 2004
Dental disease is largely an invisible problem in
may lead to lack of concentration in school, affecting
Ontario. When people with financial problems face
their ability to learn. The pain and discomfort they
the choice whether to spend their precious dollars
experience may also limit their interaction with other
on buying groceries, paying rent or seeking
children. An adult’s quality of life can also be affected
treatment at the dentist, food and rent will always
by dental disease. Poor oral health can influence an
win. The first steps toward fixing the problem are
adult’s social interactions. They may avoid laughing
raising awareness among people who can make
and smiling, and restrict conversations with others. An
a difference and working together to support the
adult’s employability may also be in jeopardy—many
change in current policies for dental care for low -or
businesses will not hire someone for a position that
no- income families.
involves customer relations, face-to-face sales, or
The effects of dental disease can last a lifetime—from
19
presentations if they have discoloured or missing teeth.
childhood through adulthood. Children who have
Unfortunately, assistance for those without dental
a toothache are unable to eat and therefore may not
insurance is limited. Programs like CINOT
get the proper nutrients for a growing body. This
(Children in Need of Treatment), Ontario Works,
and ODSP (Ontario Disability Support
Program) provide limited assistance and
often focus solely on urgent care. This
leaves a great portion of the population
with no help whatsoever—the working
poor and seniors being most affected.
“In Public Health, the Dental Department
is contacted on a daily basis, from all
populations, looking for assistance for
dental care,” says Carol Moore-Collins
CDA, Manager of Dental Programs for
Haliburton Kawartha Pineridge District
Health Unit.
The OAPHD (Ontario Association of Public
Health Dentistry) recently launched OPEN
WIDE, a province-wide, multi-year oral
health awareness campaign. OPEN WIDE
was adapted from a campaign by the
Connecticut Department of Public Health
and utilizes a train-the-trainer approach.
Public Health dental staff members
deliver information and training to other
professionals who, in turn, pass that
message along by educating others in the
community who can make a difference
Immediate action must be taken to
improve the current dental coverage
and to raise awareness of the problem
among those who can advocate for reform.
As dental assistants, we have the power
and opportunity to promote change.
Suggestions as to what we can do are
as follows:
The primary objective of the Canadian
Health Acts’ Health Care Policy is “to
protect, promote and restore the physical
and mental well-being of residents
of Canada and to facilitate reasonable
access to health services without financial
or other barriers.” As it stands now,
dental coverage and access for all
• Support policies in your office that
encourage fair treatment for all.
Canadians does not meet that objective.
• Join an existing (or start a new)
community group advocating for
access to dental care.
see that the costs are clear and the need is
• Raise the issue with non-dental
professionals that you know.
e.g. teachers, doctors, nurses, etc.
• Talk to local politicians and decisionmakers about the impact of dental
disease and access issues, and
encourage your clients to do the same.
• Support projects that help to
decrease poverty.
As a dental health professional, you can
great. Your support for social policy change
is desperately needed.
For more information on OPEN WIDE,
contact your local health unit.
To find out how you can obtain a copy
of the campaign, contact Beth McIntosh,
Campaign Co-chair
tHE
at 519-753-4937, ext. 207 or
bmcintosh@bchu.org
•Ask your local health unit to make a
presentation on OPEN WIDE to your
local ODAA society.
20
Affiliate News
Date
Time
Location
Local Affiliate newsletters were mailed in August. Please contact the ODAA
office if you have not received your newsletter. Every effort has been made to
enssure the acuracy of the following meetings. However, it is advised to check
the website: www.odaa.org prior to attending any meeting to find changes or
updates that may have occurred.
Speaker
Topic
Bay of quinte
All meetings to be held at the Christ Anglican Church, 39 Everett St, Belleville (entrance at rear). Sign-in at 6:45pm
October 18, 2005
7:00 pm
Christ Anglican Church
Judy Melville, Executive Director, ODAA
Let’s Talk Wages
November 15, 2005
7:00 pm
Christ Anglican Church
TBA
Herbalist, Toxicity in the Workplace
7:30 pm
Dr. Campbell’s Office, Port Elgin
Trudy Cook
TBA
Bluewater
October 25, 2005
brant & district
October 6, 2005
7:30 pm
Brantford
Dr. V. Schacher
New Patient Protocol
November 16, 2005
7:30 pm
Simcoe
Melissa Simpson
Open Wide
December 6, 2005
6:45 pm
Drenise’s Home
3 Richardson Dr., Port Dover
RSVP – Drenise 583-2307
Good Old Fashioned Christmas fun,
food and cheer
If you wish bring an exchange gift
($15 max). No credits for this night.
brockville
All meetings held at River Walk Mill, 123 Water St. W., Brockville. Directions: Follow Stewart Blvd South to King Street, turn right at King until you reach
Perth Street. Turn left onto St. Paul Street. At Water St. turn left. Parking lot on your left is free after 5:00 pm.
October 4, 2005
7:00 pm
River Walk Mill
Bridget Kippen
Smoking & Dental Health
November 1, 2005
7:00 pm
River Walk Mill
Dr. Martin Herzan
Stress Management
burlington
All meetings are held at the Burlington Holiday Inn. Sign-in at 6:45 pm. Meeting starts at 7:00 pm.
October 19, 2005
7:00 pm
Holiday Inn
Devra Kneblewski
Endo Microscopes
November 9, 2005
7:00 pm
Holiday Inn
ODAA Updates (with Hamilton Affiliate)
October 13, 2005
7:00 pm
Knights of Columbus Hall;
Card Room
Shawn Barnacle,
Maxill Territory Manager
Infection Control – Protecting the Staff
November 10, 2005
7:00 pm
Knights of Columbus Hall
David Goldshaw, Canadian Sales and
Education
CloSYS II – Tissue Management
cornwall
Durham & district
All meetings held at Trillium College in the Oshawa Centre (419 King Street West, Oshawa, ON). Sign-in at 6:30 pm. Meetings start at 7:00pm (2 hours).
October 17, 2005
7:00 pm
Trillium College, Oshawa Centre
November 21, 2005
7:00 pm
January 16, 2006
7:00 pm
Jacqueline Spencer
Recognizing Abuse
CPR Recertification
Evelyn Smith
Nutrition
etobicoke
All meetings held at Fairfield Senior Centre, 8 Lothian Avenue, Etobicoke. Three blocks south of Bloor Street, two blocks east of Islington Avenue.
October 17, 2005
7:00 pm
Fairfield Senior Centre
Your Executive
Interaction/Communication
Mini Workshop
November 14, 2005
7:00 pm
Fairfield Senior Centre
Elizabeth Galarza
Health Outreach – Volunteers around the
world.
7:00 pm
Italian Canadian Club
135 Ferguson St., Guelph
Dr. E. Van Gorder
Team Night
Guelph & District
November 10, 2005
21
Date
Time
Location
Topic
Speaker
Halton-Peel
September, October & November Meeting: Sinclair Dental, formerly Schein Arcona, 6275 Northam Drive Unit #5, Mississauga LV4 1Y8.
February, March & April Meetings: Canadian Academy of Dental Hygiene, 165 Dundas St. West, Mississauga, Ontario. Time 7:00 pm to 9:00 pm.
October 19, 2005
7:00 pm
Sinclair Dental
TBA
Sexual Abuse
November 16, 2005
7:00 pm
Sinclair Dental
Region of Peel Officer
Infection Control
NO MEETINGS FOR DECEMBER 2005 OR JANUARY 2006
Hamilton
October 18
7:00 pm
Rotsaert
Dr. Markowski
Neuromuscular Dentistry
November 21, 2005
Dinner:
6:30 pm
Meeting:
7:45 pm
Rotsaert
Dr. Kutcher
Occulsal Adjustments
January 17, 2006
7:00 pm
Rotsaert
John Infanti
Comprehensive Foot Care
October 24, 2005
7:00 pm
Peterborough Community Access
Centre, 700 Clonsilla Ave Suite 200,
Peterborough
Time Management
November 28, 2005
7:00 pm
Central East Correctional Centre,
541 Highway #36, Lindsay
Correction Centre Dental Services
& Dental Office Tour
October 13, 2005
7:00 pm
Ongwanada Resource Centre,
191 Portsmouth Ave
Steve Fredetto
Dental Materials, Proper Storage &
Handling
November 10, 2005
7:00 pm
KFLA Health Unit,
221 Portsmouth Ave
Sara Jane Somerville, CDAII
Local Anesthetic Update
January 17, 2006
6:45 pm
KFLA Health Unit,
221 Portsmouth Ave
Wright Dental
Infection Control & Dickie
Uniform Fashion Show
Kawartha & District
Kingston
London
All meetings to be held at the Mocha Shrine Centre, Lower Hall, 468 Colborne St. Registration is from 6:30 pm - 7:00 pm.
Meetings start at 7:00 pm and last approximately 2 hours. Free parking in the rear.
October 12, 2005
7:00 pm
Mocha Shrine Centre
Patti Griffith
Infection Control
November 1, 2005
7:00 pm
Mocha Shrine Centre
Andrew Tweedy
Digital Imaging
January 9, 2006
7:00 pm
Mocha Shrine Centre
Assertive Communication
Niagara District
All Meetings start at 7:00 pm at Henry Schein Arcona, 345 Townline Road, Niagara-on-the-Lake.
October 11, 2005
7:00 pm
Henry Schein Arcona
Urusla Pelissero, Niagara College
Piercing in the Oral Cavity
November 16, 2005
7:00 pm
Henry Schein Arcona
Chris Tracy, CT Training and Consulting
True Colours
January 12, 2006
7:00 pm
Henry Schein Arcona
TBA – Infectious Disease Department
Infection Control
The Alberta Dental Assistants Association is pleased to offer
congratulations to the Ontario Dental Asssistants Association
on the launch of its new identity.
We wish you continued success serving your members!
22
Date
Time
Location
Speaker
Topic
October 12, 2005
6:30 pm
Nipissing Building
Glen Paleczny
Ortho
November 9, 2005
6:30 pm
Nipissing Building
Judy Baily
Sex Ed (for Kids)
December 7, 2005
6:00 pm
Rose Gardens Restaurant
October 19, 2005
7:00 pm
Porcupine Health unit
Regulation/ODAA Updates
November 9, 2005
7:00 pm
Porcupine Health unit
Classic Dental Video Presentation
Sleep Apnea
North Bay
Dinner Meeting/Social – No Credits Given
Northern Ontario
northumberland
All Meetings held at the Health Unit, 200 Roseglen Road, Port Hope, 7-9 pm on the 3rd Monday of the month.
October 17, 2005
7:00 pm
The Health Unit
Steve Malone
Tsunami Relief
November 21, 2005
6:00 pm
The Health Unit
Jayne Fisher
CPR Recertification
January 16, 2006
7:00 pm
The Health Unit
Child & Youth Worker from Rebound
Young Offenders Act & Its Issues
Ottawa
All Meetings to be held at the Ottawa Hospital, Civic Campus, Norman Patterson Amphitheatre. Meetings start at 7:00 pm. Sign-in at 6:30 pm.
October 18, 2005
7:00 pm
Ottawa Hospital
Drs. Leitch and Bouris
Remote Area Medical Volunteers Canada
November 24, 2005
7:00 pm
Ottawa Hospital
Richard Turgeon, Physiotherapist
TMJ Physiotherapy
Audiologist
Owen Sound & District
October, TBA
TBA
TBA
Nancy Zantage
November 26, 2005
12:00 pm
Joe Tomato’s
Owen Sound Firefighters
October 11, 2005
6:45 pm
Zehr’s Community Room
TBA
Fluoride in Water Controversy
November 8, 2005
6:45 pm
Zehr’s Community Room
Elaine Ratcliffe
Implants
Sarnia
December
Christmas Party
Sault Ste. Marie
October 18, 2005
7:00 pm
Cambrian Dental Centre
77 Great Northern
Dan Jalbert
Handpiece maintenance
November 8, 2005
7:00 pm
77 Great Northern
Dave Samut
Syborn Endo-New Endo supplies and
procedures
January 11, 2006
7:00 pm
77 Great Northern
October 12, 2005
7:00 pm
North Simcoe Sports & Recreation
Centre – Midland (Multi-purpose rm)
Wages & Regulation/What’s New
at the ODAA
November 9, 2005
7:00 pm
Georgian College, Orillia, Rm C211
Dave, LaChappelle Dental Services
Maintenance Equipment (parking $2)
7:30 pm
Central Dental Laboratories Ltd.
Dr. Gary Ford
Forensic Dentistry
November 5, 2005
10:00 am
- 4:00 pm
College Boreal, Rm 3015
December 1, 2005
Dinner:
6:30 pm
Caruso Club Meeting 7:30 pm
Kathy Koulass
Professionalism
Dinner & Brown Bag Auction – Contact Rita
October 18, 2005
7:00 pm
Confederation College
Dave Belrose
AIDS
November 15, 2005
7:00 pm
Dr. Frank Mauro
Implants
January 10, 2005
7:00 pm
Tim Lamb, Brenda Adams
Women’s Health
Medical Emergencies in the Dental Office
Simcoe North
Simcoe South
October 11, 2005
Sudbury & District
CPR & First Aid
Cost: $50 each – Contact Debbie
Thunder Bay
23
Date
Time
Location
Speaker
Topic
Toronto
All Meetings held at the North York Central Library, located on the Younge Subway line, with direct access from the North York Centre Station, street level.
You will find plenty of public parking at the library.
October 17, 2005
7:00 pm
North York Central Library
Michael Brennan, Executive Director,
CDAA
Note: Bring non-perishable food item
November 21, 2005
7:00 pm
Endodontics
Note: Bring unwrapped toy (up to $15)
January 17, 2006
7:00 pm
RCDSO
Waterloo-Wellington
Dinner Meetings: Sign-in 6:15 pm, dinner at 6:30 pm. Non-Dinner Meetings: Sign-in 6:45 pm, Meeting 7:00 pm sharp (No charge to attend).
November 15, 2005
7:00 pm
Victoria Park Pavillion
Nancy Leach-Schaeffer
Cancer Support (Non-Dinner meeting)
January 17, 2006
6:30 pm
Golf Steak House
Dr. Richard Beyers
Dental Insurance Fraud
Wage Negotiation Workshop (3 hrs)
Windsor
November 12: Sign-in at 8:30 am. Meeting at 9:00 am.
November 12, 2005
9:00 am
St. Clair College – Rm TBA
York Region
All Meetings to be held at Aurora Public Library (parking in rear), 15145 Younge St., Aurora. Meetings start at 7:00 pm. Sign-in at 6:45 pm.
October 11, 2005
7:00 pm
Aurora Public Library
TBA
Forensic Dentistry
November 17, 2005
7:00 pm
Aurora Public Library
Honsberger Physiotherapy Clinic – Cindy
Physiotherapy for Dental Auxiliaries
It rocks!
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'JSTU$BOBEJBO1MBDF
Senior Dental Assistant
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DPOUJOVBMMZ MFBSOJOH BOE UBLJOH PO OFX QSPKFDUT "U
"MUJNB"MFYGPVOEIFSTFMGJOUIFQFSGFDUFOWJSPONFOU
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BEWBODFNFOU BOE IPTUT BOOVBM BXBSE DFSFNPOJFT GPS
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24
JuneCook
Blazing the Path for
Dental Assistants since 1946
25
Few of the ODAA’s nearly 8,000 members
have not heard of June Cook. She is an
institution in our organization, and a
driving force in our profession. A feisty
yet very independant and classy lady, June
possesses a tremendous amount of energy
and determination, even at the age of 81.
In 1961, along with several other members of
the ODN&AA, June spearheaded the project of
certification for dental assistants in Ontario. They
formed a sub-committee of the Board and with the
assistance of Dr. Wes Dunn and Dr. Ken Pownall,
both of The Royal College of Dental Surgeons of
Ontario (RCDSO), the bylaws were written for the
newly created Certification Board.
In 1946, June joined the ODN&AA. At the time,
she was a dental assistant working with Dr. Mac
Rockman. Later, she worked with Dr. Harold
Skilling, and remained a loyal employee for 25
years. During that time, she was also employed as
an instructor in the dental assisting programs at
Durham College, Seneca College and George Brown
College. She participated in both full-time and
evening programs, specializing in dental radiology.
June was also instrumental in the creation of formalized
dental education programs for dental assistants. With
the co-operation of RCDSO and a number of dedicated
dentists in Ontario, these educational programs and a
certification exam were developed.
As dental assistants and members of the ODAA, we
owe June our gratitude for her unfaltering loyalty to
our organization and her fierce commitment to our
profession.
Show Your Pride
0004 Round Neck
Snap lab jacket
EDS Round neck snap front jacket with elastic cuffs
in Soft Cotton/Polyester with a Soil Release Finish.
White, XS - XXL
0001 Fleece Vest
Anti-pill Polar Fleece, full zip, zippered pockets,
shock cord with toggle bottom.
Purple or White, M, L
0006 Long Sleeve Fashion Tee
Long sleeve fashion tee with script logo on end
of sleeve in luxurious 92% Cotton/8% Spandex.
Blue or White, XS - XXL
0002 Trim Fit Jacket
100% nylon shell, euro styled jacket,
feminine fit and shape. Mesh lined
with inside pockets and zipper.
Black, M, L
0007 Tote/Knapsack
Carry it like a tote or a knapsack.
Wide mouth zipper opening and
adjustable padded backpack straps.
Black, 12”W x 21”H x 10.5”D
0005 Unisex
Drawstring Pant
EDS Unisex drawstring pants
with one back pocket in Soft Cotton/
Polyester with a Soil Release
Finish, inseam 30” or 32”.
Blue, XS - XXL
0003 Active Wear Vest
Full zip vest with piped side panels and front
pockets. 100% Coated 240T Polyester
Water Resistant.
Black, M, L
0008 Arctic Bottle
Featuring a freezer stick which keeps drinks
cold for hours without diluting.
Purple, 24 oz.
27
Order Form
Ontario Dental Assistants Association
869 Dundas Street, London ON N5W 2Z8
Tel: 519.679.2566 Fax: 519.679.8494
Web: www.odaa.org
Name ________________________________________________________________________________________ ODAA number _____________________________________________ Address _______________________________________________________________________________________________________________________________
Apt # Street #
Street Name
PO Box #
city
Province
Postal Code
telephone (______)__________________________ (______)__________________________
home
business
Promotional items
0# Product
price
0001 Fleece Vest
$ 55.00
x
PURPLE ___M ___L white ___M ___L
=
$
0002 Trim Fit Jacket
$ 60.00
x
black ___M ___L
=
$
0003 Active Wear Vest
$ 35.00
x
black ___M ___L
=
$
0004 Round Neck Snap LAB JACKET
$ 45.00
x
white ___XS ___S ___M ___L ___XL___Xxl
=
$
0005 Unisex Drawstring Pant
$ 45.00
x
blue ___XS ___S ___M ___L ___XL___Xxl (30” or 32” Inseam)
=
$
0006 Long Sleeve Fashion Tee
$ 45.00
x
white ___XS ___S ___M ___L ___XL___Xxl
blue ___XS ___S ___M ___L ___XL___Xxl
=
$
0007 Tote/Knapsack
$ 25.00
x
black ___
=
$
0008 Arctic Bottle
$ 10.00
x
purple ___
=
$
0009 10 kt gold ring
$ 250.00
x
size ___4 ___4.5___5 ___5.5 ___6
=
$
0010 14 kt gold ring
$ 299.60
x
size ___4 ___4.5___5 ___5.5 ___6
=
$
0011 sterling silver ring
$ 107.00
x
size ___4 ___4.5___5 ___5.5 ___6
=
$
$ 65.00
x
=
$
$ 10.00
x
=
$
No Charge
x
=
$
0015 Lapel pin*
$ 10.00
x
=
$
0016 magnetic name bar*
$ 10.00
x
=
$
number of items
total $
recognition items
0012 Diamond insert on ring
additional cost of:
0013 certificate replacement*
0014 membership card
*
due to loss or name change
selected ring(s):
ODDA #:
Must be current ODAA member to order.
*Prices include all taxes. Shipping and handling is extra.
subtotal
*
total
My signature confirms the shipping address and ring size(s) ________________________________________
Payment options: ___ Personal Cheque
___ Money Order
___ VISA/ MasterCard
___________________________________________________________________________________________________________________________________________
Card #
Expiry Date
Signature for Credit Card Payment
Mail completed order form with cheque or money order (if applicable) to ODAA: 869 Dundas Street, London ON N5W 2Z8
Allow 4-6 weeks for delivery. Delivery costs are COD.
Home Study Programs
Clinical
CE-311 Preventing Job Burn-Out
CE-237 AIDS-Occupational Safeguards for
Dental Personnel
Administration &
Personal Development
CE-100 Better Business Writing
CE-313 Job Search that Works
CE-238 Managing Latex Allergies
CE-101 The Art of Communications
CE-400 The Accounting Cycle
CE-239 Hepatitis A-G
CE-102 Telephone Skills for A-Z
CE-242 Coping with Children’s Fear of
Dentistry
CE-103 Telephone Courtesy/Customer
Service
CE-402 Extending Credits and
Collection Cash
CE-244 Pharmocological Review
Update for Dental
CE-104 The Business of Listening
CE-406 Balancing Home & Career
CE-245 Children’s Oral Health, Caries,
Nutrition and Fluoride
CE-106 Getting Your Message Across
CE-500 Office Management
CE-107 Winning at Human Relations
CE-501 Excellence in Management
CE-246 Children’s Teeth at Risk,
Oral Health Concerns
CE-247 Medical Emergencies in Dentistry
CE-248 Geriatric Dentistry, Concerns for
Aging Population
CE-249 Preventing Cross Contamination,
Dental Instruments, Sterilization
Techniques
CE-250 Oral Manifestations of
Eating Disorders
CE-251 Infection Control in Radiology
CE-252 Drug Abuse, Dental Concerns
CE-600 Customer Satisfaction
CE-109 Clear Writing
CE-601 Measuring Customer Satisfaction
CE-110 The Telephone & Time
Management
CE-112 Vocabulary Improvement
CE-113 50 Once Minute Tips/Better
Communication
CE-115 Effective Meeting Skills
CE-301 Developing Positive
Assertiveness
CE-254 Practical Orthodontics
CE-304 Health Strategies for
Working Women
CE-467 Oral Health Concerns Unique
to Women
CE-468 Implants, Criteria for Success
CE-499 Temporomandibular Disorders, A
Review
CE-513 Occupational Environmental
Hazards in Dental Office
CE-602 Calming Upset Customers
CE-111 Formatting Letters
and Reports
CE-302 Developing Self-Esteem
CE-454 Nitrous Oxide Problems and
Hazards
CE-403 Credits and Collections
CE-108 Giving and Receiving Feedback
CE-253 New Products in Periodontal
Therapy
CE437 Controlling Waterline Biofilms
CE-312 Personal Wellness
NEW
CE-534 Impression Trays, Materials
and Techniques
NEW
CE-505 Systemic Risk Factors in
Periodontal Disease
NEW
CE-509 Vital Tooth Whitening Techniques
NEW
CE-541 Dental Radiography and
Digital Imaging
NEW
CE-542 Smoking Cessation
Ordering Information
CE-303 Self-Empowerment
5 continuing education credits are
awarded for each program completed
(75% minimum required)
CE-305 Personal Time Management
CE-306 Men and Women,
Partners at Work
• Each programs a $40.00 (includes GST
and shipping)
CE-307 Preparing for Your Interview
• Must be a current ODAA member
to order
CE-308 Productivity at the
Work Station
• Refunds are not permitted. Exchanges
within 30 days only
CE-309 Coping with Workplace Changes
CE-310 Twelve Steps to Self Improvement
CE-515 Infection Control, Barrier
Precautions in Dental Office
French Home Studies
CE-300F Ayez une attitude positive
CE-406F Equilibrer votre carriere et foyer
• Must complete program within one year
of purchase
Linkadvertising
You’re looking good ODAA!
As your marketing and branding team, Link Advertising
and Stride Associates are pleased to have played a part
in the creation of the new ODAA branding. Thank you
for allowing us to share your pride and help shape your
future!
519.432.1634 www.linkad.com
29
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So when your patients talk about buying an over-the-counter bleaching
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Remove from package
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DENTIST DISPENSED
T. 5 1 9 . 6 7 9 . 2 5 6 6 F. 5 1 9 . 6 7 9 . 8 494
869 Dundas Street, London, Ontario
www.odaa.org
N5W 2Z8

Tooth Whitening

Transcription

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