Dental Tribune U.S. Edition

HYGIENE TRIBUNE The World’s Dental Hygiene Newspaper ·U.S. Edition April 2012 — Vol. 5, No. 3 www.dental-tribune.com ed for only supragingival application. With the advent of a glycine-based prophylaxis powder designed for subgingival use, a new dimension in the removal of subgingival plaque and biofilm deposits has arrived. Air polishing Surprisingly, air polishing is not a new tech- nology. It's been used for almost 50 years.5 In contrast to air-abrasive techniques, air polishing employs a mixture of air, powder and water. This fine jet is directed toward the tooth surface at an air pressure of 4–8 bar and a water pressure of 1–5 bar,6 leading to the removal of surface deposits. Until now, the powder of choice has been sodium bicarbonate (NaCOH3); however, with a particle size of 100–200 μm (micro- millimeters), it has proven too abrasive for subgingival application. Compared with conventional instrumentation, NaCOH3 is more effective in the supragingival remov- alofplaquedepositsandextrinsicstaining;7 however, because of its high abrasive qual- ity, it is contra-indicated for root surface ap- plication and subgingival deposits.8 Abrasion of dental tissues Intact enamel surfaces appear not to be significantlyaffectedbyNaCOH3airpolish- ing techniques; however, pits and fissures or markings from dental instrumentation appear to be abraded more quickly and eas- ily. Enamel surfaces subjected to significant plaque colonization and areas of deminer- alization (white spots) appear to be particu- larly affected.5, 7, 8 Root surfaces (cementum and root den- tine) are lower in hardness compared with enamel, and therefore the removal of sub- gingival plaque deposits with NaCOH3 re- sults in substantial wear of the root surface. In vitro experiments on root surfaces9 have shownsignificantdefectsofmorethan600 μm following air polishing with NaCOH3.10 Histological evaluation of the epithelium, epithelial layers and base membrane of the periodontal pocket have shown significant disruption of epithelial attachment and loss of basal membrane following either hand scaling or NaCOH3 in the removal of subgingival plaque and associated micro organisms.10 While NaCOH3 application is a useful and efficient way of removing plaque and bio- film deposits from supragingival enamel surfaces, it is therefore not indicated in the disinfection and maintenance of the peri- odontal pocket. Glycine Glycine is a non-essential amino acid with oneofthesimpleststructuresofalltheami- no acids. Glycine is found in proteins of all life forms, and is important in the synthe- sis of proteins as well as adenosine triphos- phate (ATP). Glycine is water soluble, has a The removal of biofilm deposits from withintheperiodontalpocketisrecognized as being fundamental in reducing bacte- rial burden and down regulating the pro- inflammatory response in the treatment of the periodontal diseases. Recolonization of the periodontal pocket by pathogenic bacteria, however, occurs within weeks of initial phase therapy making continuous and regular subgingival biofilm removal a prerequisite in the successful management of periodontal disease.1 Repeated intervention, however, is not withoutdisadvantagesinthatafinebalance exists between root surface debridement and disturbance of the epithelial attach- ment with loss of root substance. Repeated use of traditional methods (hand scalers, curettes, sonic and ultrasonic scalers) can result in significant loss of root substance and surface smoothness,2,3,4 thus limiting the frequency of such intervention. Until now, air polishing has been indicat- Glycine: New dimension in subgingival biofilm removal Air polishing no longer limited to only supragivgival application By Juliette Reeves JuLIETTE REEvES is an expand- ed-duties hygienist and nutri- tionist with more than 30 years of experience. She has written and lectured internationally on the systemic link between nutri- tion and oral health. Her main areas of interest are oral health of the renal patient and nutri- tional influences on periodontal disease, stress, bone density and female hormones. Reeves lives in an 11th-century village on the outskirts of Peterborough, Great Britain, with her husband, Graham. Visit her website at www.perio-nutrition.com and contact her by email at info@perio-nutrition.com. ” See GLYCINE, page D2 Crest® Oral-B® has awarded Ann Benson Ross, RDH, BS, of Phoenix, the brands’ first-ever Pros in the Profession® grant for “Advancing Oral Health in the Community.” Together with her fellow staff at Mobile Dentistry of Arizona, Ross plans to use the $5,000 grant toward delivering onsite oral health services to nursing home residents who are in critical need of care but unable to ob- tain such services. Because of financial reasons, physical immobility of patients and lack of proper training among staff, oral health care tends to lag behind other forms of care in nursing homes. To continue supporting the work that the Pros in the Profession year-one win- ners are doing in their communities, Crest Oral-B called for grant proposals from these dental hygienists earlier this year. Each unique application centered on a common theme and outlined ways in which the $5,000 funds would be used to improve the state of oral health within each winner’s community. Ross was se- lected based on her compelling demon- stration of the urgent need for financial support to help bring oral health care to nursing home residents who are at a clear disadvantage in her community. “It is estimated that only 50 percent of people with a significant disability are able to find access to professional den- tal care,” Ross said. “At Mobile Dentistry of Arizona, it is our priority to close this oral health gap in our community’s nurs- ing homes by bringing dental care access to residents with mobility challenges — a mission that is greatly enhanced and supported with the help of the Crest Oral-B grant.” Ross’s goals through the grant are two- fold: Along with delivering oral health services to nursing home residents, her team will provide the necessary train- ing for nursing home staff to continue to help maintain residents’ oral health care routine, including assistance with brush- ing and flossing. “Crest Oral-B is proud of dental hygien- Grant supports nursing-home oral health ‘Pros in Profession’ winner to use $5,000 from Crest Oral-B to train care staffs ists like Ann who are truly making an impact in patients’ lives, and we are com- mitted to helping further their impact on oral health beyond their daily practice,” said P&G Dental Hygienist Relations Manager Wendy Bebey, RDH, BS. “We are excited to continue our partnership with Ann through the Pros in the Profession grant and provide her with the means to help fulfill our joint-mission of ‘Advanc- ing Oral Health in the Community.’” The Crest Oral-B Pros in the Profession program recognizes registered dental hygienists who go above and beyond the call of duty every day. Throughout the year, Crest Oral-B rewards a selection of deserving professionals, as nominated by their peers, who truly make an impact on patients and the oral health cause. To learn more about the program, you can visit www.prosintheprofession.com. For information about Crest Oral-B products and resources, visit www.dentalcare.com. (Source: Crest Oral-B) Ann Benson Ross, RDH, BS, Photo/Provided by Crest Oral-B