Thermoplastic Solutions
The Chairside “Night ‘n Day Guard”
04/29/11 10:31
The Chairside “Night ‘n Day Guard”
by: Howard S. Glazer, DDS, FAGD and Kate Liddle
Products and Technique by ALL DENTAL PRODX, LLC.
Bruxism. It is no laughing matter to about 45 million Americans who suffer from bruxism and related dental concerns. One factor may be the economy. In June 2010, MSNBC.com quoted Manhattan dentist Dr. Michael Sinken, “There’s been an uptick of about 20% in the number of appliances or chipped teeth directly related to bruxism that I attribute to these stressful times. I have a friend who has a practice that’s 90% TMJ. He says he’s absolutely seen an increase in business. People are hurting.” Presently, dental labs make less than 4 million night guards each year.
Stressful times have followed us into 2011 and there are no signs of clear sailing on the horizon. It is reasonable to believe that doctors and their patients will continue to struggle with choices related to treating bruxism as an increasing concern, and a need to protect their dentition.
Let’s look at what patients are doing now to relieve discomforts caused by bruxism, since it is obvious they are not “lining up” to get laboratory fabricated night guards? For starters, pain relief drugs for headaches or jaw pain related to bruxism is currently a multi-billion dollar business. Additionally there are any number of over-the-counter (OTC) devices that claim to fix bruxism and its related complaints. The prices are low and some of the problems with these devices are easy to recognize. “Boil and bite” type “chewy” guards only stimulate the patient to grind. Gagging is not the concern of the OTC device maker. The most important problem with OTC solutions is that they are not fabricated by the lab, or by the dental practitioner who can best determine what will suit individual need and the patient’s dental anatomy.
In office solutions are available, but they can require measurable chair time, a machine that is costly (and once purchased demands commitment to the process) and a lot time spent trimming and fitting the appliance. To the extent there is any kind of standardization, the individual occlusal landscape of every patient as unique is not adequately covered. And of course, there are the undercuts the lab blocks out that now becomes a problem for the practitioner.
Lab-prepared guards - easily the best solution - are costly for both the practitioner and for the patient. If the patient does not manage to make a habit of wearing the device, there is no ground gained towards alleviating the problem. Night guards are so easy to lose, there are small businesses selling special covers (some handmade) with attaching clips.
Now what?
Let’s look at another choice for doctors and their patients with a single goal in mind - to encourage more patients to address the damage they do on a daily basis by grinding and clenching their teeth. If we want patients to work with practitioners towards a solution, we have to be aware of a couple of basic truths:
Once the discussion of bruxism and its associative dangers is understood by the patient, the practitioner has the opportunity to offer an easy and immediate solution.
Thermoplastic Temp Tabs (in both Blue and Natural tooth colors), as well as Bite Buddy (a large thermoplastic wafer), are ready allies to facilitate this goal. Temp Tabs and Bite Buddy, both products of ALL DENTAL PRODX in Galloway, NJ, are trade names for a particular chemistry of thermoplastic material. Thermoplastic has been used safely and successfully as a splinting material in orthopedics and in other areas of the medical community for the last 70 years.
Thermoplastic is an ideal material in many ways. It is low tech, low cost, biocompatible and biodegradable. Unlike its cousin, “thermosetting” material, thermoplastic has the unique ability to retain its physical properties through repeated heating, enabling it to become moldable. It features a unique and very versatile blend of flexibility (the thinner it is formed, the more flexible the material) and rigidity. It has been used by dentists for many years as quick bite registration material, a matrix for provisional material, an implant abutment jig, implant placement stent and to repair fractures.
Thermoplastic Temp Tabs and Bite Buddy comprise the material required for a quick and efficient chairside delivered bruxism guard.
Dr. Greg Gallant from West Caldwell NJ, who conducted a Table Clinic at the 2010 Greater New York Dental Meeting said, “A night guard appliance like this is suitable to offer the longer term restorative patient and can be used to help ‘train’ a patient for a lab-prepared appliance. Thermoplastic features a predictable balance between flexibility and rigidity. It will not adhere to undercuts and can be adapted to suit any anatomy, as well as adjusted to the desired level of fit so that accidental dislodging by the patient during sleep is not a concern. There are no impressions to take, no wait time and no additional visit for fit.”
FOLLOWING IS THE STEP-BY-STEP TECHNIQUE:
Another lecturing clinician, Dr. Marty Goldstein has a slightly different technique using Temp Tabs for a chairside delivered bruxism guard. That technique can be viewed on YouTube by searching Temp Tabs Night Guard.
After researching both techniques and the materials used, I concluded that Temp Tabs and Bite Buddy have a true versatility and adaptability to the unique occlusal landscape of any patient suffering from clenching, grinding and associative discomforts. At the least this technique can be used to familiarize the patient with the concept of a lab-prepared device and help the longer term restorative patient until work is complete.
Beyond these advantages, a quick chair side bruxism guard can be delivered inexpensively and replaced the same way for patients who find wearing the thermoplastic non-invasive, safe and easy to habituate. Once patients agree they have a problem with bruxism, it is a natural solution for both doctor and patient to fabricate a Temp Tab Night Guard immediately.
Cost: Temp Tabs cost per unit at full retail (before discounts) is $ .82. The technique outlined here requires from 1-3 units as determined by the practitioner. Bite Buddy cost per unit is $3.09. However, it would take at least 5 or more Temp Tabs in size to comprise one Bite Buddy. Multiple Temp Tabs may be joined when heating and will combine seamlessly.
Downloadable information on Temp Tabs and Bite Buddy is online at www.alldentalprodx.com.
by: Howard S. Glazer, DDS, FAGD and Kate Liddle
Products and Technique by ALL DENTAL PRODX, LLC.
Bruxism. It is no laughing matter to about 45 million Americans who suffer from bruxism and related dental concerns. One factor may be the economy. In June 2010, MSNBC.com quoted Manhattan dentist Dr. Michael Sinken, “There’s been an uptick of about 20% in the number of appliances or chipped teeth directly related to bruxism that I attribute to these stressful times. I have a friend who has a practice that’s 90% TMJ. He says he’s absolutely seen an increase in business. People are hurting.” Presently, dental labs make less than 4 million night guards each year.
Stressful times have followed us into 2011 and there are no signs of clear sailing on the horizon. It is reasonable to believe that doctors and their patients will continue to struggle with choices related to treating bruxism as an increasing concern, and a need to protect their dentition.
Let’s look at what patients are doing now to relieve discomforts caused by bruxism, since it is obvious they are not “lining up” to get laboratory fabricated night guards? For starters, pain relief drugs for headaches or jaw pain related to bruxism is currently a multi-billion dollar business. Additionally there are any number of over-the-counter (OTC) devices that claim to fix bruxism and its related complaints. The prices are low and some of the problems with these devices are easy to recognize. “Boil and bite” type “chewy” guards only stimulate the patient to grind. Gagging is not the concern of the OTC device maker. The most important problem with OTC solutions is that they are not fabricated by the lab, or by the dental practitioner who can best determine what will suit individual need and the patient’s dental anatomy.
In office solutions are available, but they can require measurable chair time, a machine that is costly (and once purchased demands commitment to the process) and a lot time spent trimming and fitting the appliance. To the extent there is any kind of standardization, the individual occlusal landscape of every patient as unique is not adequately covered. And of course, there are the undercuts the lab blocks out that now becomes a problem for the practitioner.
Lab-prepared guards - easily the best solution - are costly for both the practitioner and for the patient. If the patient does not manage to make a habit of wearing the device, there is no ground gained towards alleviating the problem. Night guards are so easy to lose, there are small businesses selling special covers (some handmade) with attaching clips.
Now what?
Let’s look at another choice for doctors and their patients with a single goal in mind - to encourage more patients to address the damage they do on a daily basis by grinding and clenching their teeth. If we want patients to work with practitioners towards a solution, we have to be aware of a couple of basic truths:
- The patient requires a greater understanding of bruxism- both the immediate and longer term consequences. Once understood, a simple, immediate solution is required.
- The shortest distance between these two points is not a lab-prepared night guard.
Once the discussion of bruxism and its associative dangers is understood by the patient, the practitioner has the opportunity to offer an easy and immediate solution.
Thermoplastic Temp Tabs (in both Blue and Natural tooth colors), as well as Bite Buddy (a large thermoplastic wafer), are ready allies to facilitate this goal. Temp Tabs and Bite Buddy, both products of ALL DENTAL PRODX in Galloway, NJ, are trade names for a particular chemistry of thermoplastic material. Thermoplastic has been used safely and successfully as a splinting material in orthopedics and in other areas of the medical community for the last 70 years.
Thermoplastic is an ideal material in many ways. It is low tech, low cost, biocompatible and biodegradable. Unlike its cousin, “thermosetting” material, thermoplastic has the unique ability to retain its physical properties through repeated heating, enabling it to become moldable. It features a unique and very versatile blend of flexibility (the thinner it is formed, the more flexible the material) and rigidity. It has been used by dentists for many years as quick bite registration material, a matrix for provisional material, an implant abutment jig, implant placement stent and to repair fractures.
Thermoplastic Temp Tabs and Bite Buddy comprise the material required for a quick and efficient chairside delivered bruxism guard.
Dr. Greg Gallant from West Caldwell NJ, who conducted a Table Clinic at the 2010 Greater New York Dental Meeting said, “A night guard appliance like this is suitable to offer the longer term restorative patient and can be used to help ‘train’ a patient for a lab-prepared appliance. Thermoplastic features a predictable balance between flexibility and rigidity. It will not adhere to undercuts and can be adapted to suit any anatomy, as well as adjusted to the desired level of fit so that accidental dislodging by the patient during sleep is not a concern. There are no impressions to take, no wait time and no additional visit for fit.”
FOLLOWING IS THE STEP-BY-STEP TECHNIQUE:
- A Temp Tab from All Dental PRODX is heated until it turns clear (about 1 min.) Photo Fig. A and B The softened Tab is immediately manipulated to remove stickiness (do not use with vinyl gloves) Photo Fig. C
- Long working time allows placement in the mouth as appropriate. In this case, the softened Tab is placed on the lower arch. Photo Fig. D The Tab is air-dried for 10 seconds until it returns to an opaque state. Photo Fig. E
- Remove Tab guard and rinse in cool water to finish set. Replace guard and check patient fit so that accidental dislodging with lips and tongue is not possible. (Thermoplastic may be removed, re-heated and re-formed if necessary for better fit without loss of stability of the material.) Photo Fig. F
- Guard may be trimmed if necessary with an acrylic bur. Photo Fig. G
Another lecturing clinician, Dr. Marty Goldstein has a slightly different technique using Temp Tabs for a chairside delivered bruxism guard. That technique can be viewed on YouTube by searching Temp Tabs Night Guard.
After researching both techniques and the materials used, I concluded that Temp Tabs and Bite Buddy have a true versatility and adaptability to the unique occlusal landscape of any patient suffering from clenching, grinding and associative discomforts. At the least this technique can be used to familiarize the patient with the concept of a lab-prepared device and help the longer term restorative patient until work is complete.
Beyond these advantages, a quick chair side bruxism guard can be delivered inexpensively and replaced the same way for patients who find wearing the thermoplastic non-invasive, safe and easy to habituate. Once patients agree they have a problem with bruxism, it is a natural solution for both doctor and patient to fabricate a Temp Tab Night Guard immediately.
Cost: Temp Tabs cost per unit at full retail (before discounts) is $ .82. The technique outlined here requires from 1-3 units as determined by the practitioner. Bite Buddy cost per unit is $3.09. However, it would take at least 5 or more Temp Tabs in size to comprise one Bite Buddy. Multiple Temp Tabs may be joined when heating and will combine seamlessly.
Downloadable information on Temp Tabs and Bite Buddy is online at www.alldentalprodx.com.
Look Who's Talking - about thermoplastic from ALL DENTAL PRODX
03/17/11 08:46
Dr. Marty Goldstein will be talking about thermoplastic - our Temp Tabs and Bite Buddy, and our QuikGlaze at the following lectures during 2011: Use special pricing for these products courtesy of Dr. Goldstein to purchase products online. Find out how at his lectures - effective for all of 2011.
April 6, 2011
Essential Anterior Dentistry: Digital Portrait to Finished Case
Full day didactic session
Monmouth Medical Dental Society
Monmouth, NJ (for information: 908-620-1848)
May 25, 2011
Essential Anterior Dentistry: Digital Portrait to Finished Case
Full day didactic session
New York County Dental Society Henry Spenadel CE Program
New York, New York, 212-573-9816
June 3, 2011
Essential Anterior Dentistry: Digital Portrait to Finished Case
Full day didactic session
University of Alabama at Birmingham Continuing Dental Education
Birmingham, Alabama (Phone: 205.996.6494 Email: amkaraki@uab.edu)
August 2, 2011
Essential Anterior Dentistry: Digital Portrait to Finished Case
Half day didactic session (8:00 am to 12:15 PM)
Wake Forest University School of Medicine, Department of Dentistry
Kingston Plantation, Myrtle Beach, SC (for information 336-716-4243 or phunt@wfubmc.edu)
Sept 16, 2011
Essential Anterior Dentistry: Digital Portrait to Finished Case
Full Day didactic session
Winnipeg Dental Society
Winnipeg, Manitoba Canada
Read More...
April 6, 2011
Essential Anterior Dentistry: Digital Portrait to Finished Case
Full day didactic session
Monmouth Medical Dental Society
Monmouth, NJ (for information: 908-620-1848)
May 25, 2011
Essential Anterior Dentistry: Digital Portrait to Finished Case
Full day didactic session
New York County Dental Society Henry Spenadel CE Program
New York, New York, 212-573-9816
June 3, 2011
Essential Anterior Dentistry: Digital Portrait to Finished Case
Full day didactic session
University of Alabama at Birmingham Continuing Dental Education
Birmingham, Alabama (Phone: 205.996.6494 Email: amkaraki@uab.edu)
August 2, 2011
Essential Anterior Dentistry: Digital Portrait to Finished Case
Half day didactic session (8:00 am to 12:15 PM)
Wake Forest University School of Medicine, Department of Dentistry
Kingston Plantation, Myrtle Beach, SC (for information 336-716-4243 or phunt@wfubmc.edu)
Sept 16, 2011
Essential Anterior Dentistry: Digital Portrait to Finished Case
Full Day didactic session
Winnipeg Dental Society
Winnipeg, Manitoba Canada
Read More...
Temp Tabs Fix My Broken Smile at Home!
01/25/11 08:12
Working in the dental community means you may be very conscious of your smile. It doesn’t mean you are exempt from surprise dental issues. What you learn is not to take your smile for granted and I found that out the hard way last Friday night. Wearing my Temp Tabs night guard did not stop the quiet click inside my mouth that woke me up in the middle of the night. Pretty sleepy, I still knew something wasn’t right and hand to my mouth I found a serious chunk of front tooth in my hand.
I placed this chunk in the dark on the nightstand beside me and went back to sleep. In the morning I was sure I dreamed what happened, until my tongue inspected and found sharp edges where my porcelain central should have been.
It was now 6 am on Saturday morning and there was a full day of planned activity ahead. I looked like something from a horror movie and had no idea if and when I could get a dental appointment. I also had no idea how I was going to eat anything without damaging what was left of the tooth.
Lucky me, I had purchased a couple of ‘fix a tooth’ home remedies at CVS a while back - just in case. I brought these out and opened them and attempted a fix. No such luck. I suppose if I didn’t move at all and certainly didn’t eat or drink anything, it might have held for awhile, but the paste I purchased wasn’t sufficient for the job at hand.
I needed duct tape for this mess. I actually considered a small strip of duct tape and was about to start cutting a strip of the shiny silver stuff when a moment of sanity struck. A splint was what I really needed. Something that could fill the area where the tooth had fractured and keep the filled portion in place by anchoring it to the teeth adjacent. I needed something that I could mold and shape but that would become stable and strong enough to chew on.
Temp Tabs - I had pieces of the new NATURAL tooth colored Temp Tabs at my desk. Worth a try, I thought.
So I heated one in water until it turned clear, then molded it to fit the empty area of the central left by the fracture, and drew out the balance of the material on either side of my upper arch to create, literally, a splint.
Here are the actual, un-retouched photos of what I accomplished at home before 7 am, saving my embarrassment and my schedule for Saturday, Sunday and Monday until I visited my dentist on Tuesday.
Building Bridges Under Water
01/05/11 10:55
Building Bridges Under Water
2010
Greg Gallant is easy to like. He has a genuine manner and welcoming smile so its not a stretch to believe compliments he gets from staff and patients about his practice.We’re sitting in his office early in the morning filling interview time while we wait for Barbara at the front desk to announce his next patient. Conversation is relaxed and it seems like our interview is going to be easy too. But when the talk turns to the practice of dentistry, Gallant shifts from easy going to focused analytic. Know more about him and the transition makes sense. As a young man he had planned on a career in both engineering and computer programming.
Ask about the high tech gear in the practice and you’ll hear Gallant say he wants equipment to enhance his ability to be “ultra precise”. He does all procedures with an 18-times power microscope. His loops were customized at the manufacturer to include a prism, eliminating bending to get better vision during procedures. “I don’t know why all loops are not made this way,” he said. “The practice of dentistry is physically demanding and neck strain seems to be a pretty common complaint for dentists. I was always interested in how the human body is put together, how it functions. So developing solutions (before I have problems in my own practice) interests me.”
To read the full article click here
2010
Greg Gallant is easy to like. He has a genuine manner and welcoming smile so its not a stretch to believe compliments he gets from staff and patients about his practice.We’re sitting in his office early in the morning filling interview time while we wait for Barbara at the front desk to announce his next patient. Conversation is relaxed and it seems like our interview is going to be easy too. But when the talk turns to the practice of dentistry, Gallant shifts from easy going to focused analytic. Know more about him and the transition makes sense. As a young man he had planned on a career in both engineering and computer programming.
Ask about the high tech gear in the practice and you’ll hear Gallant say he wants equipment to enhance his ability to be “ultra precise”. He does all procedures with an 18-times power microscope. His loops were customized at the manufacturer to include a prism, eliminating bending to get better vision during procedures. “I don’t know why all loops are not made this way,” he said. “The practice of dentistry is physically demanding and neck strain seems to be a pretty common complaint for dentists. I was always interested in how the human body is put together, how it functions. So developing solutions (before I have problems in my own practice) interests me.”
To read the full article click here