Is the Absence of Ultrasonic Utilization Impacting My Patients’ Care & Overall Health?

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As a dental hygienist who has practiced for 23 years, I have seen thousands of patients for their preventative care appointments and found my career to be very rewarding. As a young hygienist, I juggled working between general and periodontal practices. Most of my treatment care felt “routine” for many patients, but we understand periodontal work often requires going above and beyond standard “routine” care. Being young and eager, I was ready to collaborate and emotionally invest in my patient’s well-being. Even with my best efforts and the patient committing to impeccable homecare and compliance, some patients continued to experience a decline in their overall periodontal health. This created a feeling that would tug at my heart and create frustration. I couldn’t help but feel so defeated at times – asking myself why my services were not delivering the success I had hoped for, and if I was providing the best clinical treatment.

Many years have passed, and dental technology has evolved significantly since my days in periodontal practice. With the pandemic, I often wonder if today’s practicing hygienists are left feeling that same frustration or defeat with the current patient care limitations. It has always been our professional obligation to use scientific and analytical thought processes when determining what is in our patients’ best interests. Amidst all the changes we have faced over the past several months, one constant is dental professionals’ commitment to patient health and safety. Clinicians continue to follow best practice guidelines and many interim recommendations set forth from the CDC, OSHA, ADA, and ADHA. Dental providers understand that best practices will continue to evolve ight alongside the pandemic, but are the best practices limitations putting their patients’ long-term health at risk?

The effects of oral health on systemic health 

Compared to other healthcare providers, we typically see our patients more often at their preventative six-month cleanings. Looking at the entire scope of what a hygienist can do to improve the health of their patients, is limiting the use of their aerosol-generating equipment truly in the best interest of their patients? The long-term effects of these guidelines are yet to be seen. Recognizing the safety of both patients and clinicians is the top priority, it still leaves me wondering if the recommendation of utilizing hand instrumentation only will impact patients’ overall health or result in long-term ergonomic effects for the hygienist. Are we really doing what’s best?

Research has continued to evolve our understanding of how oral health and overall health of a patient may be correlated. While more research is still needed, it’s becoming better understood that there is a relationship between the two types of health (Amar and Han). According to the American Academy of Periodontology, periodontal disease is an inflammatory disease that affects the soft and hard structures that support the teeth as a result of bacterial accumulation or biofilm on the teeth. Studies have shown that periodontal disease may be linked to multiple systemic diseases such as cardiovascular disease, type 2 diabetes, adverse pregnancy outcomes, and osteoporosis (Kim and Amar). Hygienists play a critical role in providing education and prevention of periodontal disease. There are a variety of procedures and modalities at their disposal aimed at the removal or disturbance of the toxic subgingival biofilms. The ability to provide such services requires clinicians to equip themselves with the necessary tools and technology, such as sonic and ultrasonic scalers (Arabaci et al.). Without utilizing these valuable tools, are we truly removing calculus, endotoxins, and biofilm? Making the choice to utilize ultrasonic instrumentation in addition to additional adjunctive therapy is one of many clinical judgment’s hygienists make when determining what is in the best interest of their patients and themselves.

Aerosol management for hygienists

You should feel confident in your decision to utilize sonic and ultrasonic technology. Research shows that up to 90% of ultrasonic aerosols can be eliminated through the use of high-volume evacuation (Harrel and Molinari). The CDC recommends the use of four-handed dentistry, high-volume evacuation (HVE), and dental dams to minimize droplet spatter and aerosols. Knowing that most hygienists work alone, implementing HVE into hygiene procedures can be ergonomically difficult. Zirc Dental Products has a solution – Mr. Thirsty® One-Step. This innovative hands-free isolation and evacuation device gives hygienists the extra hand they need to perform their procedures effectively and efficiently.

Key features of Mr. Thirsty® One-Step: 

  • Attaches directly to your existing HVE valve – no “system” or upfront costs
  • Features a built-in bite block for patient comfort
  • Retracts tongue while protecting airway and cheek
  • Designed with unique wide suction chambers to help mitigate aerosols
  • Comes pre-assembled and ready to use
  • Can be trimmed for a custom fit to each patient
  • Disposable – no time spent on maintenance or sterilization
  • No risk of cross-contamination

A recent study completed by Dental Advisor evaluated multiple hands-free HVE devices to compare their efficacy against aerosol and spatter reduction. The study revealed that Mr. Thirsty® One-Step was the only device that had the ability to evacuate aerosols and spatter as consistently and effectively as the traditional HVE tip. It’s a simple way for clinicians to go hands free without compromising suction! This device not only allows hygienists to utilize HVE for safe, high-quality oral care, it frees up the hand they would normally hold a saliva ejector with and eliminates the need for the patient to close during the procedure. They’re able to use that free hand to hold a dental mirror, giving them a better view of the oral cavity. Mr. Thirsty One-Step’s front and back suction prevents pooling, so that the hygienist can move quickly and the patient is kept comfortable. During and after the pandemic, implementing Mr. Thirsty® One-Step can assist hygienists as they tend not only to the patient’s oral heath, but their systemic health as well.

To all of the hygienists out there who are feeling frustrated or defeated – the steps you are taking to enhance safety for both you and your patient are not going unrecognized. You are highly educated in infection control and safely delivering the highest standard of care. You can reassure yourself that by continuing to utilize patient screenings, pre-procedural rinses, operatory barriers, personal protective equipment, filtration systems, and high-volume evacuation, that you are providing your patient with the best possible care. Follow the manufacturer guidelines for the ultrasonic tip you choose and adjust the settings on your devices to minimize aerosol generation. Utilize an HVE device like Mr. Thirsty® One-Step that is as effective as a traditional HVE tip without the ergonomic stress. This will deliver a high standard of care and elevated experience for your patients. You’re doing a great job!


Written by: Tina Punton, Zirc Clinical Account Executive, Special Markets. Tina spent 23 years as a practicing hygienist before joining the Zirc team. She specializes in helping DSOs and group practices become more efficient. As a consultant for our RESET program, Tina understands just how busy practices are on a day-to-day basis. She enjoys being able to help them get organized and make each day moving forward a happier one! Email Tina at Visit Zirc’s website at

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