Ok so my office has a Diagnodent. It is a great tool! I really like using it and think it helps the dr out while deciding between incipent and full blown decay. I do have a few questions/problems.
1. How important is it to calibrate with each patient? The instructions say to 'set' it to the patients specific enamel by placing it on 8 or 9 and then proceeding. One of my Drs does not do this. He just picks it up and uses it. I may have used it 10 min earlier or another RDH used it or an assistant grabbed it to use on a restorative patient so there is no telling who used it last. This brings up another question...once the machine has 'timed-out' and turned off does it remember the last calibration or do you have to reset it each time you turn it on?
2. How accurate it is through sealants? Again same dr has told me twice now that I need to be going over sealants because there could be recurrent decay under them. True. But I was under the impression that the Diagnodent read false highs when in contact with plaque, calculus, debris, restorative materials-including sealants. So here are all my patients having high diagnodent readings under sealants and I am afraid there is nothing there. Since I am not on the restorative side I am unsure if these teeth are truly decay free or not.
One of my drs has me write down the readings on each tooth after I have completed the cleaning and then he does not do it again he trusts my readings and then uses the xrays and explorer to decide what to do. I think he is the example for the office---I just wish he would tell his brother (who has me write the numbers down and then he gets the diagnodent out and does it again-I am standing there wondering why I took the time to do it in the first place).
I have read the instruction book and in my little world the Diagnodent is to be used along with xrays and other diagnostic instruments. Sealants give a false high reading and each time it is to be used it needs to be set to the patients specific enamel. I do not know how to tell the dr he is doing it wrong. I dont know how to bring up the fact it cannot go through sealant--maybe it can let me know...I just feel bad because the patient can hear the siren and know they have a cavity but I want it to be a true cavity. Maybe my concerns are not a big deal...like polishing-it does remove enamel but not enough to freak out about (according to me and my own research-not ADHA). Let me know what y'all think.
3 comments:
I too have been under the impression that you can't use the diagnodent on sealants, fillings or over plaque and calc without getting false highs. I think you should do some research and show your Doc, he'd probably appreciate it.
I know in school they taught us to calibrate with each person, but like you, in our office we never calibrate. I asked the other hygienist about calibrating it to the patient's specific enamel and she looked at me like I was an idiot, so I never brought it up again.
P.S. I'm interested in your theory about polishing removing enamel. I've never experienced or heard anything about that. Is this like Jess not believing man landed on the moon kind of thing?
HI THERE! So, my new office is a little...how do we say it..."old school!" There's no such thing as a diagnodent here so i can't really help ya with that...we had one in my old office, but the doc didn't push us to use it, so i didn't because that just took up more time. I'm no help.
Crystal.I'm a dentist and would urge you and the dentists to read up on the directions that came with the unit. I calibrate frequently, but not on every patient...I try to daily and also always place the tip on the facial of 8 or 9 and hold the button for 2 seconds until it zeros according to the patients particular tooth( that is assuming there isn't a restoration on 8 or 9 facial). It isn't accurate on sealants. Sometimes if there is a sealant with one area of marginal staining I'll run it over the whole sealant and see what it reads around the suspicious area but again, I take it with a grain of salt and I actually rarely do this. More out of curiousity than anything to see if it correlates with decay if I'm set on removing the sealant anyways. If people are using it in your office they really should read the directions and not look at you like an idiot for setting it to the patient's specific enamel. Hope this helps.
Dr. Paul Hutchinson Port Orchard, Wa
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