The Compliance Divas Podcast
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The Compliance Divas Podcast
# 122 One Item You Aren't Sterilizing After Each Patient but Should Be
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What is the one item you aren't sterilizing after each patient and should be? The is one item that you use for every patient that really should be sterilized and not just wiped or sprayed to disinfect. The Divas celebrate Dental Infection Control Awareness Month with Crystal Genics to discuss autoclavable air/water syringes.
Resources:
- FDA - letter to dentists on handpiece sterilization - 1992 https://bit.ly/3qNa3PD
- CDC Statement on Reprocessing of Dental Handpieces - 2018 https://bit.ly/3P1VnE1
- Crystal Genics https://www.crystalgenics.com/
Welcome. I'm Leslie Cannon. I'm Mary Gavoni.
SPEAKER_03I'm Linda Harvey. I'm Olivia Lon, and together we are the Compliance Divas.
SPEAKER_04Welcome to the Compliance Divas podcast. This is Linda Harvey, and I will be your moderator today. I'm especially excited about this podcast because the divas are bringing you a topic that we have not yet addressed in the past, particularly in light of the fact that this month, September, is Dental Infection Control Awareness Month, or DICAM for short. And before we unpack this exciting podcast, I would like to say that the Compliance Divas brings clarity and simplicity to compliance by navigating the regulatory world to keep you on course. Please subscribe to our podcast through your favorite podcast channel or on our website, thecompliancedivas.com. Any resources that we mentioned during this podcast can be found on our website as well as in today's show notes. You're always welcome to submit questions to support at the compliancedivas.com. Today our special guest is Donovan Barkley, and he's going to answer the question what's the one thing we should be sterilizing in a dental practice that typically we aren't? Donovan is a CEO with Crystal Genics. Donovan has 30 years experience in dental manufacturing. And before I tell you more about Donovan and his company, I'm going to ask Donovan to answer that key question today. So welcome, Donovan. Before we keep anybody waiting any longer, please tell us what's the one thing that we should be sterilizing in our dental operatory, but we typically aren't.
SPEAKER_00Well, Linda, I'm going to give you that answer. It is the air water syringe.
SPEAKER_04No, nobody thinks about that.
SPEAKER_00That's correct. In fact, most people look at the air water syringe on a daily basis and go, they look at that thing and they go, I've never sterilized it, haven't sterilized it in 20 years, but we cover it up, we wipe it down, but it's never been sterilized. Our company was founded and decided to make that change after visiting several countries in Europe and going to many trade shows. We looked at the systems that were used abroad and we compared them with what we're using back here at home and decided to partner with a famous Italian manufacturer, Mr. Luzzani. And we decided to make a change with his air water syringe and bring it to the US, Canadian, Australian, and UK marketplaces because they all follow a similar format and style.
SPEAKER_04This is exciting, Donovan. The Divas all met you at the recent OSAP meeting in Tucson. And for everybody that knows that's following us, we've talked about OSAP in the past and the OSAP meeting. It's the organization for safety, asepsis and prevention. So the divas are eager to ask you a few questions. So that being said, Donovan, I'd like to ask Mary to kick us off because she has an important question to ask you.
SPEAKER_02I have lots of important questions to ask you, Donovan. And I'm so thrilled that you're here with us today to bring up this issue because there's so much time that's spent focusing on the airwater syringe tip. But what about the rest of the syringe and why is it so important?
SPEAKER_00Well, I think it goes back to, you know, initially, people don't really think it's the airwater syringe in the classification which it's intended. A lot of people, when you buy a seven to ten thousand dollar chair, you don't exactly get an instruction manual for your air water syringe. A lot of people are expected to know how to use it. So, with that being said, if you go back to the letter that the FDA issued back in 1992, it was a dear doctor letter in which the FDA had identified two things in the dental industry. And this happened with the because of the Dr. Akers case in Florida, in which AIDS was becoming awareness for us in dentistry. They identified two major items, and one was the dental handpiece, and the other was the air water syringe. And from my experience in the industry, the dental industry had definitely jumped on the bandwagon and started making sure that every dentist had a sterilizable or autoclavable handpiece, but they deferred on the air water syringe. So our goal was to change that and now develop something that is made for the U.S. market that makes compliance easy.
SPEAKER_02Thank you for clearing that up. And I remember uh seeing that letter come to a lot of my client offices back in 1992, and it escaped so many of us that it not only said hand pieces, which is what everybody thought about immediately, but they thought about high-speed handpieces, not necessarily slow speed hand pieces, but it did say air water syringes, and we just kind of let that slide by us. So now we need to make sure that we're doing everything we can for our case.
SPEAKER_00I agree. And I think that the the industry as a whole, I think if you look back, the changes that were made, a lot of manufacturers still do make the uh what do you call opportunity for people to use autoclavable, but I don't think it's actually offered to the end user, meaning the dentist, when they're buying the equipment. So I think the awareness isn't there where it should be. That's really it in a nutshell.
SPEAKER_04I think that's so true, Donovan, because when you think about 1992 with that letter from the FDA, there are a lot of dentists practicing now that weren't even practicing in 1992. So haven't had exposure to it, maybe aren't familiar with it, didn't know it existed, as well as many team members. So I'm so happy to know that Crystal Gen X is on that bandwagon and bringing that back to the forefront. So Olivia has some important questions to ask you as well, because we're excited to learn more.
SPEAKER_03Yeah, we are excited to have you on the show, Donovan. And I would say that all of us felt like we walked away from the OSAP meeting, learning about your product and feeling like we have something that everyone needs to learn about. And it puts the missing piece to that puzzle. And as Mary pointed out, I think that, you know, back in 1992 when they issued this letter, we were spending so much time worrying about the hand pieces that we completely look overlooked the rest of that sentence that said, you know, FDA recommends that reusable dental hand pieces and related instruments such as air water syringes. I don't know what I was thinking, that I didn't really look at that. So I think this is really helping us to be more clear to our audiences and how that ties in not only to FDA, but CDC's guidelines. And I was wondering, Donovan, you know, we're all familiar with the CDC's guidelines and how to address these issues, such as hand pieces and ultrasonic scalars and whatnot. But how many states have adopted CDC's guidance as law through the state regulatory body of the dental board?
SPEAKER_00I believe it's 23 states that have adopted the CDC guidelines and they generally follow what the CDC is and makes it into their form of law. But basically, the CDC is the guiding light. The CDC kind of gives the definition, it defines it as a semi-critical device. And as you go from country to country, uh we do find that there's a little bit of variance in that. So some countries, for instance, will will rank the tip being critical, some countries will rank it as semi-critical. But I think the CDCs, in one of their training slides, you know, they give a very specific sentence where it just says that the because the majority of semi-critical items in dentistry are heat tolerant, they should be sterilized using heat. Then it goes on to say if a semi-critical item is heat sensitive, the DHCP should replace it with a heat tolerant or disposable alternative. I think that statement in itself gives us a clear definition and understanding that, hey, we've had time to change. I think now is time that we start following some of the guidelines and make the awareness more open to the people that didn't see the FDA ladder or don't look at the air water syringe as a semi-critical device. Because I think a lot of people aren't even sure or aware that there are air water syringes that should be sterilized between patients. I would say majority of chair manufacturers right now are still selling chairs with non-sterilizable airwater syringes. And that's probably the biggest problem I see here between US, Canada, Australia, and UK. Those are the four countries we've identified as having the highest amount of non-sterilizable airwater syringes.
SPEAKER_03Wow, that's incredible, Donovan. Mary, did you have a thought to add?
SPEAKER_02I did. Two thoughts, actually. One is we will make a copy of that 1992 letter available in our resources because everybody always wants to see where it says that. And also in April of 2018, the CDC issued a clarification of that letter from the FDA and their guidance that talked about any item that's attached to the dental unit that can be removed. And they also go on to say that if items can't be heat sterilized, they shouldn't be used. So there's, you know, again, where it gets a little dicey, and what are these practices doing if they're not heat sterilizing or if they're not using something that's disposable?
SPEAKER_00And I would say there's even certain countries that put the onus of responsibility back on the DHCP professional because, you know, for instance, in Australia, they say as technology changes, don't just use our guidelines. You're expected to make these changes as part of your ongoing education. So it says something very similar that we're the onus of responsibility, we're using these as your guidelines and recommendations, but we also expect you to follow leading technologies. And as technologies change, you should. One thing I always ask doctors is how often do you change your cell phone? How often do any one of us change our cell phones out? So, you know, I would say probably, you know, I think most people are guilty that once every three years, four years, we change out our cell phones, some people it's sooner. Well, when was the last time you changed your air water syringe out? You know, if you look at your cell phone that you bought back in 1990 and you look at your cell phone today, well, I can assure you that your air water syringe looks pretty close to the one it did back in 1990 to the one that looks like today. So I think I'm just gonna leave it at that for where we're at today in the air water syringe technology realm.
SPEAKER_03That's a great analysis, Donovan. I think that's a good way to look at it. Linda, back to you.
SPEAKER_04Thanks. I think that is, I love that analogy as well. And I was just thinking, you know, I remember my first cell phone in the 90s, and it was a lot bigger than the cell phones today. And I know we can kind of be a little tongue-in-cheek and say things are going retro and flip flooms are coming back, but I don't think they're exactly the same flip-blums that we remember from 15 or 20 years ago. So you're right, nobody has taken time to evaluate all the changes in technology that have really impacted the world of infection control and dentistry. You know, we're we're very focused on, you know, crowns in a day, digital impressions, you know, interval pictures, all the different things that are just moving so quickly and changing, and 3D printing in the offices. So this is an area that doctors just need to realize that this is something that's very important to be aware of. But Leslie has some questions too, Donovan. So Leslie, take it away.
SPEAKER_01I have several, but I would like to continue on the conversation about sterilization before I get to my other questions. I know for hand pieces, we are now quite used to removing the hand pieces and processing them through the sterilizer, but I hadn't thought about how to remove the air and water syringe itself. I've removed the syringe tips, but uh tell me a little bit about how easy or hard it would be to take this syringe off of the dental unit lines and uh how we would go about processing that through sterilization.
SPEAKER_00Well, let's see, I you know, and that's one of the things that I saw in my travels is basically the way we do things here at home and versus abroad. And, you know, I was part of that uh circle where I was only preaching half the truth because I realized, because I was manufacturing air water syringe tips, and then when I saw what they were doing in some places in Europe, I'm like, this is what we need to do, be doing at home. And then when I brought it back home, I'm like, we're not doing this at home. So that's what started off with the change. So the the way that they generally do it and the ease at which we can do it now with our syringe versus what's currently on the market is our syringe, the handle completely comes off with the press of a button. You can basically wipe it off and get it ready for sterilization. You stick it into a pouch, you stick it in four minutes at 135 degrees Celsius, and now you've got a sterilized sleeve. The the current systems that are on the market today make it impossible. If it's a non-autoclavable air water syringe, it's not practical to remove the syringe and sterilize it. It's coming up with a new system. And a lot of the systems you have in other parts of the world use what's called a sleeve system. So there's we're not the only manufacturer who makes a sleeve system. We're the only manufacturer who makes a compliant syringe that actually has a built-in tip, multiple tip with a sleeve system. There's no other manufacturer right now that is actually doing that. So there are sleeve systems. Serona makes one, cable makes one, cephalanthos. There's many manufacturers out there that make sleeve systems. And in fact, I know that DCI makes a autoclavable syringe as well. And I would say our competitive benefits are we are tremendously lighter in weight. So from an ergonomic standpoint, we're much lighter. But it makes sterilization relatively simple. And our current systems here that are non-autoclavable, you just can't sterilize them. You have to use a high-level disinfectant.
SPEAKER_01Well, again, I think that is amazing that there's another piece of technology that can be heat resistant and can go through the sterilizer. And you mentioned that it's lightweight. So I imagine from an ergonomic standpoint, it might be something that is more comfortable in the hand of the dental professionals when they're using it. So that is amazing. Thank you very much for that information, Donovan.
SPEAKER_04I'd like to ask a follow-up question about the ergonomic features because I know that when we were actually holding your syringe there at the OSAT meeting, the buttons were very different. So can you talk about that ergonomic feature as well?
SPEAKER_00Absolutely. Our buttons follow a natural hand layout. So when you're basically have the syringe in your hand, you're not extending your button to a higher level, which the typical designs currently offer here in America. But we also have several other things that I wanted to follow up on Leslie's point. In the ergonomics, I believe our syringe reduces liabilities, it increases compliance. We're also the only syringe manufacturer I'm aware of that has this complete system, but most importantly with a biodegradable tip. A lot of doctors right now are using air water syringe tips, but we're the only ones that have a completely biodegradable tip. And when you currently are using your current systems, you have to use an extra air water syringe sleeve. You're using extra disinfectants, wipes, and time to properly decontaminate it with our system. You're not only going to save money, but it also makes it safer for the environment because you're reducing the amount of waste as well.
SPEAKER_04I'd like to echo that, Dada, because the divas have heard all from our clients and teams and audiences over the years that some are concerned about the types of waste that we have in the dental setting because of all the infection control protocols and barriers that we use. And so there are some alternatives, and it's great to know that you have a quality alternative product to make that happen. And I know that I see, and I'm sure my fellow divas do as well. Team members will say, I just like to spray that handpiece down really well. And they they think that, you know, allowing the spray to get in there is what's going to really work, and it doesn't really get into all the crevices like they think it does. And so it's they're they're thinking about cleaning it, but they don't know yet, many of them, because they haven't been in practice before back in 1992. They don't know about this option. So this is a super topic today. We're just thrilled. I think, Mary, you had a follow-up question there for Donovan, didn't you?
SPEAKER_02Well, I do. And in a statement as well, we we all know how frugal many of our doctors like to be. They're very sensitive to their overhead expenses, and and rightfully so. And so the go-to for many of the practices that want to try to be more eco-friendly is rather than use a disposable tip and add to the waste, they go for the reusable autoclavable tips, which we know you cannot clean. And if you cannot clean them, they are not sterile. So I like the fact that that your tip is biodegradable, but there's other issues associated with us. How do we convince our clients or how does their infection control coordinator convince the doctor that they need to change their uh air water syringe and how the patients and the practice would benefit from that?
SPEAKER_00Number one is uh the increased risk. I mean, I I tell people if you were to see a patient's face and you told them, hey, I use this item on every patient for every procedure, and I just wipe it down, I don't think a lot of patients are aware that it's just being wiped and not sterilized. I I think that in itself, if you tell a patient, because you know, we've we've seen videos where you know people are asked that specific question, and you know, it it's it's a breach of trust because it's the what's already expected in a dental office or in a medical office, you expect everything to be sterilized before the next patient or you know, before you enter the room, that it's going to be clean. And I think there's many studies that also show a high-level disinfectantness is not a substitute for sterilization. And I think that's something else that a lot of people need to be aware of, you know, when they say, hey, why I wrap it up? You know, I think OSAP created a very good video that, you know, when if saliva were red video. And when I look at that video, I said, you know, to me, the one thing that I want to see as part of that is now show the people how to properly decontaminate something because a lot of people see that you know, blood and saliva spray everywhere. But then how do we properly decontaminate for the next patient? That's part of the missing piece, you know, the the proper way to decontaminate your air water syringe, your hand piece, the surfaces. All of this is an integrated approach where, and that's kind of why we called ours an integrated cross-infection control system, because we take it as a system and we want to make it complete, we want to make it easy. Because I do find that I think most dentists want to do the right thing, they just want to be shown what is the right way of doing this, and they're going to comply. I really do believe that.
SPEAKER_04I couldn't agree more, Donovan. I think that once exposed to this concept and the fact that there's a genuine effective alternative, I think people will want to comply. And I think, as you said, if patients knew that this wasn't being sterilized, they probably would be freaking out because there's an assumption that's that's there. When you think about something I've said over the years is patients are expecting, you know, care in a safe and trusted environment. And I think he used those words as well, Donovan. So, Mary, did we cover your question?
SPEAKER_02Yes, I think we did. I just wanted to share that Donovan, you were talking about how people, you know, they they think they're doing a good job decontaminating a great learning experience for the team for everyone to be able to see where the contamination really lies that they're not getting is to use the products from a company called Glow Germ, and they will show under black light. They have a non-toxic equipment safe contact lotion that you can spritz. And I when I do this, I spritz it under the buttons on the air water syringe and all around, and you let it sit for a minute, and then you get a black light and you show, and people are just astounded at how that contamination that they didn't get it clean and they didn't get it can decontaminated. It's also pretty astounding on their hands as well.
SPEAKER_04That's right, Mary. Thank you for sharing. Um as we get ready to go into the round robin, I think Olivia, you had a question.
SPEAKER_03Actually, I just wanted to supplement a thought, Donovan, that in representing dentists in my law practice, you you made a point that I think our listeners need to take to heart. How many states adopt this as state rule, these guidelines? And when a dentist unfortunately is in violation to an infection control rule, the documents that they're presented with indicate this type of language: unprofessional, dishonorable, and unethical conduct. And that the board takes the action to protect the health, safety, and welfare of the people. So this is such a great area for us to pay attention to, Donovan. And I I'm just I'm still I'm thrilled with this product feature, and I wish I'd known about it sooner. So just wanted to share that.
SPEAKER_04And Donovan, I'd like to add to what Olivia just said, and working with uh disciplinary cases in Florida, even as a risk manager, not even as an attorney, attorneys in Florida. Lorda have told me that when complaints come to the dental board about infection control and a dental practice, they go straight to the top of the list, just as if it was an impaired practitioner complaint. So, and I think using the language that Olivia's just shared, you can we can certainly understand why it's such a very important topic. So, Donovan, I think you were telling us before we began the podcast that you have some programs going on. I think one was called Make the Switch. Can you tell us a little bit about that? So our list and how our listeners can reach out to you and find out this information and what they can do next in their practice to be compliant.
SPEAKER_00Absolutely. In fact, uh what we try to do is we try to make I know because one big thing that everyone always talks about is the price. So our goal is to try to make it affordable at the same time, work with doctors and institutions and DSOs, because our goal is to get them to make this switch. So what we're doing right now is we're offering practitioners and institutions the ability to trade in their old product for new product. We assign a value for it. If you have any branded air water syringe that we can read the label that is actually a branded product, we will give you a value for that syringe on converting to our system. We also have a program that is for the tips as well. If you have open or open bags or closed bags of this disposable tips, we'll take those in on trade as well with the purchase of one bulk. Uh a doctor can get up to 3,000 tips for free with the purchase of one bulk of ours. Our goal is to make compliance and switching easy. We do believe that, like I said before, people want to make the right choice and want to be able to do it. And in times of high inflation, it's not an easy time to release anything at this moment in the market. So we're trying to work with the dental community and offer alternative solutions and you know engineer a way to make it possible for everyone to be in compliance.
SPEAKER_04And what's your email address, Donovan?
SPEAKER_00It's Donovan D-O-M-O-V-A-N at Crystalgenics.com.
SPEAKER_04Perfect. I think we'll add that to the show notes today as well. So that way it's easy. So if someone's listening and didn't get to write it down, but again, it's Donovan at crystalgenics.com.
SPEAKER_00And our toll-free number is 800-801-1234.
SPEAKER_04800-801-1234. That's too easy.
SPEAKER_00Well, and if you're in Europe, it's 800-801-12345. We paid a lot of money to get those two numbers.
SPEAKER_04That's perfect. Well, that's memorable. That makes a difference. We talked about so many important aspects today, and I think this was really amazing. And I'm so pleased to be able to introduce what we're what's new to the divas. I know it's not new in other countries, Donovan, but this whole new product, this whole new awareness of how we can achieve compliance and a higher standard of care, which is the standard of care, you know, meet the standard of care by looking at the product that you have, this whole autoclavable airwater syringe, and it probably should be called airwater handpiece, right? It's more than just a syringe. And you and I had that conversation. Um it's just even though we think about the standard of care, and it may not be written out verbatim in every state dental practice act, the standard of care is addressed in every dental practice act using language that Olivia just used, you know, that she's come across with cases that she's worked with. So it's very important that offices look to that next level and try to just be as compliant and make that visit for each and every patient the safest patient visit ever, as OSAP tells us in their program. So, Donovan, thanks so much for joining us today. I can't wait for everybody to reach out to you. And we will have all this information from today in the show notes. So thank you for joining us in today's podcast episode as the Compliance Divas. We bring clarity and simplicity to compliance by navigating the regulatory world to keep you on track. We invite you to subscribe to the podcast through your favorite podcast channel or on our website, thecompliancedevas.com. Resources that we've mentioned today in speaking with Donovan will always be found on our website and in today's show notes, including his email address and phone number. And we invite you to submit any questions that you have to support at thecompliancedivas.com. And we look forward to seeing you the next episode.