Monthly Archives: October 2018

Talk to Patients: A Bioactive Conversation

By Karen Comisi CDA, RDA, FADAA

As Treatment Coordinator at Dental Care with a Difference®, PC, I had the opportunity to present treatment options to patients and answer their questions. After reviewing their restorative needs I would ask what they knew about filling materials. I quickly discovered most patients have no idea what materials are used in their mouth and why. Then I would ask if I could share some really interesting information about the materials we used at our practice.

Most of our patients either had composite restorations or knew someone who did. I explained most dental offices use traditional tooth-colored composites, and they attach this filling material to the tooth using a bonding agent. Put simply, a plastic filling is affixed to the tooth with an adhesive. After a while the adhesive breaks down, leaving teeth vulnerable to acid attack.

I said that our office uses bioactive filling materials, like ACTIVA BioACTIVE, that are ion-releasing and provide teeth withthe minerals they need to become stronger. I would then mention some of the other benefits of bioactive restoratives, including:

  • reduced sensitivity
  • marginal integrity which keeps the bacteria out
  • resistance to fracture and chipping
  • reduced wear
  • excellent esthetics
  • shorter appointment times because it can be bulked filled

Taking the time to educate your patients about the materials going in their mouths will set you apart from the other offices in your community. An educated patient is also a wonderful referral source.


About Karen L Comisi, RDA, CDA, FAADA
Over the past 33 years, Karen Comisi has held almost every staff position in the dental office, with the exception of dentist and dental hygienist. She has been an orthodontic dental assistant, oral surgeon dental assistant, general dentist assistant, front desk and insurance coordinator, office manager, CFO, Co-Founder of Dental Care with a Difference, PC and currently Co-Founder and CFO of Sleep Focused Solutions, Inc.  She is one of the first licensed, registered dental assistants in New York State and is a founding member and Treasurer of the Southern Tier Dental Assistants Society. Karen is a DANB Certified Dental Assistant, a member of the American Dental Assistants Association, the American Association of Dental Office Managers, the Office for Safety & Asepsis Procedures (OSAP), and The American Academy for Oral Systemic Health (AAOSH).

Pulpdent Donates Embrace Sealant and Varnish to the SMILES Program in Arlington, TX

Every week, the SMILES program sends a team of dental professionals and portable dental equipment to forty Title 1 Schools in North Texas. SMILES is run by Dental Health Arlington, a non-profit dental clinic, and provides free oral health screenings, dental sealants and fluoride treatments to over 10,000 low-income students in the first, second and third grades. For some students, the SMILES program is their only opportunity to see an oral healthcare provider. Some even receive their first toothbrush from a SMILES staff member.

Pulpdent has donated 600 applications of Embrace Pit & Fissure Sealant and 200 applications of Embrace Varnish to the SMILES program for the 2018-2019 school year. “Embrace is the best sealant product that I’ve ever used as a dental hygienist,” says Kristin Parrino, RDH, who has been placing dental sealants for ten years with the SMILES program. According to Parrino, there are clinical and cost benefits to using Embrace Sealant. “Our program keeps retention records of the sealants we have placed on the children. Since we started using Embrace our stats have improved” which means fewer “re-dos” and decreased risk of tooth decay. Parrino also notes that, unlike some sealants, Embrace does not require a drying agent, which saves time and money.

A staff member from Dental Health Arlington holds up Embrace Pit & Fissure Sealant donation from Pulpdent.

Embrace Pit & Fissure Sealant is moisture-friendly and also releases and recharges phosphate and fluoride. Research shows remarkable sealing ability and adaptation to tooth structure.

Embrace Varnish releases bioavailable calcium, phosphate and fluoride ions to strengthen and protect teeth. Embrace Varnish fills superficial, non-carious enamel lesions and can be used as a desensitizer.

Pulpdent offers in-kind donations to qualifying organization that provide services to children and/or to adults with limited access to oral health resources. Click here to learn more about the Pulpdent Public Health Partner Program.

Direct from the Operatory: Tuff-Temp Plus

by Robert A. Lowe, DDS

In the clinical environment, an artistically contoured and well-marginated provisional restoration nurtures the gingival tissues with proper marginal seal and emergence profiles during the interim phase of treatment. A provisional matrix can be fabricated from the pre-operative stone model /  composite mock up using a clear plastic stent material and a thermoplastic suck down device. After the teeth are prepared (Figure 1), Tuff-Temp Plus is dispensed into a matrix and placed on the prepared teeth for approximately two minutes.  Once the Tuff-Temp Plus provisional shell is recovered from the matrix, a sharp lead pencil is used to delineate margins and the contact zones proximally, so they are not accidentally damaged during the trimming process. 

Figure 1. Teeth are prepared for provisional material

Specially selected instrumentation is utilized to artistically carve the morphologic tooth replicas (Figure 2). 

Figure 2. Instrumentation is used to carve morphologic tooth replicas

An ultra thin, safe-sided diamond is used to make the initial cut between units as the gingival embrasures are developed and later to delineate separation between units developing facial and lingual embrasure form (for multi-unit provisional restorations).  An impregnated composite polishing brush or medium grade pumice on a chamois wheel is then used to polish the finished restoration.  A final luster is achieved using a small, dry muslin wheel.  Finally, Tuff-Temp glaze is painted on the surface of the restoration with a fine sable brush, and then light cured. This glaze is also included with Tuff-Temp Plus Provisional material as is the add-on flowable material (Figure 3).

Figure 3. Tuff-Temp Plus Add-On flowable material is applied as needed

Figure 4 shows the final provisional restoration.

Figure 4. Final provisional restoration


About Robert A. Lowe, DDS
Robert A. Lowe, DDS, received his Doctor of Dental Surgery degree from Loyola University School of Dentistry. After completing his residency, Dr. Lowe went into private practice and began to pursue another passion: clinical teaching. While running his own practice, Dr. Lowe served as a Clinical Professor in Restorative Dentistry at Loyola University School of Dentistry until its closure in 1993. In 2000, he relocated to Charlotte, NC.