Ideal Patients for pH Testing
MI Paste Study
Michelle Strange: A Tale of Two Hygienists presents this week’s TIPisode: quick and easy tips to keep you up to date and presented by the experts in the profession. Now, get ready for your unofficial TIPisode, this week brought to you by GC America.
Susan Wingrove: Hello from Missoula, Montana. I’m Susan Wingrove, and I’d like to share a new application for MI Paste and MI Paste Plus. A special thank you to GC America for their research and development of MI Paste to buffer the pH level in the oral cavity.
As hygienists, we need to look at oral plaque and pH differently. Biofilm is dental plaque in the oral cavity, and now the research indicates that we need to focus on the whole patient, not just the oral cavity. Consider adapting the biofilm term for dental plaque, and look at oral biofilm differently as a focus for our prophylaxis, not just to remove calculus that’s present.
MI Paste and MI Paste Plus contains recaldent that binds to oral biofilm, soft tissue, and dentin providing a reservoir of bioavailability, calcium, and phosphates in the saliva and at the tooth’s surface to protect.
The science behind MI Paste speaks for itself as truly amazing. The active ingredient in MI Paste is a milk-derived protein and should not be used by patients with milk protein allergies.
Let’s shift our prophylaxis appointment into a new gear. Eliminate biofilm and remove the calculus with equal focus. To move into biofilm-focused care, the hygienist needs to start testing the patient’s saliva for pH, identifying and removing the oral biofilm, applying fluoride and/or antimicrobial varnish each time, educate the patients on pH and biofilm and the link to oral-systemic health.
For biofilm-focused care, the objective is to bring the patient’s oral cavity into a balanced, neutral pH. How does a patient present for their prophylaxis appointment? Have they just eaten? Have they drank a soda drink or sipped on a coffee? As a true Norwegian, I often have coffee, and I would walk into the operatory and place my to-go cup on the counter, get into the chair for my prophylaxis appointment. My pH would automatically be in a low level due to the coffee. So who do you test for this?
It’s important to get a baseline pH on any new patients coming into your practice; any recare patients, especially recare patients with unexplained caries, high-risk caries patients, or diagnostic periodontal disease patients; current patients prior to orthodontics, implants, or restorative treatments. Patients with serious medical treatments use MI Paste prior to radiation and chemotherapy two to three times daily. If the oral cavity’s in a neutral pH, they are less likely to get the mouth sores that are prevalent in radiation or chemotherapy.
I’d like to introduce you to another application for MI Paste and MI Paste Plus to use as an integral part of biofilm-focused care prophylaxis protocol that includes testing the patient’s saliva for pH — a healthy saliva will be at a 6.8 to 7.8 level — identifying the oral biofilm to remove, and note any acidic areas of 4.5 pH or lower with products like GC Tri Plaque Gel. Remove the oral biofilm by polishing first or using a subgingival air polisher with erythritol or glycine powder. Next, add your MI Paste or MI Paste Plus to buffer the patient’s pH level in the oral cavity and obtain a neutral pH oral cavity for the time of their appointment.
In a study that was completed, they had MI Paste and MI Paste reused [sic] as directed and applied to all the teeth. The pH was measured, then, after 30 minutes, 60 minutes, 24 hours, 36 hours, 48 hours, and 96 hours. After you applied the MI Paste, which works within three minutes to neutralize the pH in the mouth, how long does that last? Well, for MI Paste according to this study, it lasted for 48 hours; MI Paste Plus lasted for 96 hours. Of course this will change due to diet and other things that are happening with your own medical history.
So patients should apply MI Paste or MI Paste Plus twice daily is recommended. Patients or clinicians would then apply the MI Paste in the mouth while the patient is in the chair. The patient can spit out the excess in the cup, or the clinician can suction. Do not rinse. Take any necessary radiographs and assessments with an intraoral camera, then complete your prophylaxis debridement and polish any stains on any restoration.
Now, with the neutral pH oral cavity, apply your fluoride or your antimicrobial varnish or your desensitizing treatment. Studies show that these bioactive, innovative products will work to their optimal level if the patient is in an oral pH balance when they’re applied, so have the patient not eat or drink for one hour following the appointment, or follow the varnish or desensitizing treatment’s directions for use.
Set your recare at least every six months for patients with any restorations or implants. Send the patient home with MI Paste or MI Paste Plus to use at home twice daily. Ideally, the patients would use it after breakfast and not eat and drink for a half hour or the last thing before bed.
Biofilm-focused care, prophylaxis protocols, and innovative products like MI Paste and MI Paste Plus can be used to eliminate inflammation that lead to the bone loss in natural teeth and around implants. It’s a vital time to protect our patient’s teeth with these type of products and around implants, restorations, and most importantly, for your overall health.
Michelle Strange: Thanks for listening to another TIPisode, and thank you to GC America for sponsoring this week’s episode. You can find out more about their great products at gcamerica.com.
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