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Orientation
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Tips and Tricks
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 Zyris.
Well, isn’t this just a little holiday treat? You and I are doing a TIPisode!
Andrew Johnston: How fun! When was the last one that we did together?
Michelle Strange: Oh, I don’t know. It’s been a minute.
Andrew Johnston: I feel like one of the last ones we did together was, like, more of an emotional one.
Michelle Strange: A COVID thing. No —
Andrew Johnston: — Was it COVID?
Michelle Strange: — wasn’t it a COVID thing?
Andrew Johnston: Mmm. You could be right. You probably are right. You’re almost always right.
Michelle Strange: You don’t forget that either.
Well, this is [laughing] going to be — we’re going to talk a little bit about our experiences with the continuous suction. Both you and I have used the Isolite, and we thought we’d give some tips and tricks since high-volume evacuation is the — I would like to call it the engineering control of the year.
Andrew Johnston: Ha! But isn’t that kind of sad, though, because it’s, like, it has always —
Michelle Strange: — It’s been around. [laughing]
Andrew Johnston: — supposedly been important.
Michelle Strange: [laughing] Exactly.
Andrew Johnston: But no one gave any two cents about it until this year.
Michelle Strange: Yeah. Absolutely.
Andrew Johnston: And that’s kind of the unfortunate part.
Maybe we start off with, like, what our experience — like, what was your first experience like using it?
Michelle Strange: Well, I will say I was very thankful for the intent — I don’t want — no. Intense is not the right word because it’s not, like, annoyingly intense. But it was very thorough. That would be the word I would use. A very thorough orientation from the, you know, the company.
My understanding is that you don’t really get to pur — I mean, you can purchase it without doing it, but they really want you to take this orientation because there is some — there’s a learning curve to it.
Andrew Johnston: Yeah.
Michelle Strange: And I think — and the only reason that I know that that learning curve really helped me is because when I introduced it to my doc and I said all the things that I had just learned, he came back to me the next week, and was like, “I’m glad you told me about those things.” And I was like, “Me too! I’m glad I knew about those things before they happened.” Because I think I would have been frustrated, and I would have been like, “This isn’t going to work for me.” But it was almost like I had it in the back of my head, and I’m going, “Okay. I’ll alter it.” And then I could identify it and make the changes that I needed to make.
Andrew Johnston: Yeah. For sure. And my — so I’ve had two, I guess, first experiences with it. It’s — I mean, so I’ve used the Isolite at two different periods of my career. So early, early, early on — you guys have probably heard in some of the ad work we’ve done in the restorative aspect — that was one of the most ingenious things I had ever used for all the sedation patients that we were doing. As we were working with, like, amalgam, which as you’re condensing and little crumbles are kind of getting everywhere and you have this patient that’s sedated, you don’t want them to aspirate that, choking on things, like, all of those things.
So my first use of it, I had no idea what it was, and there was no one really there to train me because the office had already had it.
But then my second first with it was much later in my career now, and I reme — I had like a whole different onboarding experience. So, just like you said, we had a dedicated person to — by the way, super flexible on the scheduling of this training. Since we had a very large team, they wanted to do the training — I don’t even know how to describe it because, like you said, intense isn’t the right word, but also, she was not strict, but she was very, you know, in charge and really wanted the other team to have their individualized training rather than me trying to train them, which at the time it was — I was like, “Oh. That’s different.” In retrospect, though, I’m like, “That is really the way it should have been.” And so she made a lot more time for that as well.
And we did everything from the setup of how it connects to the hose to, you know, if you’re going to move it from a chair to a chair, what does that look like, to sizing. All of that, like, in this one really good training. And it was video conferencing training too, which is really fun. So we took our little laptop around the operatory, showed her what it was. It was comprehensive. It was very nice.
Michelle Strange: Yeah. And my other experience with it — so I’ve had it in two ops — or two offices now. One of my ops had two HVEs, which I always loved because I could use their version, which is called the Isovac, which is very portable from room to room. But I tend to want a second high-volume evacuation, especially when I’m doing the spatter and spray procedures like Air Flow because there’s a ricochet, and that’s a very intense kind of ricochet. So I need that second HVE. At least I — no. I definitely know I do. I think all of us do, but I am really trying to implement that.
And the thing about Isolite, though, is it has the ability — I guess it would splice? I don’t know if that’s the right word, but under the unit where you hook it up to — and it has the light and all the stuff for the restorative side — I was able to have a second HVE line. So, for the room that I ended up in in my last office where I only had one HVE, I was very excited for that second line because I really do want to have two HVEs.
Andrew Johnston: Look at you being all spoiled with your two HVEs.
Michelle Strange: I know. And I really didn’t realize how spoiled I was. I never had one, like, for the first, you know, 12 years of my career, and then when I got that second HVE and every one of the rooms had it, I was like, “Ma –” at first, I was like, “This is kind of overkill. Like, come on guys. This is a little much.” But, once I got that continuous suction and then added — and I’ve always used something like the prophy jet or whatever — but this — when I really learned how important HVE is as an engineering control to manage spatter and spray any time we’re using our ultrasonics and anything that’s going to create those aerosols and has energy behind it that can really generate those tiny, tiny particles, I need to be using my high-volume evacuation. No ifs, ands, or buts about it.
Andrew Johnston: For sure. For sure.
So let me ask you this: If you had just a couple of things like a must know or must do or must think about, what would those be in relation to Isolite?
Michelle Strange: Um, I think you are not going to be great at sizing at first.
Andrew Johnston: [Laughing].
Michelle Strange: I think every — [laughing] right?
Andrew Johnston: [Laughing]. Do you remember doing like the “try this one. Oh, it’s so big”? [Laughing].
Michelle Strange: [Laughing]. Yeah. And they give you like this finger technique where you can, like, do this many fingers. And it does work. It gets you pretty close, but my fingers and your fingers are very different.
Andrew Johnston: Right. Right.
Michelle Strange: So there’s some discrepancy three, but it’s overall pretty accurate.
Inserting it, I would encourage you to probably do it on yourself a few times —
Andrew Johnston: — I love that.
Michelle Strange: — and on your friends in the practice. Like, y’all just get acquainted with how you put this thing in. It’s not super hard. Like, once you get that flow, it’s like you could do that blindfolded. But, at first, it’s [laughing] a little hard.
Andrew Johnston: There’s a way to hold down the flap as you’re insert — [Laughing] — I — you just —
Michelle Strange: — Yup.
Andrew Johnston: — do the training. And then — I like it. Do it — you’re right. Do it on yourself so that you can have a little bit of empathy for the patient too. Like, what are they feeling? How can you adjust? And then you’ll be an expert.
Michelle Strange: Yep. And I will say, like, go back and look at our Instagram TV or our YouTube or our website because I have a three-part series, and you can see me using it on — these are actually my friends that came in and were my little guinea pigs. All of them were like, “That looks like a lot.” And I was like, “It’s alright. It’ll be alright.” And then all of them were like, “Man, that bite block is very nice. My tongue was out of the way.” People who would give me some honest feedback. Like, they’re not there to be like, “Oh, Michelle, this was so great.” They’re the ones that are like, “Oh, are you sure you should be doing that?”
Andrew Johnston: [Laughing].
Michelle Strange: [Cross talk]
Andrew Johnston: What else? What else is on our list of things that you need to be thinking about?
Michelle Strange: Well, personally, I would say I would go one step farther — further. We talked about this before. Further.
Andrew Johnston: One of those words. Mm-hmm.
Michelle Strange: One of those.
One step further and check your vacuum line, like the actual system, and make sure you’re maintaining it. You’re changing your traps. You’re running your enzymatic cleaner through it every single day. And, even if you’re doing an extraction in that room and it’s a bloody little experience, you want to run your enzymatic cleaner through that, or whatever your maintenance is that you — maintenance, whatever liquid that goes through, and check your amalgam trap or amalgam —
Andrew Johnston: — Separator.
Michelle Strange: — separator because that gets built up with sludge, and it slows things down. And be sure not to put Bleach in there because that goes in dental unit waterlines only, not in your suction. That will ruin and create quite the chemical reaction with your amalgam separator.
So I think as much as I love Isolite, I love all my other HVE tips, they’re only going to work as good as your machine or your vacuum system, right? Like, you can’t make a Kia act like a Ferrari, so just know that.
Andrew Johnston: My Hyundai works as well as a Ferrari, though.
Michelle Strange: [Laughing].
Andrew Johnston: Just saying.
So going back to that for just a quick second though is the office size really does play a factor in this. And I can’t stress that enough because we’ve had these really elongated offices that the very, very far ends, the furthest away from — the farthest? The furthest? No. Just kidding —
Michelle Strange: That’s the farthest —
Andrew Johnston: [laughing] — the furthest away from —
Michelle Strange: — right? Because that’s distance. [Laughing].
Andrew Johnston: Is it? Oh, my gosh. Anyways —
Michelle Strange: — That’s farthest, yeah. [Laughing].
Andrew Johnston: — the longest distance away from the actual suction units themselves and the generation, all those things.
So thinking about those ops specifically and how you would treat those ones a little bit different and finding the points along the way that you can do extra cleaning so it doesn’t have to be from way — that farthest op away. It could also maybe be in the middle somewhere where you need to do some maintenance to encourage better flow from that fur — far — the most distanced —
Michelle Strange: — The fartherestest —
Andrew Johnston: — fartherestest op —
Michelle Strange: — away from the vacuum.
Yeah. And I would encourage getting your technician in there. Like, I mean, I think this is a very big conversation, and technicians are actually out there willing to help.
Yeah. So those would be my things. Get comfortable with sizing, take the orientation, get the feedback from your patients, but try on everyone else before you start, like, going in there with your first patient [laughing].
And I would say — now, did you find — well, you were probably doing more restorative, and I’m doing more, like, day-to-day hygiene procedures, but I had to change my workflow, which I think honestly — if we’re all very honest, and I’m honest with myself — that was the hardest thing to do.
Andrew Johnston: Um, yes. Because the space is different, and the retraction’s already being done or needs to be kind of helped a little bit in certain cases. And so, yeah, I absolutely had to as well depending on which tooth that we were working on for the restorative portion of it. And even how you hold your mirror. It’s not even just, like, the fulcrum and your operative hand, but it’s also the mirror hand. And so it just takes a little bit, though. It’s — usually, you can adapt within a day or two if you’ve —
Michelle Strange: — Oh, yeah.
Andrew Johnston: — been practicing for a little bit, so. But, yeah. It does take a little getting used to.
Michelle Strange: But, if you’re not somebody that likes change, just —
Andrew Johnston: — Got to embrace change, though.
Michelle Strange: — you just got to embrace it. And I’m not someone — I like — as much as I embrace change, I don’t like changing my routine all that much because I know, like, if a doctor walks in, I’m like, “I ended here.”
Andrew Johnston: Right.
Michelle Strange: “This is where I will come back next,” right? So this changed it a little bit. It’s a little awkward and put me in a little bit of a space that I didn’t enjoy for a moment, but I got past it, and it’s fine.
Andrew Johnston: I guess then let’s say let’s embrace positive change. Because that’s —
Michelle Strange: — Positive change, yeah.
Andrew Johnston: — that’s a type of change that you’re going to want to make —
Michelle Strange: — Yeah. For sure.
Andrew Johnston: — and that you’re going to be unhappy if you don’t, so. Yeah.
Anyway, I think that’s pretty good coverage.
Michelle Strange: Yeah. Absolutely.
Andrew Johnston: I think that those are some really helpful tips.
Michelle Strange: I think so too. I agree.
I hope you guys enjoyed this TIPisode from us. I know it’s a little bit of a change. We really want to thank Zyris for being partners of the podcast. And, y’all, give us your feedback. We’d love to hear if these tips helped you out and your experience with continuous suction.
Anything else?
Andrew Johnston: That’s it.
Michelle Strange: Alright. Thanks guys.
Andrew Johnston: Bye everyone.
Michelle Strange: Thanks for listening to another TIPisode, and thanks to Zyris for their sponsorship. You can find out more at Zyris.com where they have all kinds of resources, and you can learn how it works and view more products.
And don’t forget to hit the “subscribe” button in your podcast app, follow us on Facebook or Instagram, and head over to our website, ataleoftwohygienists.com, to sign up for our newsletter. We always appreciate ratings and reviews. Thanks for listening to your unofficial dental hygiene podcast.
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