Patti Jourdin |
Building confidence with patients
Dr. Barr: In many dental procedures, a minor mistake can be corrected or adjusted quickly, without the patient knowing that anything has gone amiss. However, this is not the case with impression-taking. Retakes or remakes make it obvious to patients that something has gone wrong, and patients typically are not very pleased about having to undergo the procedure again. This makes the impression-taking process a very important step, with the potential to have a big impact on the patient’s confidence in the dentist’s skills.
I began practicing dentistry in the civilian sector after three years in the Navy, in the early 1990s in an office that used hand-mixed polyether for impression-taking. The material at that time was adequate, but it was not unusual for patients to comment on its bad taste as soon as the tray was removed. When I started my own practice soon after, I was happy to switch to vinyl polysiloxane materials, which enabled me to leave hand-mixing behind in favor of guns and automix cartridges. I employed VPS for many years, and while I never had a serious issue with impression-taking, I did certainly notice that VPS was prone to developing drags, due to the fact that it begins setting as soon as it is mixed. Working with VPS, dentists and assistants often feel pressure to move as quickly as possible, which can in itself lead to errors.
Recently, I decided to give polyether material another try. I was swayed by testimonials from other dentists who told me that the taste of the material has been improved from previous generations. And, unlike in the past, polyether can now be used with an automix dispenser. My colleagues also discussed the material’s “snap-set” characteristic, wherein it does not begin setting until the end of the working time, at which point it sets very rapidly. I realized that this might help address the issues I had seen with drags in my VPS impressions.
Another virtue the testimonials pointed out was that polyether is the only truly hydrophilic material. All of these qualities combined seemed too great to ignore.
I doubt patients will ever enjoy having an impression taken, but now when I remove an impression tray and review it, I am able to say to them, “The good news is that this impression came out so well we don’t have to take another. It’s beautiful!” I also like to tell patients that if the impression is their only complaint about the appointment, then I can live with that. A positive presentation like this, coupled with strong technique, can help make the impression procedure just another aspect of your practice that leaves patients feeling confident.
While I never felt overly stressed by impression-taking, switching to polyether has given me even more confidence than before. The combination of the automatic mixing unit, intraoral syringe, and Impregum™ Polyether Impression Material from 3M ESPE has helped me deliver a level of care in which I take great pride. We have found that patients notice and appreciate our attention to these details.
Careful technique
Dr. Barr: Today, my general procedure for impression-taking begins with very careful preparation using magnification and a headlight. I have found that magnification helps keep the margins smooth and prevents making a mess with the soft tissues. I try to avoid using cord whenever possible, and recently have been using a diode laser to perform troughing when necessary. Wash material is applied with an Impregum™ Intraoral Syringe from 3M ESPE, which allows me precise control over the application. I then dispense Impregum Impression Material into a tray and apply additional wash material on the occlusal surface. The tray is then seated for six minutes, after which we typically have a very crisp, precise impression.
