INITIAL PERCEPTIONS OF IMS
BY THE NEWLY FORMED STAFF
The newly formed staff had preconceived
notions regarding cassette usage as well.
Two staff members were opposed to the
implementation of IMS. They felt that
cassette usage would be more time consuming than pouches due to the need
to wrap them and tedious opening and
closing. They felt that this time spent
would detract from patient care. Concerns were also expressed regarding the
sound of cassettes with the mention of
a previous office where cassettes could
be heard “clanging in the sterilization
area.” These two team members noted
that they were in favor of processing
loose instruments in pouches for all reasons noted.
Two other staff members were in favor of cassette usage. These team personnel agreed that cassettes were safer
than pouches during instrument processing. One recounted an experience
during instrument reprocessing utilizing pouches – a sharp instrument poked
through the paper portion of the pouch,
causing an injury in her hand. The other
assistant noted an explorer once fell out
of a wet/perforated pouch and hit her in
the ankle. They agreed that they would
be less likely to spend time searching for
misplaced instruments during operatory preparation or interrupting patient
The final staff member inquired,
“What’s a cassette?” as she had never
seen one before. As cassettes were described to her she inquired, “Do you
mean we have to wrap these up like gifts
each and every time we want to package
a cassette?” Although this was a new
and innovative idea to her, she listened
to the cassette controversy within the
office, and ultimately agreed to remain
open and receptive to a new way of instrument management.
THE DECISION TO
Dr. Thomas explored costs involved and
space considerations in cassette imple-would feel unsafe without the lead shield.
The ADA statement uses the phrase “may
not be needed,” which leaves me wondering. As long as the lead shield doesn’t
block or distort the image and it makes
the patient feel safe, it does not seem prudent to abandon lead shield usage. The
last thing we need is for patients to leave
our offices wondering if they have been
harmed, and even worse, having dental professionals wondering if they have
caused harm. RDH
All the best,
continued from pg. 85
organization and efficiency are essential
to the smooth operation of the instrument processing system. He believed this
would be accomplished by cassette usage
and was in favor of the implementation of
an IMS in his new practice.
OF IMS BY DR. DALE:
Dr. Dale however, was ambivalent regarding cassette usage. His perception was
that both cassettes and pouches were
equivalent with regard to productivity
and stated that he would be satisfied with
either method of instrument processing. With an observant clinical staff and
keen attention to detail, he believed that
streamlined dental procedures couldeas-ily be performed with minimal interruptions or instrument retrieval.
He also expressed a cost concern stating that cassettes would require much
more of an initial investment than pouches and he suggested a cost analysis of cassette implementation. As a new business
owner, he believed that their new dental
practice should invest in products and
supplies that would ultimately generate a
greater cash flow or improve productivity.
Thus, he questioned whether the benefits
of cassette usage would outweigh the initial costs and preplanning requirements
for his new practice.
to the thyroid during dental radiographic
procedures. Because every precaution
should be taken to minimize radiation exposure, protective thyroid collars
should be used whenever possible. If all
the [NCRP] recommendations for limiting
radiation exposure are put into practice,
the gonadal radiation dose will not be significantly affected by use of abdominal
shielding. Therefore, use of abdominal
shielding may not be necessary” (www.
What are the NCRP recommendations
to which this article refers?
extraoral radiography (panoramic and
• All intraoral X-ray head collimators
shall be rectangular, not circular, to
minimize stray radiation.
“E” or faster. D film shall no longer be
used. Since Kodak no longer makes E
speed film, this will mean going to F-speed or using another manufacturer’s
intensifying screens shall be used in
extraoral films and digital systems
shall employ a similar equivalent.
•;For;all;new;construction,;shielding;de-sign will need to be provided by a qualified expert. Lead need not be used if
proper thickness of gypsum board is
used for the walls.
•;Dentists;must examine their patients
•;Rigid;dark;room;requirements,;docu-mentation and daily developer chemistry evaluation, and a quality assurance
protocol manual will be required.
All dental professionals need to be
aware of their particular state guidelines.
For the California reader who addressed
the question above, California mandates
the use of the lead shield, although many
experts today do not feel the use of the
lead shield is necessary. However, we have
to take into consideration the opinions
and beliefs of our patients. Some patients