Medical Device Link.

Originally Published PMPN March 2002

MEDICAL

The Drill on Dental Packaging

Disposable, single-dose packages address issues of cross-contamination and help dental healthcare workers perform procedures with ease.

Kassandra Kania, Managing Editor

Sidebar: Improved Access to Dental Burrs Packaging Helps Dentists Avoid Confusion

In recent years, possible exposure to HIV or other infectious diseases, such as hepatitis B or C, while in a dental office has increased patient anxiety. Fortunately, steps have been taken to protect patients from the transmission of disease as a result of cross-contamination, as well as to protect dental technicians. The Centers for Disease Control (Atlanta) has recommended that dental workers employ infection control practices that include wearing protective attire, disinfecting and sterilizing instruments, and adopting single-use disposable instruments. Manufacturers of dental equipment and supplies have responded to the need for greater infection control with innovative single-use packaging that reduces the risk of cross-contamination.

But these packages do more than control contamination. They can help dental workers perform procedures more easily and effectively, control dispensing and eliminate waste, and facilitate product handling and mixing.

UNIT DOSING FOR DENTISTS

Dental procedures typically call for only a small amount of product to be dispensed at a time. In the past, dentists relied on multidosing systems, such as jars, bottles, multidose syringes, or tubes, which increased the risk of product contamination and microbial cross-contamination each time they were opened and product was applied to the oral cavity. "The real issue that has come to the forefront in the last 10 years is the realization that it's very hard to keep [these types of containers] free of cross-contamination from other patients," says John Snedden, DDS, president of Unicep Packaging Inc. (Sandpoint, ID). The company specializes in unit-dose dispensers for gels and liquids.

Innovative Swab Technologies offers premoistened swabs for pinpoint application of chemicals.

Innovative Swab Technologies (Antioch, IL) also offers a single-use package that reduces the risk of cross-contamination and helps the dentist apply the correct dosage. "Single-use convenience packaging has been a growing trend in a series of markets—particularly dental packaging," says Bill Casey, vice president and general manager. The company's dental swabs consist of a sealed plastic tube that snaps open to reveal a ready-to-use swab with a premoistened tip. A variety of chemistries can be used with the swabs for the application of topical anesthetic for toothaches and injections. "[The dentist] isn't dipping back into a larger bottle or jar," explains Casey, "and once the product is applied, the swab is discarded so the office is kept clean, and the chances for cross-contamination are minimized." But it is not only dental healthcare workers who are benefiting from this product. This spring, Zila Inc. (Phoenix) will be using the swab package to launch a new baby-teething product that treats the discomfort caused by infants' new teeth.

EASY DOSE IT

Centrix Inc. offers composites in single-dose tips for precise application.

In addition to reducing the likelihood of cross-contamination, unit-dose packaging is making it easier for dental workers to perform their job. Single-dose packages can save dentists time when performing a procedure. For example, LolliPacks from Centrix Inc. (Shelton, CT) are used to apply liquids or gels, such as topical anesthetics, sealants, bonding agents, and fluoride varnishes. "Formerly, these products were packaged in bottles and jars, opened chair side, and dispensed into a well," explains John Discko, executive vice president. "Then a brush was dipped into the product and placed on the teeth. From the dentist's standpoint, it's easier to use something that's already packaged in a ready-to-use format. You don't have the problems with the bulk jars and the applicator in a box somewhere else. They're able to perform the procedure much faster if everything's in one place, ready to go." The LolliPack consists of a well of material with an applicator brush or a cotton swab next to it. The package is form-fill-sealed with a peelable lid. Once the lid is peeled open, the applicator can be dipped into the well of material and applied to the appropriate area for treatment.

Unit-dose packaging also allows the dental worker to control the amount of product dispensed and the placement of the product. Unicep specializes in unit-dose packaging that can be used to dispense dental products through a fine tip for precise placement on teeth or gums. "Placement is critical," says Snedden, "and dispensing a small volume is not enough. It needs to be placed accurately on areas that are difficult to access."

THE PERFECT MIX

Sometimes dental products need to be mixed at the point of application, and single-use packaging can simplify this process. Sonic Packaging Industries Inc. (Westwood, NJ) offers a presaturated applicator called the Dip 'n' Do that keeps the solution and the applicator separate until point of use. The solution is held in the lower chamber of the ampule and the applicator is contained in the insert. By applying minimal pressure to the applicator, the insert is submerged into the solution, saturating the applicator. The package can also be designed with multiple chambers in the ampule that will mix two different products at the point of use.

Single-use applicators and syringes from Sonic Packaging Industries simplify dental procedures and promote cleanliness.

"With other products, when you dip [the applicator] into it, you don't know if you're taking too much or not enough," says Howard Thau, president. "You don't know the size of the dose you're using. [The Dip 'n' Do] is a premeasured dosage so you know what you're getting each and every time."

Single-dose packaging is also being used with dental syringes to eliminate manual mixing prior to application. Sonic Packaging offers a dental syringe that uses a static mixer to automatically mix and dispense a premeasured dose when pressure is applied to the plunger. "By the time the product comes out, it has already been uniformly mixed and can either go into an impression material, the dental cavity, or wherever the product's being used," says Thau. Unicep also supplies the dental industry with single-piston syringes or dual-piston syringes for two-component products.

Centrix manufactures disposable prefilled tips that are placed into a syringe and injected directly into the patient's mouth. "We started with a dental syringe that used disposable cartridges," explains Discko. "Initially, the materials that were used in the syringe had to be mixed on a pad, and the dentist had to load them chair side. Eventually, these two-part materials became a single part, and they were light activated, which enabled us to prefill them into tips, thereby eliminating the mixing stage. The combination of the device and the material enabled dentists to work faster and more easily. This direct injection technique from the package to the mouth eliminated a lot of steps and made for a much better filling."

WASTE NOT, WANT NOT

Although unit dosing increases the cost of the product, experts say that it's important to consider the savings that it generates as well. For example, the convenience and ease of unit-dose packaging translates into time savings for the dentist as procedures are performed more quickly and effectively. Furthermore, there is less product waste as single-dose packages replace jars and bottles. Dentists can supply patients with single-use swabs for the application of topical anesthetic following a treatment rather than providing a jar that contains multiple, unnecessary doses. Another consideration is inventory control. "[Unit dosing] helps the dentist in terms of his cost control," says Discko. "With a jar, you really don't know how much it is costing per usage."

According to Snedden of Unicep, the increased costs associated with unit-dose packaging will not prohibit manufacturers from continuing to follow the trend toward unit-dose dental products. "Larger companies in the dental industry have identified unit-dose packaging as a necessity," he says. "They realize that current dispensing of many dental products in a clinical setting is unacceptable from a cross-contamination standpoint."

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